We met 45-year-old Catherine Chebet at the 13^th Fistula National Camp held at the Kenyatta National Hospital (KNH) in July 2019. A teary but beaming Catherine, who hails from Bomet county, shared her fistula journey with us.

“My second pregnancy was one that I enjoyed; it was smooth without any complications. However, the outcome was not what I expected.

When I began feeling slight contractions signifying the start of labor, I decided not to go to the hospital –just yet, instead opting to delay until when I was sure my labor was in its final stages.

Several hours later at about 3am, the labor pains intensified and I knew that baby was about to be delivered. But since I was deep in the rural area with no access to transport, I had to wait till dawn so that I could begin the 3-kilometer trek to where I would find public transport to the hospital.

Stillbirth  

It was a very difficult walk as I was in great pain. Thankfully, my sister-in-law was with me and comforted me along the way. When we finally got into a matatu, the ride to the hospital was no better as the contractions and the pain were intense.

Finally, we got to the hospital at 7am. Upon examination, the medics informed me that my baby was distressed and tired. I too was very exhausted and I had very little energy, if any, to push my baby. I was immediately taken to theatre for a caesarean section.

Sadly, my baby, my second born son, did not make it out alive. He had pooped in my stomach and ingested the contents.

Blaming Myself for my Son’s Death

The news of my baby’s death shattered me. For nine months, I had been looking forward to holding my newborn, but that was not to be.

I blamed myself.

If I had gone to hospital earlier, my baby would have survived. The main reason I delayed going to hospital was because I didn’t want to spend a lot of money there. You see, I had heard stories of women who went to hospital early, only to be sent back home to return later. Others had been retained in hospital only to deliver days later -thus increasing their hospital bill.

We are not well-off financially, so I only wanted to spend a minimum of one day in hospital, hence my decision to endure part of the labor at home. However, what I didn’t realize is that my decision had endangered my baby’s life.

Absence During Burial

What’s worse is that I ended up staying in hospital for seven days following the caesarean section. I ended up spending the same money I had been trying to save and worse, with no baby to show.

My relatives buried my newborn in my absence since I was unable to leave the hospital. It saddened and hurt me deeply. I kept wishing I had gone to hospital earlier.

But my tribulations were far from over.

After delivery, I noticed that I was unable to control my urine. Since it was my first birth via caesarean section, I didn’t think it was odd. I thought it was just the usual lochia.

However, one month later and still leaking urine, my sister advised me to return to the hospital. At the hospital, they termed it as a ‘complicated women’s issue’ and referred me to a better-equipped hospital.

Unable to Control my Urine

At this second hospital, I was informed that I had a fistula. I underwent surgery, but which didn’t resolve my leaking urine problem. When I returned to the hospital two months later with my concern, I was referred to yet another larger hospital. There, I was informed that the fistula repair surgery would cost Sh300,000 which neither me nor my family had. I returned home dejected, knowing that I would have to live with the fistula for the rest of my life.

Life became difficult after that. I had to constantly pad my underwear with pieces of old clothing. Whenever I needed to leave the house to attend a function or go to church, I had to wear children’s diapers. This was so humiliating. Diapers were also very expensive so eventually I stopped leaving the house.

I couldn’t get any employment as a casual laborer either because of my condition. After a while, my husband left me because of my constant ‘urine leaks’ and smell. I returned home to my parents with my first-born son.

My Life Has Changed for the Better

One day, I was listening to the radio at home when I heard an announcement on Radio Citizen about a free fistula camp for women. They also said it was free! I quickly looked for money and made the journey to Kenyatta National Hospital (KNH) in Nairobi.

The first thing when I arrived at KNH was to confirm with the medical team that the services were free. I was so surprised because I couldn’t imagine that there would be organizations willing to help so many women get free fistula surgery.

I am now recovering from the surgery and I already feel like my life has changed a lot. Each time I stand up after sitting, I keep touching my buttocks just to check how wet my dress is, but I keep getting shocked each time I find that my behind is completely dry. I cannot describe the joyful feeling that gives me. It’s a miracle!

My Testimony

I am even more fulfilled to know that when I feel like passing urine, I’m able to go to the toilet and relieve myself. This is unlike before surgery when the urine would just trickle down on its own, uncontrollably.

