By: Lucy Muriithi
Nine years ago, I had a permanent sitting position in our local church. Similarly, an older lady, Magdalene, had the seat before me. Every Sunday, she made numerous visits to the washroom and every time she stood up, her seat was wet. Out of curiosity, I began investigating why she was wetting herself. All the older ladies I asked laughed it off and said that the lady was insane and that’s what insane people do. Unconvinced by their answer, I asked my mother why a lady of old age would be wetting herself in public. Her response was “she must be sick.” This answer triggered my curiosity to know what this disease was. Since that day, I saw pain, desperation, and helplessness in her. Additionally, I felt her disappointment in the community for stigmatizing her.
Three months later upon resuming my university classes, I heard an advertisement for a free fistula treatment medical camp at the Kenyatta National hospital. The advert described the condition and immediately I diagnosed the old lady’s disease. Excited that I had not only identified the problem but also an immediate solution, I excitedly went to Magdalene to tell her about the good news. Little did I know that this was the start of this journey. Magdalene didn’t want to see me nor hear anything I had to say. Due to the stigma and discrimination she had faced for years, she was not sure that any help would ever come her way. After three months of following her, she gave in to my persistence and accepted to talk to my mother about her condition. Magdalene had been leaking urine for 28 years since the birth of her last child.
Having sought care at more than ten facilities without any success, she had given up and believed that she was cursed. Her husband abandoned her, and she was left to suffer alone. Her children, too, avoided her due to the constant smell. The more I listened to her story, the more my heart sunk with sorrow and anger towards a system that had failed her. Unfortunately, she missed the treatment opportunity and I had to figure out how I could help her again. Six months later, another free medical camp was organized, and I managed to take her to hospital using my pocket money. 28 years later, Magdalene was cured and dry. The joy in her was so evident. For the first time in years, she was laughing her heart out. She felt whole again.
Obstetric fistula is an opening that connects the bladder and/or the rectum to the vagina leading to urine and stool incontinence. The injury mainly occurs due to prolonged labor and is considered the single most dehumanizing injury resulting from childbirth. Fistula is often considered a disease of the poor as it is most common in low-resource communities with limited access to emergency obstetric care service coupled with high illiteracy levels. Besides leaving the woman incontinent and smelly, fistula also subjects the victim to psychological torture, social exclusion, and economic depression. Young teenage girls are at higher risk of getting fistula due to early marriages and pregnancies which occur before their bodies are fully developed for childbirth. In most cases, the young mother loses the baby, and gets a drop foot in addition to the fistula. As a result of the injury and limited information, the young girl or the woman is sent back to her parents helpless where she lives in isolation and depression due to the shame of a medical problem often considered curse in the community.
According to the World Health Organization, an estimated 50,000-100,000 girls and women experience fistula globally every year. In Kenya, an estimated 3,000 girls and women suffer from fistula annually with only 7.5% of them able to get the required medical attention. Due to the stigma associated with fistula and lack of information about its treatment and management, a majority of the victims live in isolation and great suffering. In Kenya, the major method of treatment is through medical camps which occur annually but are skewed to urban areas.
These challenges pushed me to further explore the delays in obstetric fistula treatment in Kenya as my master’s degree project. I believe that every woman has a right to the highest possible quality of maternal care and that all deserve the joy of motherhood. My desire has always been to set up an organization that holistically supports fistula patients and the community to not only get medical treatment but also end stigma and empower champions economically.
This fellowship has offered a great opportunity to think through the whole organization, prioritize what is feasible, and come up with a workable plan towards achieving this goal. I believe by the end of the fellowship, I will have an organization that offers holistic care to fistula patients and the teenage girls who are most vulnerable to fistula, towards a fistula-free community.