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[Music]
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foreign speech
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[Music]
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speech foreign
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spe
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[Music]
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speee
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spe for
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foreign
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[Music]
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speech
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foreign
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[Music]
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no
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speech for
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speech foreign
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fore
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foreign for
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speech
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speeech
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fore
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foreign
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speech
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foreign
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foreign
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spee
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fore for
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speech
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[Music]
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foreign speech speech
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[Music]
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speech
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[Music]
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for speech
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speech
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[Music]
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speech foreign fore
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speech foreign
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spe
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[Music]
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forch fore speech
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foreign foreign
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speeech speech
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speech foreign speech
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spe
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for
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speech
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fore
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foreign
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spee
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speech
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[Music]
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this
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thise
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spee
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fore
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speee
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speech
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for
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for
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for
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[Music]
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[Music]
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in
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entry
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[Music]
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[Applause]
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[Music]
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foren
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foreign
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speee
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foreign speech for
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foree
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speech foreign
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speech foreign speech
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foreign
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[Music]
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Fusion
00:09:01
[Music]
00:09:07
[Music]
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these women are not welcome in a general
00:09:26
hospital they can't often get in because
00:09:29
of the tremendous pressure on the
00:09:32
hospitals for other more urgent things
00:09:34
also they're not welcome because they're
00:09:36
smelling and they're poor and they're
00:09:38