The first thing that I’ll do when I return home is to go to church and share my testimony. I will encourage all women who have this problem to have hope that they too will be healed of their problem. I thank the FDSA team and all the partners who have given me reason to smile again. I know my son will have a bright future now because I’ll be able to get a job and get money to educate him!

33-year-old Beth Cecilia Piyai from Kajiado county is a mother of five. Her children –all boys -are aged 11 years, 9 years, 7 years, 5 years and 2 years. After delivering her lastborn child two years ago, Beth, an unemployed widow, developed a fistula, and had no means to have it repaired. But as from July 2019, Beth received a new lease of life. She tells us more.

“When I went into labor with my fifth-born son, I knew it would be a normal delivery devoid of any complications, just as it had been with my previous births.

My labor began while I was at home with my husband at 9pm. He then accompanied me to a nearby health facility where my labor continued.

However, when I had not delivered by 10am the following day, which was unusual based on my previous births, the nurses informed us it was because the baby was in breech position, hence the difficulty.

Aware of the potential risks associated with a breech birth, I was referred to a better-equipped facility. There, I was informed I would have to deliver my baby via caesarean section.

Something Wrong with my Caeserean Section

My baby was delivered successfully weighing 3.4kgs. However, I remember during the caesarean section (it was an epidural), the two doctors at one point appeared worried and in disagreement about something. Concerned, I asked if there was something wrong, to which they assured me that all was well, that I just needed to relax. A few minutes later, they called for another doctor.

When the third doctor came in, he put me to sleep through general anesthesia. I wasn’t informed about why this was being done. When I woke up about 13 hours later, I was handed my baby, who was in perfect health.

I continued recovering well, save for the time I noticed that alongside the lochia, I was also passing urine involuntarily. Since I had never undergone a caesarean section before, I assumed this was part of the side effects of the surgery. But just to be on the safe side, I asked the nurses about it, who told me it was nothing to be alarmed about, that the leaks would stop on their own.

Discovering that I had Fistula  

Three days later, my baby and I were discharged.

The urine leaks continued and when, a month later I was still wetting myself with urine, I decided to return to the hospital because I thought it was quite unusual.

At the hospital, the doctor informed me that I had developed a fistula. I was shocked because I hadn’t expected to develop such a complication because I had given birth in hospital. I always knew that people who give birth at home are the ones who undergo a myriad of complications, so the doctor’s diagnosis greatly surprised me.

Death of my Husband

Around the same time, my husband died suddenly through a road accident. It was a double tragedy. Widowed with five children –including a newborn, and now with a fistula!

The doctor told me that I would have to undergo a fistula repair surgery and referred me to Kenyatta National Hospital (KNH). I however never went to KNH because I knew that the surgery would cost a lot of money, which I didn’t have. So I decided to leave well alone and focus on raising my sons.

I couldn’t afford diapers to contain the leaked urine, so I would use pieces of old cloth which I would then wash at the end of the day.

Letting go of my Job Because of the Smell

Before I delivered my son, I was working in a salon. But with my fistula, it became difficult to return to work. Owing to the smell that would emanate from me and considering the nature of salon work –which many times has a personal touch, I found that the odour would be offensive to my clients, so I decided to stay at home.

One thing that I did was never hide my condition from family and friends. They were very supportive and would help me with food and baby sit my children whenever I needed to run an errand.

My eldest son has however always been worried about me, and especially how my fistula has limited me from taking advantage of various opportunities, including job offers.

I also stopped going to church regularly with my children like I used to, and when I went, it would be for only 30 minutes and even then, I would sit at the back of the church.

The Concern of a Son

One time, my eldest son asked me how much the surgery would cost, and I told him it needed a lot of money. Sometimes, I would give my sons 20 shillings each for camel rides, and he told me that instead of riding on the camel, he would instead save the 20 shillings in a piggy bank and let it accumulate until the day it would be enough for me to undergo the fistula repair surgery. I could see that the issue bothered him a lot, but I knew that there was no way I could ever afford to have the surgery.

In June this year, he one day excitedly told me that he had seen an advert on Citizen television announcing a free fistula repair surgery at KNH. He was so excited that finally, I could be treated!

But sadly, I didn’t share the same excitement with him.

Fear of another Surgery

I was worried about going to theatre again because, what would happen if I didn’t come out alive? Who would take care of my five sons? I didn’t want them to be orphaned, so I told him that I would not take up the offer.

