Kenyatta National Hospital, East Africa’s largest referral hospital alone receives 400 cases annually of Obstetric fistula, which is known to be the most devastating of all pregnancy related injuries.
Here we met, 32 year old Purity Kageni, one of the thousands who suffered for eleven years from Obstetric fistula. Prolonged labor is one of the main causes of Obstetric fistula. So destructive is the injury that later it leaves the woman in constant pain as she almost continuously leaks urine and fecal matter.
The result is the unbearable odor of the condition that becomes a deadly curse, that saw Purity live as an outcast in her own family, loose several jobs, and eventually attempt to take her life twice.
Obstetric fistula can be treated with surgery, but thousands remain ignorant of the available treatment and the condition itself. Beatrice Muthoni, an HIV patient is also another survivor of fistula, who despite living in Nairobi city, suffered for two years.
With health facilities available, Beatrice claims that even the health workers in public hospitals didn’t tell her that the solution to her condition was surgery. She perhaps is just one the few lucky African women, who had her husband stand by her, but also underwent self isolation as she never spoke of her condition to anyone.
According to the African medical and research foundation, AMREF, It is estimated that in East Africa alone there are over 5000 new fistula cases each year. In Kenya, the condition mostly affects poor women and girls in remote and rural parts due to a severe shortage of health facilities.
Many women are forced to walk in labor for long distances in order to find a skilled supervised health facility to deliver, and often its too late for the baby.
Health workers in Kenya have in the past complained of a shortage of trained health workers, cited low wages and poor work conditions and are currently on a strike. The Kenyan government has in return sacked at least 25000 health workers in the country in the face of an existing shortage with no replacement.
With 400 cases reported every year in Kenyatta hospital, only 25 % are operated on. The cost for a single surgery is on average 300 $, a reason why many stay back at home due to lack of money.
For Purity, it was sheer luck after years that she underwent surgery during a free AMREF fistula camp. Later she tried reconciling back with her family only to realize that she was tagged for life as an outcast.
Thousands of women are reported with fistula every year, but the biggest loophole remains the access to information. This is one of leading causes of maternal mortality in east Africa, where government systems have failed to provide adequate health facilities and personnel to manage a curable and preventable condition. Experts believe that fistula is here to stay unless something is done soon.