KISII, Kenya – Obstetric fistula is a crippling condition that affects millions of women globally, leaving them with physical, mental, and social scars. Although surgery is often the first line of treatment, experts warn it is only half the solution.
It is now evident that to rebuild their lives, restore their dignity, and reclaim their place in society, women with fistulas need comprehensive assistance outside of the operating room.
The implications of obstetric fistulas extend far beyond the obvious ones, like incontinence and chronic discomfort. Women with fistulas typically experience social isolation, emotional distress, and financial hardship as a result of their incapacity to participate in economic activities and their frequent social rejection by their communities.
Many suffer in silence because of financial constraints, cultural taboos, or ignorance of possible treatment options.
Obstetric fistulas, which are holes that develop between a woman’s vaginal system and her bladder or rectum, are usually caused by prolonged, challenging labour during childbirth. This condition results in severe bodily and psychological discomfort from urine and/or faecal leakage.
What are some of the main difficulties presented by fistula
Therefore, specialists collaborated to treat the full woman rather than just her physical state as Kenya joined the rest of the globe in commemorating this year’s International Day to End Obstetric Fistula (IDEOF).
Obstetrician, gynaecologist, fistula surgeon, and fertility specialist Dr. John Omboga noted that fistula presents many difficulties.
“Apart from the continuous leakage of urine and stool, which is a social problem for the women, and most of the time these women are isolated; they cannot mingle with anyone else; they live alone, secluded lives, and that one brings along depression,” said the medic.
He disclosed that on most occasions, when some of the fistula victims go to treatment centres to seek care, they are depressed.
“You see, physically in their faces, they look depressed. So, this is why we need a lot of psychological counselling,” added Dr. Omboga.
How the Fistula Foundation is combating the fistula condition
Nelson Musa, Programmes Director for Fistula Foundation Kenya, echoed Dr. Omboga’s remarks, saying that when women battling go for treatment, you will understand that other mental health issues come with it.
“After treatment, you will find that these women who have lived with fistula for a very long time, some of them developed depression, some of them even started abusing drugs, and so they will require long-term support in terms of mental health care. And of course, unfortunately, we don’t have that direct and clear program to support women with that kind of condition,” Musa lamented.
As a program, Musa disclosed that their main goal is to increase treatment access.
“This will mean training more doctors and partnering with more hospitals to ensure that the time a patient gets to be treated with fistula is reduced, and eventually women can walk to facilities and get treated in case they get the condition we are calling fistula,” explained Musa.
Musa also revealed that currently, under their ongoing program in Kenya, they have conducted over 16,000 procedures, that is, from 2014 when the program started to date.
Susan Mwabilo, a nurse working at the Vihiga County Referral Hospital and also a nurse trained on fistula treatment, stated that so far, they have been able to form a support group for mothers who have been treated and healed from fistula conditions.
“The group is based in Emuhaya sub-county, and they are also assisting us. So, from the survivors, we have been able to identify 10 mothers, and we thank them for that,” she disclosed.
What healthcare providers can do to combat the fistula condition
Mwabilo also encouraged all the healthcare workers, all the nurses across the country, to push forward in the campaign to end fistula in the country.
“Let us work hard and even spread the gospel wherever we go. When we have our maternity open days, when we have even the barazas, let us spread the gospel because we have these mothers within our communities,” said Mwabilo.
Musa further disclosed that the Fistula Foundation has supported over 16,000 fistula surgical procedures by March 2025, training over 11 Fistula surgeons.
“Fistula Foundation also supports 11 treatment facilities by meeting the surgery costs for the patient and supporting equipment. It also provides transport to the facilities for the patient and back home,” Musa explained.
To identify and refer women with fistula, the Fistula Foundation supports six outreach partners who are distributed across the country.