My decision completely devastated him. He became so sad and withdrawn, making me miserable as well. But I was too scared, thinking of the future of my sons without me. Going under the knife was not an option for me.

But the more I looked at how dejected my son was, and how my reluctance to get a solution to my obvious predicament that had changed our lives for two years, I decided to overcome my fear –if only to bring back the joy in his life.

And that is how I took up the offer of the free fistula repair surgery at KNH this year. I have just undergone the surgery and I am very happy that I came out alive! The nurses and the doctors were very helpful and kept explaining every process, in detail, which assured me that all was going to be well. I am the happiest mother today!

Adelaide Khabere Ganira is a 46-year-old mother of two daughters, aged 26 years and 24 years. Originally from Kaimosi in Western Kenya, Adelaide is a businesswoman who operates in Kiserian, Kajiado County. Adelaide has lived with a fistula for the last two decades. She talks about this journey.

“My experience began after I delivered my second child. While my first delivery was in hospital, I gave birth to my second child at home. I remember that day very clearly. On one night -about eight days to my Expected Due Date, my waters suddenly broke. This was followed by intense contractions.

Ripped Apart

I was at home with my mother, and unsure about what to do, she quickly rushed to the neighbour’s house for help. The neighbours however didn’t seem to know what to do as it was clear I was in the final stages of labor. Baby was just minutes away from arriving

When my baby started crowning, my screams grew louder and louder. My mother then became intensely worried that the baby’s head was getting stuck. Fearing that she would lose both her daughter and her grandchild, my mother quickly inserted her fingers inside me and manually extracted the baby. The pain was unbearable. I felt myself ripping apart.

Thankfully, baby came out safe.

Surgery not an Option

I however didn’t go to hospital immediately after the birth, only doing so two weeks later when I took my baby to the children’s clinic. While there, I told the doctors that I was having trouble controlling my stool. I would also pass wind unintentionally.

The doctor informed me that my birth experience at home had caused me to have a condition whose repair required surgery. He didn’t tell me the name of the condition. I was young and with no job, and neither did my mother have any money. Surgery was therefore not an option.

To manage my condition, I would be very selective about the foods that I ate. I only consumed foods that would not require me to pass stool often.

Marriage and a Third Baby?

My second birth had traumatized me enough, so I made sure I never got pregnant again. I got scared of getting married again because, wouldn’t my new husband demand a child from me? It’s not a thought I dared entertain so I closed that chapter.

I am a hairdresser and one day, as I was plaiting a client, I loudly passed wind. When my client asked me about it, I opened up to her about my story.

She told me that I had a ‘fistula’ -which was the first time I was putting a name to my condition. My client went on to share that her mother too once had a fistula, which was repaired successfully through surgery. She told me to be on the lookout for fistula medical camps which offer free surgeries.

Sharing my Fistula Story with Friends

In 2015, I got information about a free fistula medical camp, but my friend told me that it was only for those who leaked urine (VVF). Since I leaked stool only (RVF), I knew I didn’t qualify. However, I started talking more about my condition openly because I realized I was not the only one suffering from fistula. I even told my friends to keep their ears on the ground and let me know about any RVF camp that they would hear about.

One day, as I was plaiting yet another client, an advertisement ran on Citizen TV, calling on all women suffering from VVF and RVF to avail themselves at the Kenyatta National Hospital (KNH) in Nairobi for free treatment. I listened very carefully and after confirming that they were treating RVF cases too, I quickly prepared myself and went to KNH.

A New Lease of Life

At the registration center, I was surprise to meet many other women like me. In fact, what shocked me most that there were many beautiful women who I would never have thought also suffered from fistula. I felt comforted. We spoke about our experiences and encouraged each other. It was a very empowering moment.

I am grateful to the organizers of the VVF/RVF camp, who have given me a new lease of life following my successful fistula repair surgery. I also encourage all those who hear the advertisements on radio and TV to share the information with all their friends and relatives – including those in the rural areas who may not have access to this information and help them access the medical camps.

“I was so excited to hold my son in my arms. It has been a relatively smooth pregnancy and I was grateful for the positive outcome –a bouncing baby boy,” she says.

But the delivery had not been an easy one. Trizah had endured a painful 12-hour labor ordeal and after delivery, she remembers the nurse telling her that she had undergone ‘a serious tear that needed to be repaired’.

