Edith, a mother of one, has been struggling with fistula for the last two years. She has been in tears. She didn’t know what to do as she had tried her best, to treat the condition.

“I got blessed with my firstborn in September 2021. At the time I was a new graduate and we had just started life,” she opens.

At the time the coronavirus wave had just hit the country and people were restricted from moving from one location to the other. “After delivery, I realized all was not well as I had second-grade perineal tears. I took long to heal,” she says noting she didn’t have people consult as visitors were regulated due to the coronavirus outbreak.

At the time Edith acknowledges that she didn’t have a problem as there was restriction of movement. Her problem started when normalcy started coming back into the country. A lot of friends wanted to visit and as expected with time people anticipated her to start looking for a job.

“When I realized the problem I had was persistent; I decided to visit a gynecologist who broke the news I was suffering from a fistula. I didn’t have much information about the condition, and I decided to research about it,” says Edith 29.

She notes that for a period of one year, she was gathering information on Google on how to manage the condition. “There is little information about fistula, but I have been trying to look for it to know how in case I don’t get treated I can manage it,” she says.

At the time Edith and her husband were straining financially, and they would not be able to treat the condition. In 2022 she went for treatment, but it was not successful.

“I was very much discouraged that we spent a lot of cash, but we didn’t see the results,” she says. This saw her remain in the house only to engage in light duties.

It’s during her research that she learned how Kenya Flying Doctors in partnership with Safaricom Foundation and Royal Media Services have helped treat women living with the condition.

‘I immediately started following them and in early August I got the news that they were visiting Tharaka Nithi county,” says Edith happily.

“I knew this was a golden opportunity I didn’t want to miss. I was eagerly waiting for the day. I didn’t want it to pass me,” she says.

For now, Edith is happy she has been treated and she is ready to go back home and look for a job as she engages in other life activities.

She recalls how she has applied for jobs in two instances and called for an interview only to shy back from them when she recalls her condition.

“The condition is traumatizing. I am not sure I will get my second born anytime soon,” she says.

Edith is grateful that her husband stuck with her during all this time, and she would give the support needed. “I am happy for my husband for he has been my number one supporter. Sometimes I have been down as I didn’t know how life would turn out, but he has always been there for me,” she showers her husband with praise.

I am happy for The Flying Doctors. They have given me a new lease of life. To me this is a second chance to live a normal life,” says Edith happily.

“I am now going to look for a job and try and earn a living like my age mates,” she adds.

She notes that there is a need to create awareness about fistula as most women are suffering silently. “I think a lot of people don’t know about the condition. Some of those who know about it are not aware it can be treated and if they do majority don’t have the means,” she says.

She further says that there is a stigma for people suffering from fistula as they are alienated from others. “There is a lot of misinformation about fistula, there are those who think it’s a curse, some think it’s as a result of family issues, and so on,” she explains.

She advises young people suffering from the condition not to bow down but to press on until they get treated.

“Fistula can be treated. Don’t give up your day of restoration is coming,” she concludes.

Karen, a mother of three, narrates how she has lived in disgrace for a quarter century.  “My journey with fistula started way back in January 1998 when I went to deliver my third-born child,” Karen kicks off our interview.

She says that it all started in the labor ward. “Having borne some other children before I knew well the signs of labor pain and I was aware when it hit me. But unlike my other pregnancies, this was different as I labored more hours,” says Karen 65.

She notes that the long hours of labor pain might have contributed to the death of her newborn.

Karen marks this as a genesis of her woes as since this period her life has never been the same. “My life took a new turn during this period as I have never managed to go back to the woman I was before,” Karen says with a tinge of bitterness.

She says that since this delivery she would not be able to hold short or long calls for long. She has to be close to the washroom or else she will soil herself. “At the early age, it was worse as it affected me both physically and psychologically but with time, I started managing it,” she notes.

“At my age now, I had learned what to do to avoid embarrassment especially when on social gatherings,” she says.

She notes that whenever she knew she had an event she would start planning her diet some days before. “I would cut down on the amount of water I drink sometimes I would as well avoid light food and Instead do hard foods that would take time to digest,” she says insisting the goal was to dehydrate her body.

This has seen her attend some social gatherings without a lot of struggles although she is quick to note it’s a sacrifice. “Do you imagine attending an event, but you avoid food and drink and if you have to take you do it in small amounts?” she pauses.

Karen, a farmer, feels the condition has wasted a better part of her life as it limits her from exploring the world and utilizing her potential fully. “Fistula patients live in fear. They are anxious about what will happen in the next minute, especially in social places,” she says.

Her situation has been made worse by the fact that she has a child living with a disability. “I am not married, and I have a child living with a disability. I am also not different from a person living with a disability since the condition has limited me. I have been praying to God to redeem me from this shame so that I can be able to provide for my child,” she says.

Karen says that she heard about the Tharaka Nithi fistula campaign during the church service announcements. She examined herself and she felt her time to get healed had arrived. “Deep inside my heart, I knew all was not well. I knew I was ailing but I didn’t have money to seek treatment,” she says.

She notes that at her age she had given up on living a better life and it had reached a point she had made peace with her predicament. “I had gotten used to the issue. It reached a point where I made peace with it but I am really happy God has been gracious to me. I am now whole again. I have been treated,” she says with tears of joy rolling down her cheeks.