often turned away by the guard at the
00:09:40
gate and this is really why we built the
00:09:44
[Music]
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hospital
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[Music]
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for
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[Music]
00:10:37
[Music]
00:10:46
[Music]
00:10:55
[Music]
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spee
00:11:14
help needed when the baby can't be born
00:11:17
in the usual 12 hours that it takes to
00:11:19
have a
00:11:20
baby usually it's due to a small pelvis
00:11:23
or a Mal position of the baby inside the
00:11:26
mother's
00:11:27
uterus
00:11:29
it occurs all over the world in 5% of
00:11:32
all neighbors help is
00:11:34
[Music]
00:11:55
[Music]
00:11:57
needed
00:12:01
[Music]
00:12:09
[Applause]
00:12:15
[Music]
00:12:25
spe she starts labor and she expects be
00:12:29
perhaps delivered by the evening if it's
00:12:31
the morning early morning but the day
00:12:33
goes by and she hasn't had the baby
00:12:44
eage women encourage her the second day
00:12:47
goes by and even the third and fourth up
00:12:49
to 10 days I've had a woman in labor by
00:12:53
that time the little girl is exhausted
00:12:56
dehydrated and she finally pushes out a
00:13:00
dead
00:13:01
baby but she wakes up to a worse
00:13:06
[Music]
00:13:24
horror so the size of the f is 2x 3 cm
00:13:31
[Music]
00:13:39
every time the uterus contracts it
00:13:42
pushes that baby's head against the bone
00:13:45
of the pelvis the blood supply of that
00:13:47
area is cut
00:13:49
off so that lump of tissue that's being
00:13:52
squashed will die and it just drops
00:13:56
out so this means that she's lost some
00:13:59
of her bladder or some of her rectal
00:14:08
wall the fish it's not only physical
00:14:11
trauma they are suffering of it's a
00:14:13
social and then
00:14:16
psychological you know in the
00:14:17
countryside it's being a woman is be
00:14:22
able to be a wife and be a child to you
00:14:25
know and have a family but when they fa
00:14:28
to do that they considered themselves
00:14:30
that they are not like any
00:14:33
[Music]
00:14:44
woman the husband he said you go back to
00:14:47
your family he'll just send her off with
00:14:50
a bundle on her back they run out to
00:14:52
welcome her thinking that she's coming
00:14:55
home with a baby and they find her in
00:14:58
this date her life is ruined so they'll
00:15:03
build her a little Hut outside and there
00:15:06
she will stay till death unless she
00:15:09
hears that she can be
00:15:14
[Music]
00:15:27
cured fore spee
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speech
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foreign
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speech
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foreign
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fore
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[Music]
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spee
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around
00:16:01
now
00:16:09
[Music]
00:16:20
[Music]
00:16:27
around
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[Music]
00:16:38
[Music]
00:16:41
speech
00:16:42
[Music]
00:16:51
[Music]
00:16:56
speee most P women in the developing
00:16:59
world have to do all the hard
00:17:02
work they have to do the cooking the
00:17:05
grinding of the Corn collecting of the
00:17:07
water from the well carrying sticks from
00:17:09
the forest so all her energy has gone
00:17:13
into work instead of into
00:17:15
growth she hasn't had enough
00:17:18
[Music]
00:17:27
nourishment
00:17:29
[Music]
00:17:36
if we take someone like this little girl
00:17:39
what has happened is at the age of two
00:17:42
she started carrying a jar of
00:17:45
Water by the age of eight she's carrying
00:17:48
something that I can't
00:17:50
lift but all those years she's been
00:17:53
eating a good diet but not enough
00:17:55
calories what happens is she grows was
00:17:58
short now if I stand you'll just see how
00:18:01
short she
00:18:02
is and I'm an average height I'm
00:18:06
5'3 a girl especially on a girl in the
00:18:10
countryside they are too small for their
00:18:14
age so if she gets at pregnant at the
00:18:17
age of 14 definitely the baby will be
00:18:20
too big for her per pelv to pass through
00:18:23
during delivery so she will end up in
00:18:25
obstructed
00:18:27
labor
00:18:37
foreign
00:18:40
foreign
00:18:48
fore
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speech
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fore
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foreign
00:19:03
foreign
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[Music]
00:19:13
speech
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foreign
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fore
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[Music]
00:19:42
[Music]
00:19:43
for usually think they are the only
00:19:45
person in the world who leaks urine so
00:19:49
being a fisha hospital is a part of
00:19:53
psychotherapy they discuss their problem
