NAROK, Kenya- Because of her privacy, I’ll refer to the individual who kindly agreed to share her personal story of obstetric fistula with me for this article under a pseudonym. For now, she’ll go by Mellisa Keshi.
I recently met 21-year-old Keshi at the Narok County Referral Hospital. It all started after her first delivery; she felt something was wrong.
“I was taken to the hospital and diagnosed with obstetric fistula. To my surprise, the condition had been recurring after I gave birth to my first child,” Keshi recently told Y News from her hospital bed.
After a prolonged labour, she had developed an obstetric fistula, a hole in the birth canal that renders women incontinent, unable to control their urine, faeces or both.
Left untreated, the condition can cause infection, pain and a host of other problems – including social isolation and depression.
“I was thinking that I would leak urine throughout my remaining life, and there was no cure for my suffering. I was always ashamed to leave the house because of the smell,” Keshi explained.
What is an obstetric fistula
One of the most dangerous birth traumas is a fistula. Furthermore, it is virtually avoidable.
In many parts of the world, the injury has been completely eradicated due to the increased availability of maternal health care, especially caesarean procedures.
Nevertheless, it still affects the most vulnerable women and girls—those who lack the resources or capacity to pay for high-quality obstetric care.
Adolescent brides and other girls who fall pregnant too soon are particularly vulnerable.
It is estimated that over 2 million women in poor nations currently suffer from the illness.
“I have battled obstetric fistula for almost one year. But I am now recovering after seeking medication at the Narok County Referral Hospital. After undergoing surgery, I feel relieved, and I know I will go back home soon,” she explained.
How obstetric fistula victims live in isolation
Keshi is among women who have endured living with obstetric fistula. All along, she was especially miserable from the social isolation that resulted from this.
She was isolated at home, too upset to face neighbours who spoke negatively of her, rather than visiting the market and seeing friends and family.
She is not alone.
Meet 42-year-old Everlyne Shani, a mother of 8 from Ntulele in Narok County who was left with a debilitating childbirth injury after her third pregnancy.
“The saddest part is that whenever I would go close to a village baraza (assembly), some of my fellow women would cover their noses and ask where that bad smell emanated. I would wash my clothes several times a day,” Shani recalled.
However, Shani is proud of her husband, who has stood with her during her hour of need.
“All I can say is that any woman out there battling this condition should seek treatment. It’s better to get treated,” said Shani, adding that she endured her second obstetric fistula condition for two years while the first one lasted 23 years.
Medical experts speak out about obstetric fistula
Dr Francis Otulo, a gynaecologist and specialist in correcting obstetric fistula at the Narok County Referral Hospital, told Y News that he operates at least eight surgeries per week on patients battling the condition.
“This is the only public health facility dealing with obstetric fistula patients. All our patients who come for treatment leave when they are dry and comfortable. We also conduct medical camps across the country,” Otulo explained.
However, Otulo regretted that the facility receives most referral cases when they are late.
“To prevent fistula, we need to prevent early teenage pregnancies since the pelvic is not conducive for the baby,” he said.
The facility receives cases from all 47 counties across the country. After undergoing treatment, the patients spend one to three weeks at the hospital.
“We keep data on the kind of patients we get. After screening, we filled out a form about the kind of surgery conducted. We also have had to follow up on these cases for the last six months, even though it has been quite challenging in some cases due to poor communication and the stigma that comes with it,” he said.
However, some women cited a lack of equipped facilities and health practitioners as the main factor derailing the management of the condition.
This is even as many counties have yet to put up health centres that can offer fistula coactive surgeries.
Why obstetric fistula is a global concern
According to the World Health Organisation (WHO), 50,000 to 100,000 women are affected by this illness each year.
Additionally, it is believed that throughout Asia and Sub-Saharan Africa, more than two million young women suffer from this untreated illness.
Every 100 births in Kenya results in two fistulas for the women, which leads to 2400 additional instances every year.
One of the main reasons for fistula is labour obstruction. This is typical of women of average stature bearing large babies or women of short stature with little pelvic bones (outlet).
In light of this, Sarah Omega, an obstetric fistula survivor, founded and is the executive director of the “Let’s End Fistula Initiative.”
“At that point, I made it my goal to use my experience to connect as many women as possible with the then-free fistula surgical care, knowing that I was in the same situation as many others who would not disclose or mention it and were suffering in silence,” Omega stated.
How Kenyan NGO is giving hope to obstetric fistula victims
With time, the “Let’s End Fistula Initiative” developed into a legitimate non-governmental organisation (NGO).
“We began by locating and arranging for the care and treatment of ladies with fistulas. Through community-based interventions, we help put a stop to fistula in Kenya and help women and girls who have experienced this birth damage get their lives back together,” stated Omega.
Omega has also founded Young Champions Fistula Clubs and Young Adolescent Mothers Programmes through the NGO to enable teenage girls and boys to be agents of social change.
The majority of these female fistula victims are viewed as social misfits. Therefore, we use a network of fistula survivors—based in the 12 counties we operate in—who we refer to as regional representatives to contact them. Thus, I teach them to convey the correct message upon their return after receiving treatment,” the speaker stated.
Through training, the organisation also promotes economic empowerment among obstetric fistula survivors.
“You may be developing your ability to understand entrepreneurship and financial literacy. However, how can you organise a company venture you’d like to take care of? We also offer startup money and, eventually, mentorship. We are proud when we witness their lives,” she remarked.
From 2011 to now, the NGO Omega has supported about 2,000 women in healthcare.
Obstetric fistula victims find footing after recovery
After their recovery, Jane Tata, the chairwoman of the Cheptais Solidarity Group in Mount Elgon, Bungoma County, praised Omega for introducing her and others to projects aimed at economic empowerment.
“I work in table banking, animal farming, and chicken farming. My life has changed for the better because of table banking. I even purchased a plot of land. I am a ray of hope for my neighbourhood now,” she remarked.
Another fistula survivor who fought the illness for 20 years, Leah Chemosoto, stated that she is currently one of the regional leaders in Cheptais educating the public about obstetric fistula.
“To prevent becoming victims of these complications, we encourage our fellow women to consider giving birth in hospitals,” Chemosoto stated.
Florence Chemolorenyu, a fellow fistula survivor and member of the Cheptais solidarity group, disclosed that she had turned to agribusiness following her recovery and economic empowerment through Omega’s organisation.
“Under Omega, I created several solidarity groups in Kenya and Uganda. I’m grateful for how far she’s brought me. In addition, I am the Chesiro Women’s Cooperative Society’s female spokesperson. I have made KSh 230,000 this year alone through coffee cultivation,” Chemolorenyu said.
Living without an obstetric fistula offers these women more benefits than just being pain-free. It provides relief from loneliness.
Reflecting on the time she will finally leave the hospital, Keshi remarked, “I know the moment I leave my hospital bed, it will be like walking out of prison. I will be in tears of joy.”