“I didn’t understand what that meant, but I told her to go right ahead.”

Trizah was then discharged and asked to return after a month for checkup.

“When I went back to see the doctor a month later, he checked me and said that I had indeed gotten a bad tear during delivery and unfortunately, it had not been properly repaired. He told me that I had developed a fistula as a result.”

As the doctor explained more about the fistula, Trizah began making sense of some of the experiences she’d been having post-partum.

“After the birth of my son, I had noticed that I could no longer control my farts. They would come out loud and loose, hard as I tried to restrain them. I also noticed that I was unable to control my urine, and it would keep leaking, making me always wet,” she says.

All the while, Trizah had assumed that what she was going through was normal, and that all new mothers experience the uncontrolled farting and leaking urine. In fact, when she mentioned it to some of her friends, they advised her to place a hot towel over her tummy, saying that would help control her bowel activities.

The doctor then informed Trizah that she needed to have corrective surgery to repair the fistula. However, there was a challenge. She couldn’t afford the Sh100,000 she was told would be the cost for the surgery.

“I had lost my job as a reservationist in the hotel industry just a few months before. I had no money at all, and I was living with my parents. It would have been impossible for me to raise that kind of money.

She tried fundraising from her friends, but they told her that she would just have to learn to live with the condition because she would never be able to raise Sh100,000 no matter how many friends she had.

“They told me that Sh100,000 was too much to raise for a ‘small condition like that’, because I wasn’t in pain after all. They told me that the only difficult thing about fistula would be painful sex, which I could live with because I wasn’t married anyway.”

As she began to accept her condition, knowing that she would have to live with it for the rest of her life, Trizah one day chanced on an announcement in one of the local television stations –Citizen TV, calling on all women with fistula to make way to the Kenyatta National Hospital (KNH) for free fistula repair surgery.

“It was music to my ears, and I couldn’t believe what I was hearing. Without wasting any time, I packed my bags and went to Kenyatta National Hospital (KNH). I went on to have the surgery and today, I can proudly say that I feel different and I know that I will be able to carry on with my life as usual. I will no longer be afraid of going out like before, because I was always scared of farting or staining seats with urine,” Trizah told us, when we met her at the recovery ward at KNH the day after her surgery.

Trizah is all thanks to the Flying Doctors Society of Africa (FDSA) and the Freedom from Fistula Foundation (FFF) who made her surgery possible.

“It would have taken me years to raise that amount of money. But this is no longer the case, because of the generous contribution of FDSA and her partners to make my surgery possible. In fact, and to give back to FDSA, I have committed to become a volunteer for FDSA and I will help the organization spread the word about fistula, and mobilizing women to come for the free camp. My interaction with FDSA will certainly not end with this surgery.”

]]> https://www.flyingdoctorsafrica.org/i-have-pledged-to-become-a-volunteer-to-the-organization-that-helped-me-access-free-fistula-repair-surgery/feed/ 0 https://www.flyingdoctorsafrica.org/in-addition-to-losing-my-son-i-also-began-leaking-urine-mwanarabus-story/ https://www.flyingdoctorsafrica.org/in-addition-to-losing-my-son-i-also-began-leaking-urine-mwanarabus-story/#comments Thu, 08 Feb 2018 21:21:17 +0000 Maryanne W. Waweru https://www.flyingdoctorsafrica.org/?p=1915 ...Read More]]> My name is Mwanarabu Mwambasa, and I come from Vihiga County in Western Kenya. I am 20 years old and I am educated up to class 8. I have lived with fistula for five years now, and this is my story.

At the age of 15 years, I fell pregnant. It was a relatively uneventful pregnancy since I didn’t experience any significant challenges. If only I could say the same of the labor!

When I went into labor, I trekked to the nearest public hospital where I had been undergoing my antenatal clinics. But I was in for a rude shock because the government nurses were on a nationwide strike, meaning there was no one giving care to patients and those seeking services, including pregnant women such as myself. There were only few volunteers, mostly retired nurses.

I was in labor for endless hours, just hoping for the best. Eventually, when the volunteers arrived to attend to me, they told me that my baby was already dead. Apparently, I had been in labor for too long. I was also informed me that because of my age and diminutive structure, I needed to have the foetus removed through a caesarean section. I was sad to hear that because I had been looking forward to becoming a mother. I was taken to theatre where they delivered my dead son. I went on to stay in hospital for two weeks as I recovered, where I continued being attended to by volunteers.