00:19:55
with other woman they start to
00:19:58
understand and there are other women
00:20:00
with the same kind of
00:20:02
problem so this is very important to
00:20:05
nurse them together and they have a
00:20:08
social life together we see them talking
00:20:12
they feel at home they feel they're not
00:20:14
being ostracized from their society and
00:20:17
they're loved and they feel welcome so
00:20:20
this is where the healing process starts
00:20:23
of the mind and this is very
00:20:27
important
00:20:39
spee fore foreign foreign
00:20:45
fore
00:20:47
foreign
00:20:49
speech
00:20:57
for
00:21:01
[Music]
00:21:18
spee for
00:21:22
[Music]
00:21:27
was
00:21:28
[Music]
00:21:38
we've got this girl with her whole life
00:21:40
ahead and if she's not cured it's going
00:21:43
to be a misery and a horror to her
00:21:46
forever is not very big well mobilized
00:21:49
now and uh I'm going to close it this is
00:21:53
the fascination of fistular surgery to
00:21:56
make a new life for a young girl that
00:21:59
suffered more than any woman should be
00:22:01
called on to
00:22:03
[Music]
00:22:16
endure we just finished closing the fish
00:22:18
La now and then we are going to do a die
00:22:21
test to make sure that the uh s line is
00:22:25
water tight so we put a d if there is
00:22:27
any hole the D comes through the the
00:22:29
hall now it's
00:22:32
uh there is nothing coming through the
00:22:36
hle this mean that the hall is closed
00:22:44
[Music]
00:22:56
completely know
00:23:04
we leave her with a catheter draining
00:23:07
for 12 or 14 days and we hope that she's
00:23:10
going to be able to pass you
00:23:12
[Music]
00:23:26
normally
00:23:31
[Music]
00:23:49
[Music]
00:23:50
a new clothes it's a symbol for us they
00:23:54
are cured they are going to start a new
00:23:57
life
00:24:04
for spee
00:24:09
foreign
00:24:10
[Music]
00:24:21
foreign
00:24:26
fore
00:24:28
foreign
00:24:34
spee
00:24:38
foree
00:24:43
spe
00:24:45
foreign
00:24:56
speech
00:25:16
is negative stress in
00:25:26
Dynamics
00:25:34
the F that is the hole on the bladder is
00:25:37
closed and uh now uh the bladder
00:25:41
function is not restored so we are going
00:25:43
to uh do certain examination run certain
00:25:46
tests and see where where the problem
00:25:49
actually
00:25:52
is that's what we are meing this is a
00:25:55
urodynamic examination this is a machine
00:25:59
uh which measures the uh intraabdominal
00:26:03
pressure and it also measures the same
00:26:05
time the pressure inside the
00:26:10
bladder and then the machine will give
00:26:12
us the bladder capacity how much the
00:26:15
bladder can
00:26:26
hold
00:26:43
according to the results she has reduced
00:26:47
bladder capacity it is reduced by half
00:26:50
as compared to normal persons but the
00:26:53
good thing is that there is some
00:26:54
regeneration capacity of the the bladder
00:26:56
that we hope with time her BL capacity
00:27:00
will increase to some
00:27:04
extent spee
00:27:08
speech
00:27:26
speech for foreign
00:27:30
speech
00:27:32
fore
00:27:35
[Music]
00:27:53
speech
00:27:56
foreign
00:27:59
fore
00:28:05
foree for
00:28:09
speech
00:28:11
spech fore
00:28:16
speech
00:28:26
speech for
00:28:32
Fore
00:28:42
foree
00:28:47
speech fore
00:28:51
speech foreign
00:28:56
speech
00:29:02
[Music]
00:29:13
[Music]
00:29:22
[Music]
00:29:26
forign
00:29:29
[Music]
00:29:42
foreign
00:29:45
[Music]
00:29:46
speech foreign
00:29:53
foree
00:29:56
spee
00:30:18
fore
00:30:22
[Music]
00:30:26
speech
00:30:28
[Music]
00:30:37
[Music]
00:30:48
alas she was found to have a double
00:30:51
fista double fista means a whole
00:30:55
communicating between rectum and vagina
00:30:57
and blading
00:31:00
vagina you don't have to be a woman to
00:31:03
understand woman's problem if somebody's
00:31:05
in continent and cannot control here for
00:31:09
fces and urine this is simple to predict
00:31:13
what's going to happen to her in the
00:31:15
community and in the in the family so to
00:31:18
relief such a problem it's very very I
00:31:21
mean good good
00:31:26
job
00:31:29
[Music]
00:31:43
I've repaired the platter and now I'm
00:31:45
doing the
00:31:46
rec
00:31:53
[Music]
00:31:56
rep
00:31:57
[Music]
00:32:16
[Music]
00:32:21
we are able to close the fista in about
00:32:23
93% of
00:32:26
cases we're able to operate on 30 women
00:32:29
a week and so we hope this year that
00:32:32
we'll be able to do 1,500
00:32:36
operations but we estimate there over
00:32:39
100,000 waiting in the countryside in
00:32:42
Ethiopia
00:32:45
[Music]
00:32:49
alone my husband and I came to Ethiopia
00:32:53
in
00:32:56
1959 the previous gynecologist that we
00:32:59
replaced said to my husband the fistular
00:33:02
patience will break your hearts and
00:33:04
that's really what they
00:33:07
[Music]
00:33:12
did we didn't plan to stay but as we
00:33:15
began to cure them of course more and
00:33:17
more came to us so we stayed on and I've
00:33:22
been here ever since my husband would
00:33:24
still be here if he was alive
00:33:27
[Music]
00:33:52
theee foreign
00:33:55
spee
00:33:58
for
00:34:00
foreign
00:34:02
speech
