She says that she stopped working the moment she learnt of the condition as it couldn’t allow her to work. “The condition had limited me. I couldn’t go on with business as I would pass faeces and urine without my knowledge,” Jackline remarks.  She notes that there was a time she tried going back to work but she couldn’t manage the condition. Most women living in fistula are stigmatized. Women like Jackline are rejected because they leak and smell urine hence people avoid sitting or working with them. The condition makes one lose value in employment as well as in business. The fact that she has not been working has made her depressed, “my husband does casual jobs and the cost of living has gone too high. I have always wished I could be able to work and assist him pay the bills,” she notes.

Jackline describes fistula as an embarrassing condition; sometimes people would even start covering their noses when they came close to people suffering from it.  She points out that sometimes she would be too broke to buy sanitary pads, hence stuffing her underwear with rags. However, faeces still leaked onto her clothes, forcing her to wash them several times a day.

“For a woman, you must be very careful if you are married like me. A man can leave you because of dirt. Women suffering from condition work double to maintain high standards of hygiene in their bodies, house, and home compound,” she notes. She says she heard about Webuye fistula camp via a text message sent on her phone. “M-PESA Foundation was creating awareness about the campaign and they happened to send me a text message and that’s how I came to know about it,” she notes.

Since I didn’t have bus fare to the hospital, I walked approximately 50 kilometers for me to attend this clinic. “I had lost hope, I never knew the day will come and be free from fistula. I am happy God has made it come to pass,” she says crying.

“There was a time we tried to look for treatment but the medical fee was way beyond our ability. I never thought I can get treated for the condition. I am happy with what God has done for me. This is a miracle,” says Jackline.

“There are all these myths that go on in the communities: you are promiscuous, you are bewitched or you have HIV,” says Jackline. She notes that she has now moved from rejected life to a life of hope. She shares that now she will be a good ambassador of fistula in her village and the neighborhood. “Before I couldn’t speak about fistula because I was stigmatized. I was really ashamed to speak about It. I am now free. I will volunteer to speak to women about the condition and help them find help,” she points out. In addition to that, she says that most people don’t know fistula has a cure.

She urges women not to fear speaking out on issues they are going through since that’s how they get healing. “I will urge all women who are disturbed by issues some embarrassing like fistula not to give to brave themselves, talk to people and look for help,” she says.

Experts say about 70 percent of women living with fistula never seek treatment because they do not know what is wrong with them. Fistula was virtually eradicated in developed countries in the 19th century, following the discovery of the Cesarean section.

“I became a fistula victim in 2009. At the time I was only 16 years old,” she recalls.  Priscah notes that she is a victim of teenage pregnancy. She became pregnant at the tender age of 16 years. “I was in a relationship back at secondary school. At the time I was very innocent, I was only trying to discover myself and the world around me. It’s in that relationship where I got pregnant,” she explains.

She notes that although she was not mature for marriage at the time the man responsible for the pregnancy was ready to start life with her. “It’s normal for girls to get pregnant at a tender age in the village and so it was not a big deal,” she says.

Priscah says that, like most girls who get pregnant early in life she didn’t continue with her formal education. The pregnancy marked the end of her 8-4-4 education. “So I started cohabiting with the father of my child and when the time came to deliver he supported me fully,” she expounds.

Even though she had all the support she required, she notes that her delivery was not smooth as she struggled to push the baby to the extent that the doctors were planning to take her for a caesarian section but just before they took her to the theatre she delivered miraculously.

Unfortunately, her child didn’t survive. She died before they left the hospital. To add salt to the injury the doctors realized all was not well with Priscah. She had suffered a fistula. She would pass urine without her knowledge. “Although they did not reveal to me the condition I was suffering from they tried to treat me but they didn’t succeed. Not even going back to the hospital would save the situation,” she observes.

She notes that it didn’t take long before her man would get tired of her. He abandoned her. This saw Priscah go back to her parents where she shared with them about the condition.