But my agony didn’t end there. Upon my return home, I noticed that I would wet myself like a baby. I couldn’t understand why this was the case, but I hoped that as my caesarean wound continued to heal, then the urine would stop leaking too. I nevertheless became ashamed and withdrawn because of the foul smell that would be with me constantly. It became very embarrassing to be in the presence of people, because they would begin holding their noses around me.

In fact, the most taunting comments came from my peers –fellow girls. They would refuse to hang out with me, and immediately walk away when I approached them, or when I walked into a room. I became so broken, to the point that I contemplated suicide. I was young, an outcast who was shunned by my friends. My son was dead, and I therefore felt that I had nothing to live for.

I decided to live a solitary life at home. I stopped going out to social places such as the church, to the market and other places where young girls would gather. I also decided to stop visiting friends, because while at their place, they would offer me a cup of tea or water to drink and immediately I did so, I would start leaking urine and hence stain their seats. I chose to stay home instead.

This went on for years until sometime in June this year, when a neighbor who works in Nairobi told me that there would be a free hospital camp for women who had a problem such as mine. Having witnessed the agony I had undergone over the years, and knowing I couldn’t afford the transport costs, she sent me money for my bus fare and I made my way to Kenyatta National Hospital (KNH) in Nairobi. When I got there, I was registered, evaluated by the doctors, and scheduled for the surgery, which went on successfully.

Today, as I recover at the KNH wards, I beam with happiness because I feel as though I am starting my life afresh. It has been a difficult five years where I was unable to accomplish much, because I was always in the house. Now I feel confident that I will be able to go out and even look for work and be able to earn my living.

I am grateful to all the people who made this surgery possible, because it helps people like me from the rural areas who are not able to afford such treatment. Thank you FDSA, FFF and other partners for giving me a new lease of life!

It all began with the birth of her second child in 1997.

“I had enjoyed a good pregnancy, but I wish I could say the same of the birth!

It was a very difficult delivery. My son was big –weighing in at 4.5kg. I had been in labor for almost 12 hours before I finally delivered him. It was a very painful and extremely agonizing vaginal birth. But I was proud of the end result –a happy and bouncing baby boy who I was delighted to hold in my arms.”

However, this joy had come with another set of challenges.

“When I got home, I noticed that I would wet myself all the time. But that wasn’t the worst part. I noticed that I would fart involuntarily, and I also could not hold my bowel movements. Even worse, I would pass stool on myself! This puzzled me because I had not experienced anything of the sort after my first birth. My first born was a daughter, so I thought maybe it was something to do with baby boys.”

Marion didn’t return to the hospital, as she assumed that all that was happening would disappear with time.

But it didn’t.

“I’m a single mother, and I therefore had to go out and look for work to enable me provide for my children. But I always had this foul smell that I carried with me, and so getting employment was difficult. The most suitable job that I could get was a farm laborer, since that way I didn’t have to work closely with people. In addition, the outdoors was good and kept the smell at bay. In addition, whenever I felt myself becoming wet with either urine or faeces, I would just rush to the nearby bushes and quickly relieve myself. Most of the time I kept my smell to myself. I also avoided getting involved in social activities such as ‘chamas, women groups meetings, or church activities because of my condition.”

Only recently, Marion’s village became connected to electricity, hence enabling many homesteads to buy television and radio sets where they today enjoy watching and listening to their favorite shows. Since she herself could not afford one, she would pass by her neighbor’s place each evening to catch a glance of her favorite TV station -Inooro TV. One evening, she saw an announcement calling for women who suffered from leaking urine or feaces to make it to the Kenyatta National Hospital (KNH) where they could receive free fistula repair surgery. She knew she was the one who was being called out.

“I was surprised because the television advertisement was describing me! Afraid of the opportunity passing me by, I didn’t waste time but immediately took out the little savings I had and came over to Nairobi. At the Kenyatta National Hospital, where the medical camp was being held, I found kind people from the Flying Doctors Society of Africa (FDSA) and Freedom from Fistula Foundation (FFF) who had sponsored the activity. I was surprised to see so many other women there –both young and old with the same problem such as myself. Yet all along I had known that I was the only one who had this problem!” an elated Marion told us.