00:34:04
spee foreign
00:34:07
spee
00:34:12
forch
00:34:16
speech
00:34:18
foreign
00:34:22
for
00:34:23
[Music]
00:34:25
Fore
00:34:32
foree fore speech
00:34:38
speech speech
00:34:48
speee
00:34:55
for
00:34:59
foreign
00:35:11
speech
00:35:14
speech
00:35:17
fore
00:35:25
foreign
00:35:35
[Music]
00:35:40
chal light a hidden epidemic it's silent
00:35:43
epidemic nobody talks about
00:35:47
it because it's a problem for poor women
00:35:51
it's a problem of
00:35:53
woman was 100% preventable lack of good
00:35:58
obic service this is the main cause of
00:36:04
fistula for a population of 77 million
00:36:07
people now in Ethiopia we've only got
00:36:11
146 gynecologists and Obstetricians and
00:36:14
most of these are in the
00:36:16
cities so the country women are just
00:36:19
completely neglected this is a
00:36:25
tragedy
00:36:31
[Music]
00:36:37
fore
00:36:39
foreign
00:36:43
for
00:36:45
Fore speech
00:36:55
speech
00:37:01
M if there is no any leakage on the bed
00:37:04
that means they are dry but up to now
00:37:06
she is dry and we hope that she will be
00:37:11
[Music]
00:37:25
okay
00:37:30
foreign
00:37:34
foree fore
00:37:37
[Music]
00:37:39
speech
00:37:42
[Applause]
00:37:43
[Music]
00:37:55
spee fore foreign
00:38:00
speech
00:38:23
[Music]
00:38:25
speech fore
00:38:29
foreign
00:38:31
foreign
00:38:34
[Music]
00:38:39
foree speech
00:38:43
fore
00:38:46
for
00:38:48
[Music]
00:38:55
speech
00:38:56
[Music]
00:39:05
foreign
00:39:10
[Music]
00:39:25
foreign
00:39:27
[Music]
00:39:33
I'll
00:39:36
[Music]
00:39:42
[Music]
00:39:55
goas
00:39:58
[Music]
00:40:05
[Music]
00:40:10
[Music]
00:40:18
okay I mean she's on the E postoperative
00:40:21
day and until now she's okay so she will
00:40:25
be here I mean for for another week so
00:40:29
after that we will check whether the
00:40:31
blood is healed or not and the rectum is
00:40:33
healed or not if it is okay she will go
00:40:39
[Music]
00:40:52
home
00:40:53
[Music]
00:40:55
you
00:40:59
[Music]
00:41:05
[Music]
00:41:24
speech speech
00:41:31
and then when she feels the blood full
00:41:32
she just pulls this out and the UR comes
00:41:41
away
00:41:45
foree
00:41:47
speee
00:41:51
speee speech
00:41:55
spee
00:41:57
foreign spe
00:42:00
speech foreign speech
00:42:04
fore she
00:42:16
okay usually it's very difficult for
00:42:18
these girls to learn how to put these
00:42:20
plugs into urethra it's a very small
00:42:22
spot to try and a for but she was um got
00:42:25
first go first time I've ever seen
00:42:27
anyone get it the first guy so I'm sure
00:42:28
she'll be able to manage it very
00:42:44
[Music]
00:42:54
well I
00:43:06
for
00:43:09
foree
00:43:25
speeech
00:43:42
[Music]
00:43:50
[Music]
00:43:55
gu
00:43:56
[Music]
00:44:23
she's happy I mean I can't explain I
00:44:26
have no words I mean I'm happy very very
00:44:29
much Happy I mean to make a lady I mean
00:44:32
who has been in continent for both urine
00:44:34
and fces to make her continent I mean
00:44:37
that is a I mean her happiness is a
00:44:40
prize that I'm getting now
00:44:47
[Music]
00:44:53
okay she secur we talk to them about
00:44:57
their future we'll tell each patient
00:45:01
must get to a hospital for the next baby
00:45:04
we give every patient a card with a
00:45:06
description of the
00:45:07
operation with all the findings so we
00:45:10
say when you feel the baby walking
00:45:12
inside your stomach you start walking
00:45:15
towards the
00:45:16
[Music]
00:45:24
hospital
00:45:30
[Applause]
00:45:30
[Music]
00:45:40
for
00:45:42
[Music]
00:45:44
speech foreign
00:45:52
spee
00:45:54
hey
00:45:56
[Applause]
00:45:56
[Music]
00:46:24
knowe
00:46:34
[Music]
00:46:44
foree
00:46:54
speee
00:46:57
[Music]
00:47:24
foree
00:47:27
fore
00:47:32
[Music]
00:47:33
foree fore
00:47:40
speech fore
00:47:43
speech
00:47:48
foreign
00:47:54
for
00:47:57
[Music]
00:47:58
foreign foreign
00:48:02
speech
00:48:04
[Music]
00:48:24
forign
00:48:25
[Music]
00:48:48
[Music]
00:48:51
the children are orphans because their
00:48:54
parents died of AG
00:48:56
[Music]
00:48:58
IV we've given bet four children to take
00:49:02
responsibility for and we've told the
00:49:04
children this is going to be your mom
00:49:07
and already in the the little ones you
00:49:09
can see that they love for so the
00:49:11
bonding is
00:49:14
[Music]
00:49:24
starting
00:49:33
[Music]
00:49:38
yes I think just to have some future to
00:49:42
look forward to has made her grown up
00:49:45
and now she has work to do and she's
00:49:47
learning and it makes people grow giving
00:49:51
them a responsibility it helps them
00:49:54
enormously
00:49:56
[Music]
00:50:02
sing How
00:50:06
Sweet the
00:50:09
S
00:50:16
that's
00:50:17
[Music]
00:50:23
light my
00:50:27
[Music]
00:50:29
was
00:50:32
[Music]
00:50:33
but
00:50:36
I'm
00:50:39
[Music]
00:50:54
was
00:50:58
[Music]
00:51:07
just
00:51:10
and
00:51:11
[Music]
00:51:17
I
00:51:19
[Music]
00:51:24
this this
00:51:27
gra
00:51:29
[Music]
00:51:31
has
00:51:35
[Music]
00:51:54
me
00:51:56
[Music]
00:52:13
[Applause]
00:52:14
[Music]
00:52:22
Nova is a production of WGBH Boston
00:52:26
[Music]
00:52:28
I am
00:52:30
PBS