She notes that her parents tried to take her to the hospital but didn’t succeed. They tried herbal medicines but again they were not successful. “Nobody has ever heard about the condition in my homestead. So we started looking for traditional solutions and even seeking prayers from men of God but the results were more of the same,” she says.

Priscah explains that it reached a point her condition was dividing her parents as they would shift blames on who was responsible for it. “Some paternal family members would accuse the mother of moving outside her marriage. Some thought it was a curse or witchcraft, everyone had different opinions about it,” says Priscah sobbing.

She notes that the fistula stopped her life completely. “I was abandoned by my husband, lost friends, and my health. I couldn’t work. I would stay at home alone. This is the only place I would find solace,” she explains.

A new chapter…

For now, Priscah is happy her life has taken a new turn. “I am starting a new chapter. I have lived an embarrassing life. I don’t believe that I can sleep and wake up without having soiled my bed. This couldn’t happen before. I am learning how to start living again. This is a new chapter in my life and I am very grateful,” she says. She terms fistula as a crippling condition that denies a person social life.

Priscah says she first heard of the fistula on the radio. “When I first heard of it on the radio, I was with my brother and he helped me look for details about it on Google. In the process, we learned how the Flying Doctors Society of Africa has helped women to overcome the condition. It didn’t take long before I heard about the Webuye Fistula Camp,” she says happily.

“ I even didn’t have bus fare to the camp venue. I borrowed the money Kshs250 to this place,” says Priscah a Uasin Gishu county resident.

She points out the lack of resources and qualified doctors are among the top reasons why most local hospitals can’t treat such conditions. “Most of the local hospitals don’t have qualified doctors to treat fistula. Treating the condition is also very expensive,” says Priscah.

For now, Prsicah is grateful to the Flying Doctors of Africa, M-Pesa Foundation and Royal Media Services for assisting women to get this treatment. “A lot of women are suffering silently. They don’t know where to find help but I am happy I am now treated,” she concludes.

Celestine has been suffering from a fistula since October 2022. Fistula causes infections, pain, and bad smell, and often triggers stigma and the breakdown of family, work, and community life. Celestine, a church leader in her fellowship, says the last six months have been the worst in her entire life. She has not been in a position to serve her people well.

She points out that, she has been in awkward positions since the condition has disabled her from carrying on her duties as she ought to. “It has been tricky to serve in my condition. I had to look for survival tactics. I would sometimes attend meetings late to avoid messing with the clothes I have on or arrive late and leave early. Failure to do that I had to keep excusing myself. I feared traveling long distances or places we would spend a night out on a mission” says Celestine adding she has been avoiding long meetings like a plague.

Celestine says that she realized she had the condition six months ago when she went to the hospital for surgery. “Initially I didn’t know where I was ailing from but I knew all was not well. It’s not normal for a grown-up to pass urine unexpectedly,” she says.

When it started…

The mother of one notes that it all started in 2019 when she developed some problems in her uterus. She started bleeding heavily. This saw her seek medical advice. The doctor’s test revealed she had some growth and hence advised to do an operation,” she says.

After the operation, Celestine went back home but this time something was amiss. “It’s back home she realized all was not well with her. I would pass urine without my knowledge at night and sometimes during the day time. The experience made her restless,” she remarks.

She notes that the situation was so embarrassing and has been among the top secret in her life. “I didn’t want anyone to know about it but I opened up to my husband, a fellow woman leader in the church and my daughter-in-law,” she says

Celestine says that the three were her pillars. They supported and encouraged her. “I flipped off from sharing the issue with my son but God helped me to open up to her wife. Since she is a woman and very close to me it wasn’t hard to share with her,” she says.

She notes that fistula is an embarrassing condition and hinders women from going on with their day-to-day activities like other people. “I think this is the worst condition ever as you can’t mingle with people comfortably and humans are social beings. There is no way I can live alone and expect development in my life,” she says.