Marion was one of the beneficiaries of the 2017 free fistula camp, undertaken by FDSA and FFF in collaboration with other partners, among them KNH and Royal Media Services.

It all began on the night that she went into labor, at nine months pregnant. Even though she was mentally prepared for the baby’s arrival, she hadn’t anticipated that her labor to come at night. The time was 9pm.

Juliet’s house was a considerable distance away from the main road and with no public means to get her to hospital at that late hour, she began to panic. Thankfully, her older sister lived nearby and together, they decided to brave the difficult and risky walk through the dark bushes, hoping they would get to hospital before the baby arrived. Thus they began the eight-kilometer trek to the main road, where they hoped they would get a lift from a Good Samaritan to the hospital.

The time then was 11pm and slowly, the two women walked through the dangerous thicket, hopeful that they would not meet gangsters or at worst, wild animals.

“We live right next to the Aberdare forest and often, wild animals stray into our farms. Our paths only illuminated by our small mobile phones. Even though we were very scared, all we could do was pray and hope for the best,” she remembers.

After a walk of about 30 minutes, Juliet told her sister that she could walk no more. She was too exhausted.

“My sister then spread a lesso on the grass and asked me to sit down. I said my last prayers because I was sure that I was going to die. I felt horrible, because I would leave my young children parentless. However, my sister kept praying and telling me to be strong.”

After laboring for hours in the dark, cold night, an exasperated Juliet eventually delivered her baby with the assistance of her sister.

“My sister had thankfully carried a razor blade and a string, which she used for the delivery. The only light she had for the childbirth was the dim light from our mobile phones. Sadly, my baby – a boy, was already dead,” a mournful Juliet remembers.

After the birth, Juliet became cold and started shivering. She was also bleeding heavily.

“As I lay there, I wasn’t sure if I was alive or dead as I kept drifting in and out of consciousness. By the grace of God, 6am found me alive and at once we saw light, we slowly walked the remainder of the journey –about 6 kilometers to the main road where we stopped the first vehicle that passed,” Juliet remembers.

At the hospital, Juliet would be admitted for a week. During this time though, she noticed that her urine would freely flow, and hard as she tried to stop it, she just could not. The doctors informed her that she needed to undergo some tests to determine the nature of her problem, and referred her to a private hospital.

When she went there, she was informed that the tests would cost Sh13,000 –money she could not afford. She accepted that her new life would be all about leaking urine.

One day, she and her sisters were seated together listening to a radio broadcast, when they heard something interesting.

“It was an announcement calling all women who leaked either urine or faeces –or both, to attend a free fistula camp at the Kenyatta National Hospital in Nairobi. We could not believe our ears. I immediately travelled to Nairobi. That was in June 2015.”

Juliet underwent the free surgery and upon discharge, she boarded a matatu back to Nyeri.

“The matatu ride was rough and difficult, as I kept being thrown up and down. I was in so much pain from the fresh surgery and was relieved at the end of the two-and-a-half-hour journey.

Unfortunately, a few weeks later, she realized that she was back to the leaking urine problem.

One year later, in July 2016, she once again attended the free fistula camp sponsored by the Flying Doctors Society of Africa and the Freedom from Fistula Foundation. This time round, she planned to avoid travelling back to Nyeri immediately after discharge, until she was sure she had the doctor’s approval.

“I thank all the people who have made this surgery people, because my dignity has been restored and now I can carry on with my business –which had greatly suffered because of the fistula. I will now focus on raising my children again,” she says.

When it was time to deliver her baby, Milka began experiencing labor pains while at home at 5am. She then boarded a bicycle taxi (boda boda) and began her journey to the hospital.

With no clear road, the path that the bicycle took were rocky, bushy and practically non-existent, making the ride and arduous one for the woman in labor. The bicycle dropped her off at a stop, after which she then boarded yet another bicycle, which would then transport her to the main road where she would be able to find a vehicle that would take her to the hospital. By the time the heavily pregnant Milkah got to the hospital, it was 4pm. The journey from home to the hospital had taken her 11 hours.

She would eventually end up having a caesarean section after the doctors established that a normal delivery would not be possible because her pelvis was ‘too small’. Unfortunately, Milka’s baby was born dead.

Four years later, Milkah conceived again. This time round, she was married and was no longer living in a remote rural area where infrastructure was poor. When time came for her to deliver –signaled by labor pains, Milkah quickly made her way to the hospital.