During those days delivering to the hospital was the safest delivery one could make. Those were the days when women were highly encouraged to deliver in hospitals as health service providers helped to save women from maternal-related deaths.

Although Rose was lucky to deliver at the hospital, all didn’t go well. She suffered from a fistula. “After delivery, I realized it was hard for me to hold either a long or a short call. I was really confused since I had not experienced such in my previous deliveries,” Rose a mother of four opens up.

Rose, once a vibrant woman started distancing herself from her circles since she didn’t want her friends to know what she was going through.  “I decided to keep this top secret. Not even my children and husband were aware of what was happening in my life. I shared my story for the first time with the Flying Doctors team at the Tharaka Nithi Fistula campaign held from August 25 to September 5, 2023. It was my issue,” says Rose, a granny.

She admits that although it was a hard decision, she was at ease with it. “I would have revealed it to my husband, but he is a drunkard he wouldn’t have helped in any way,” Rose points out.

Rose notes that since 1994 she has missed many family occasions all in the name of not feeling well. “I had to shun them all and live alone since I didn’t want shame,” she says.

Change of tune.

But now things have changed. Rose’s life has been transformed by the Safaricom Foundation, The Royal Media Services, and the Flying Doctors Society of Kenya in their Fistula campaign.

“I heard the good news via Muga FM- a Royal Media vernacular station airing in the Ameru dialect. The description of the condition they were promising to treat seemed similar to what I have been suffering from. I listened and I made up my mind to attend the clinic,” she says.

She notes that after doctor diagnoses they found out that she was among women who needed treatment. and she was treated. She notes that for now, she has seen a change.

“I was treated, and my story has changed for good. My story is similar to the women in the Bible who suffered for many years with an issue of blood,” she explains quoting Mark 5:24-35.

Rose, a farmer confesses she never thought there was a cure for the condition since she had never heard about it. “I had not heard about it. Initially, I was hesitant about the treatment. Actually, I was not sure how I would be treated but I am well now,” she says happily.

Although she had made up her mind not to open up about the condition, she encourages women suffering from fistula to visit hospitals and find out more about the condition. “I am sure it’s expensive to treat the condition, but I would like to encourage fellow women, suffering from fistula, to visit doctors for advice,” she urges.

Rose adds that she has always been in a dilemma when travelling with public means for she didn’t know what to do.” I had to miss meals and drinks whenever I was travelling since, I knew if I ate anything, I might mess up. I would carry a lesso whenever I am travelling to avoid embarrassment,” she says pointing that as a management skill.

“You have to be smart whenever you are with people and know when to leave a gathering and even when to join. Fistula patients don’t have the liberty to spend a lot of time in social gatherings,” she adds.

Fistula is a condition usually caused by surgery gone wrong or an injury during delivery. It is estimated that, 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.

Sarah, 33, narrates the events of what happened in 2021 as if they happened yesterday.

“Just like most new mothers, I had prepared to receive my firstborn child. I had planned the hospital I will deliver in and so on,” Sarah kicks off the interview.

Sarah a single mother says she didn’t expect that the day she received her firstborn child would change her life negatively. “My child came earlier than expected but I was lucky to have a traditional birth attendant to assist me in delivering,” she notes.

“I suffered some perineal tears during delivery, but I didn’t know they were worse since I was a first-time mother. After delivery, I decided to visit the hospital and it’s here I realized all was not well but the fact that I didn’t have enough resources I couldn’t go on with medication,” explains Sarah.

Local dispensaries are not able to treat the condition and they refer you to a bigger hospital where most of the time are far from residents.

Sarah notes that fistula is so frustrating that it cuts a person’s relationship with her friends and relatives as one doesn’t want to expose herself to the stigma it brings.

“It’s a humiliating condition. It’s automatic that people start avoiding you. You will find that once people realize you have such a condition, they start backbiting you and none of them is bold enough to ask what is happening or ready to help,” says Sarah.

She notes that most people don’t know about fistula, and some think it’s a curse. The fact that people don’t open up about it has made the information about it scarce.

“I think fistula is among the worst condition as it even hinders you from making a living. You live in fear all the time,” she says.

She points out that the condition has hindered her from engaging in a relationship that can lead to marriage. “You can’t even try to entertain a relationship because you might get heartbroken. Few people would start a serious relationship with a person with the condition. A lot of times, to avoid heartbreak, you decide to stay alone even when you see potential suitors,” she says.

Sarah adds that the condition also makes one lose self-esteem hence affecting personality which has ripple effects on a person’s productivity.

She notes that she heard about the Flying Doctors Fistula Campaign via the radio and since she had longed for such an opportunity, she wouldn’t have let it pass.

“I received the information about it via Royal Media Services and that’s when I decided to come and find out whether I could get help. I paid Ksh 2500 from Narok to Tharaka Nithi to come for the treatment. I am grateful I have been treated and so far, so good,” Sarah says joyfully.

Sarah notes that she is expectant, that she will go back to her normal life and engage in nation-building activities like other people.

“I am grateful to God and the Flying Doctors Society of Kenya. They have given me a reason to smile. I am now okay and ready to start mingling with people freely without fear like I used to do before. My focus will now be to look for a better job so that I can provide for my child without straining too much,” she notes adding that she has been in a fistula prisoner for the last four years.

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.