Celestine encourages women suffering from the condition not to keep quiet as they might find help. “It’s good to share whatever situation you might be going through as you don’t know where your help might come from,” she observes.

She says in her case it’s a fellow woman who shared with her about the campaign that was being conducted in Webuye County Hospital by the Flying Doctors Society of Africa, M-PESA Foundation, AMREF, and Royal Media Services.

At the time I even didn’t have fare to the hospital, I walked almost 50 kilometers but I can’t regret it since I got treated and now I am healed. “I got operated on. The operation didn’t take long. We have been treated well with dignity and I am very grateful that I am okay again,” she adds.

She observes that sometimes courage is all we need to overcome some situations, “since I am a woman leader I will volunteer to reach out to fellow women and find out whether there are those keeping quiet and suffering from the condition,” she says.

“I want them to know fistula can be treated and I will direct them on how they can get help,” Celestine says happily.

Although the full global extent of this problem is not known fistula has crippled thousands of women worldwide. According to the World Health Organization, fistula strikes roughly 50,000 to 100,000 women and girls every year, mainly in resource-poor countries in sub-Saharan Africa and Asia.

In Kenya, approximately 3,000 women and girls develop fistula every year, while the backlog of those living with untreated fistula is estimated to be between 30,000 and 300,000 cases.

Mary developed fistula after delivering her child in 1993. She had laboured for a long while and was eager to meet her bundle of joy in whatever way possible therefore when she was referred for a caesarean section, she did not mind it. Unfortunately, Mary had a still born. She was heartbroken. To add on, while getting ready to be discharged, her catheter was removed only to discovered that she was unable to control her urine flow. Not only had she lost her child but she had also been left with a disease she was not sure was curable.

Through the years, Mary has sought help from three different hospitals but whenever the catheter was removed, she would find that she had not recovered and would be back to her struggles. This saddened her but did not discourage her. She was still hopeful and continued to seek opportunities to get medical treatment.

Having fistula has not been a walk in the park for Mary. She was forced to use diapers to avoiding making a mess. Mary could not sustain her friendships. Her friends abandoned her once they discovered that she had fistula. She was forced into a life of solitude. Mary tried to maintain a normal social life and attended gatherings such as church when she could, but she did not disclose her situation to anyone. She also could not maintain a job. She had been a casual labourer offering domestic services and not all employers could accept for her to offer them her services given that she often had a stench following her.

While out on a casual job, Mary heard about the fistula camp hosted by the Flying Doctors Society of Africa from her colleague. She was informed about a text message with information about the camp. That evening, Mary hang around her neighbour’s house with the hopes of getting the information from the news. She was lucky enough to catch the discussion on fistula which highlighted the medical camp. Mary was resolute that she would not miss out and would present herself to try and get help.

Mary went to Migori County Hospital where the service was being offered. She was treated and is hopeful that she is now fully recovered. Mary is thankful to the M-PESA Foundation, Ramogi and The Flying Doctors Society of Africa and all other partners who have made the clinic possible. She looks forward to living an improved quality of life after the surgery.

Peninah narrates that she developed fistula in 2019 while delivering her 2nd child. She had laboured at home for 4 days and ended up having a home birth without any help. After delivery, she went to hospital to ensure that all was well and informed the health care workers that she was unable to control her urine flow. The hospital unfortunately offered no solution and left her to own devices.

She has managed to live with her condition and her life has not changed much.  She continued to attend social events and mingle with others despite her condition. Despite her husband not being able to afford diapers, she has managed to go about her life without them. Lacking the financial muscle to do much has not stopped Peninah’s husband from supporting her. He even brought her to the medical camp for treatment after receiving information about the medical camp.

Peninah underwent surgery on Monday 27th February 2023 and is hopeful that she will recover. She is looking forward to resuming her normal life. She is thankful to the partners for the help.