Owing to her previous birth experience, Milkah informed the nurses about her ‘small pelvis’ condition, advising them to take her for a caeserian section immediately. However, the nurses ignored her pleas.

Four days later, still admitted in hospital and in labor, the nurses, rather belatedly, realized that she was not going to delivery naturally, and realized that a caesarean section was inevitable. But as fate would have it, it was at the same time that the country was undergoing a crisis in the health sector as doctors in public hospitals had gone on strike. Unfortunately for Milkah, there was no doctor in the public hospital she was in who would perform the surgery.

Her family then decided to rush her to a nearby private hospital, where she underwent a caesarean section. Unfortunately, once again, the baby was already dead –something they told her was because she had been in labor for too long and the baby had died out of distress.

However, her problems were far from over.

“A few days after being discharged from hospital and without a child for the second time, I realized that I was leaking urine. When I returned to the hospital, I was told it was as a result of prolonged labor which had caused internal injury. I was further informed that I needed Sh30,000 to correct the problem. I could not afford this money, so I returned home dejected,” she remembers.

However, relief came from her friend who had suffered the same condition and had the previous year undergone a successful fistula repair surgery at Kenyatta National Hospital (KNH) in Nairobi. She informed her of a similar surgery that was to be conducted by the same people -the Flying Doctors Society of Africa (FDSA) in collaboration with the Freedom from Fistula Foundation (FFF) and KNH.

We met Milkah recuperating at KNH three days after her free successful surgery. The joy that she beamed was contagious.

“I can’t believe that I’m not leaking urine anymore,” a jovial Milka told us, adding that “my life is just about to get back on track.”

Milka told us that she has always been a hardworking girl, never one to sit idle. However, all that had changed since the loss of her two babies and the fistula she developed.

“Before my first pregnancy, I was working as a chef and waiter at a small restaurant near home, which enabled me earn and income and contribute to the household expenses. However, after I lost my baby, my morale went down as I mourned the loss of my first child. After I got married, I wanted to get back to the workforce after I had nursed my baby, but that was not to be. Even worse, I now had this condition that further dented my self-esteem. After the loss of my child and the leaking urine problem, I lost all form of dignity and became a very sad girl. However, now that I have already undergone the surgery at no cost, I feel as though a new chapter of life is starting for me. My dignity has been restored!”

She traces the start of her agony to the birth of her second child in 1996. When labor came, she was at home with her husband. With the contractions increasing by the minute, it greatly worried the young couple because it was late in the night and they did not have a vehicle or any means of transport to get them to the hospital, which was a distance of 14 kilometers away. It however soon became clear that they would not make it to hospital, prompting her husband to dash out of the house to fetch his mother, who lived about 100 meters from their house. An experienced woman, they had no doubt that she would help them birth the child.

However, by the time Evalynne’s husband returned home with his mother, Evalynne had already given birth –alone. The following day, a neighbor who was a nurse, came and checked on them and after certifying that they were both okay, she left.

However, two weeks later, Evalynne noticed she was leaking stool and informed her husband about it. Concerned for her health, the couple yearned to see a doctor, but were nevertheless constrained by their finances. She never sought treatment, and leaking stool would define Evalynne’s life for the next 10 years.

One day in 2006, she met a doctor who told her that her condition was treatable through surgery. It would however cost Sh40,000 –a huge amount that would clearly be difficult for her to raise. But eventually, after almost a year, she raised the money and recalls the day of the surgery.

“The doctor’s clinic was a small office in the rural town center. The room where the surgery took place was not a theatre, but just a small bed which he asked me to lie in. He began the ‘operation’ at 10am, and I did not wake up until 5pm.”

But her agony was far from over. It was not an in-patient clinic, and so Evalynne had to return home -a distance of 14 kilometers aboard a boda boda (bicycle taxi) since she could not afford any other transport means.

“I had to sit on the bicycle all through the rough and dusty road. It was a most grueling, painful experience,” she remembers.

However, her joy was short-lived. She had expected to stop leaking stool after the surery, but became disappointed when the problem persisted. She suspects the arduous bicycle journey may have damaged her. Her life remained difficult.

“It was tough for me because, as a teacher, I have to stand before pupils all the time. Sometimes I would fart uncontrollably while other times, I would soil my clothes. My life was full of embarrassment,” she says.