Nasieku developed fistula in August 2019 when she was delivering her child. She had visited the local hospital for delivery but was referred to Narok Hospital where she delivered her bundle of joy. 2 weeks after delivery, Nasieku discovered that she was unable to control her urine flow. She sought medical treatment immediately but unfortunately the surgery was not successful and she still was unable to control her urine flow. In April 2020 she decided to seek medical treatment but again it was not successful. She resigned to her fate and went back home distraught.

Life with fistula has not been easy. She has had to use diapers to avoiding making a mess. She would often suffer diaper burns and would have to change her clothes several times a day. This cost her, her social life. Her peers ridiculed and made fun of her. Her friends abandoned her and left her in solitude. Further, she was unable to maintain a job. Luckily, her husband and her family has been very supportive and provided both emotional and psychosocial support.

In early February 2023, she received a message informing her of the free medical camp at Migori County Hospital. She was not going to miss the opportunity and was eager to attend the clinic. She successfully went through surgery on Monday 27th February 2023 and is very happy and grateful.

Nasieku is looking forward to going back to school now that she is healed. She is thankful to M-PESA Foundation, Ramogi and the Flying Doctors’ Society of Africa for the help and urges all suffering from fistula to seek medical help and take advantage of opportunities such as this.

Betty first developed fistula while delivering her first child in February 2020. She had prolonged labour. Her water had broken, and she suffered labour pains for 2 days before she finally delivered the baby.  When labour began, Betty was in excruciating pain. She went to hospital as she thought her delivery time was close. When she got to the hospital, the doctor admitted her but told her to wait and left her unattended. Whenever she tried to inform the nurses of her pain, they ignored her. She then felt the urge to push the baby out and walked herself to the delivery room where she still did not receive any assistance. Without any support, Betty lay on the bench and pushed out the baby. The baby let out an ear-splitting cry that then attracted the students on training to run to her aid.

During the delivery, Betty had suffered tears which were stitched. However, after three days the stitches came apart. During these three days she also realized that she had uncontrolled flatulence through her vagina and had a foul smell. She went back to hospital, but they did nothing to assist her. The nurse who attended to her informed her that the stitches were poorly done and because it had already healed, there was nothing that could be done.

Her situation was quite embarrassing, and she was sinking into depression. She could not mingle freely and was confined to the routine of going to work and returning home. Her husband who she thought would be her strongest support system abandoned her. He worked in a different town and reduced the frequency of coming home. She tried to keep busy at work which helped her get her mind off her problems. She explained her situation to her employer, and they indulged her. Despite being able to attend work, she was still unable to freely mingle or have a social life.

Betty decided to get pregnant with hopes that during her second delivery, the problem would be corrected. This was however not the case. Betty delivered her second child in October 2021 via caesarean section which did not offer her a solution to her problem. The doctor who assisted in delivery informed her that the stitches were not professionally done but did not offer a solution. This was heart breaking for her.

One afternoon in May, Betty received a call from the matron at the district hospital informing her about the medical camp, and she purposed to attend. She came to the district hospital for screening and assessment and was identified as a good candidate for the surgery.

Betty says she is feeling better and is now comfortable to sit with others. She is extremely grateful and wishes God’s blessings upon M-PESA Foundation, Beyond Zero, UNFPA, Royal Media Services and Flying Doctors’ Society of Africa. She urges women to get help and not feel embarrassed to speak out about fistula because it does not choose its victim.

Juliet developed fistula in 1988 when delivering her last child. She underwent a caesarean section which resulted in her developing uncontrolled urine flow. Because of her lack of economic capability, Juliet could not seek medical attention and resigned to her fate and accepted her new normal. She did not seek any medical attention.

Juliet lived a life of solitude. She could not socialize with her friends and family neither could she participate in activities she enjoyed such as going to church. Her husband is deceased, and her children already married, and she therefore was on her own. Her children were not able to complete their education and do not have stable jobs. They are therefore only able to assist her with small things such as purchasing soap.