One day, Evalynne heard a radio announcement calling on women suffering from leaking urine or stool to attend a free fistula repair camp in Nairobi, at the Kenyatta National Hospital (KNH). She wasted no time and immediately boarded a bus to Nairobi, where she underwent a successful fistula repair surgery in July 2016. The surgery was made possible by among others -the Flying Doctors Society of Africa (FDSA) and the Freedom from Fistula Foundation, in collaboration with KNH and Royal Media Services.

We met her a few days after her surgery, and she was all smiles.

“Do you know what I will now be able to do?” she asked us.

“I have always loved politics, but my ambition was limited by my fistula. But not anymore. I will run for office, starting with the Kenya National Union of Teachers (KNUT) politics in my Western Kenya backyard.

Evalynne informs us that she had once, on a campaign trail for an elective post in the teaching fraternity, stood up to address a crowd comprised of her fellow teachers.

“As I was speaking, I began farting loudly, uncontrollably. The farts were coming from both my front and back sides. It was so embarrassing as my entire audience heard the farts. I had to abruptly end my speech, as I felt so much shame and humiliation. That was the day I quit politics. But now, I will return since my problem is over. I am confident I will win and bring change to the education sector in the country, starting with my community in Bungoma,” she says.

Evalynne adds that she will use her influential teaching position to create awareness around fistula because, just like her, she knows of the many women who are suffering from the condition.

Having never gone to school all her life, Naropil would spend her days herding her husband’s livestock, or staying at home undertaking domestic chores. Her marital bliss would further be heightened when she fell pregnant shortly thereafter.

It was a smooth pregnancy for the 15 year-old, who knew that the end result would be a bouncing baby and a happy husband –and by extension -a happy family and a happy community around her.

At the end of her pregnancy, at nine months, Naropil would begin experiencing labor pains. Even though she was miles away from a health facility, it did not worry her since she had no intention of giving birth in a health center anyway.

“Where I come from, we don’t go to hospital. All health remedies are found locally. During birth, –mothers, aunts, cousins and female neighbors are the ones who assist in the delivery,” she says.

But after five days of intense pain with no baby in sight, her husband, fearful that he would lose his young and new wife, decided to go against his culture and take her to the local hospital. There, Naropil underwent an emergency caesarean section.

“Unfortunately, my baby was born dead. The doctors told me that I had taken too long to come to the hospital after my labor started, so the baby had died in my stomach. It was a baby girl,” a mournful Naropil says.

A few days after she was discharged from hospital, Naropil noticed that she would always urinate on herself. She wondered why she was unable to hold in her urine like she had always done before.

Naropil explained this ‘strange phenomenon’ to her husband, who told her not to worry and that with time, she would heal and the leaking urine problem would be a thing of the past. However, days, weeks and months went on, with the urine continuing to leak with no reprieve in sight.

Thankfully, in 2013 –two years after the stillbirth of her daughter, she decided to return to the hospital and inform them about the problem she had developed after the delivery.

“The doctors told me about a free surgery for women with problems like mine, and referred me to a private hospital in Nairobi for the surgery. I immediately went for it.”

However, Naropil says she was disappointed because even after the surgery, the leaking never stopped, yet the doctors had reassured her that it would. Disappointed, she continued with her regular life in rural Narok, sad that she would always have the leaking urine problem –and the constant smell it brought along.

That was until she learnt of the free fistula camp at the Kenyatta National Hospital in July 2016, which was being undertaken in collaboration with the Flying Doctors Society of Africa (FDSA) and the Freedom from Fistula Foundation (FFF). She informed her husband, who facilitated her journey to the capital city of Nairobi for her surgery.

We met her at the KNH ward, recuperating after having undergone a successful fistula repair surgery just two days before. She was beaming and full of hope.

“These doctors were very good and told me that they have now fixed the reason behind my urine leaks. I am very excited and when I return home and after six months, I will try to get pregnant again,” she said.

Before undergoing the fistula repair surgery, Naropil told us that she had once lost a pregnancy at two months, which nurses had told her was because of the fistula.

“The fistula has now been repaired and I believe I will be able to carry my next pregnancy to term. It is my great desire to be a mother. Aside from that, I really want to give my husband a child and I now believe that it will be possible to do so,” a beaming Naropil told us.