Because she was unable to hide her condition, the women in her community took it upon themselves to help her whenever they could. They mobilized each other to cook and fetch water for her whenever necessary. This kept her going and made life a little easier for her.

While sitting in her home, one of her community members visited her and informed her about the medical camp at Tharaka Nithi which she purposed to attend. Juliet went through successful corrective surgery on 25^th May. She is very happy with the results.

Juliet states that she will take it upon herself to empower women and advise them to seek medical treatment. She is grateful to Flying Doctors Society of Africa, Citizen and all other partners. She thanks them from the bottom of her heart and urges them to continue helping others.

Having successfully delivered two children, Stella did not anticipate developing any complications. Like any other mother, she was excited to meet her bundle of joy. At the time of delivery, Stella encountered some challenges. Her child was too large. The baby was four-kilograms heavy and caused her to suffer tears during delivery. The doctor attending to her was not thorough in stitching the wound causing her more problems than good. Because of the poor stitching, Stella was unable to pass stool neither could she control her urine flow.

Stella tried to seek medical assistance severally but kept getting turned away because the wound had already healed. She sought help at the District Hospital and the doctor who attended to her told her that he would transfer her to Eldoret Teaching and Referral Hospital. He however gave a caveat and stated that it would be costly. Due to her limited finances, going to Eldoret for treatment was not an option for Stella.

To manage her condition, Stella had to remain hydrated and to eat light foods. She was extremely embarrassed by this situation. She could not interact with others because she was afraid of soiling herself. Her self-esteem took a plunge and she sat in solitude most days. She did not feel like a complete woman.  Luckily, her husband was extremely supportive. At first, she did not share her problem with him, but he noticed that she was always sitting outside, and he tried to find out what the problem was. When she shared with him, he stood by her and assisted her to find solutions for her. He got her a bucket to use while in the house. He stood by her and encouraged her.

While performing her household chores, Stella heard about the Flying Doctors Society of Africa’s medical camp on Innoro FM. She was determined to attend and not miss out on the opportunity. She travelled from Eldoret and successfully got surgery on 24^th May 2022. She couldn’t be happier with the results. She feels confident and has an improved self-esteem. Stella says that she now feels like a complete woman.

Stella is excited at the possibilities the future holds. She is grateful to the Flying Doctors Society of Africa. She also encourages women suffering fistula to be bold and come out to seek help.

Francisca Chepng’eno is a 39-year-old mother of two living in Bomet. She has a heavy accent that slightly strains our communication, but we push through. Francisca sounds a bit tired; she is still recovery from her surgery.

Francisca first suffered fistula in 2002 during the delivery of her second child. She suffered prolonged labour and had to go through a caesarean section. After the surgery, she realized that she was unable to control her urine flow. She had suffered ureterovaginal fistula. She informed her doctor who advised her to seek treatment after three months. He further advised that she should look for funds to facilitate the treatment as it is expensive. This broke Francisca’s heart. She accepted her fate and tried to live a normal life.

Because of lack of funds, Francisca has been at her home and working on her farm which is her primary source of livelihood. Because she is a single mother and the sole-bread winner of her family, she did not have the luxury of seeking treatment for herself. She had been unable to mingle with others due to her condition. To try to manage the situation, Francisca had to wrap herself with worn out clothes to avoid any leakage. Further, whenever she happened to be away from her house, she would moderate her liquid intake to reduce the chances of her messing up and embarrassing herself.

Francisca received a text message about the medical camp in Kajiado and made the five-and-a-half-hour-long journey from Bomet to Kajiado to receive treatment.  27^th April 2022 will forever be a memorable day for Francisca as it is the day, she successfully received the corrective surgery. She is excited with the results and cannot wait to go back home and resume normalcy. She is eager to socialize with family and friends, fully enjoy life and to finally dress well.

Fransica is grateful to the M-pesa Foundation, Flying Doctors Society of Africa and urges women suffering from fistula to come out and seek medical help.