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.

Celina Nekesa sounds tired, frail even. It could be from anxiety. She is just about to be wheeled into the theatre for her corrective surgery. Celina is a 63 -year old single mother of nine living in Kituni village in Bungoma County. She has sadly lost seven of her children and does not have a relationship with the two living children. You can tell from her voice that this is an emotional topic for her.

Celina developed fistula in 1992 after delivering her last child. Celina narrates that she carried her child for 12 months instead of the regular nine. Despite attending pre-natal clinic at the hospital, Celina had a local midwife attend to her. Whenever she experienced some semblance of labour pain and called the midwife, she would be told that the baby was not yet due. Why would she argue with the midwife who knew what she was doing? it was her job. Celina obediently sat at home and waited for the due date.

After labouring for seven days, Celina went to Misikhu Mission Hospital hoping to get help. While there, she gave birth to a sleeping baby. As if that was not enough trauma, in a sombre tone, Celina emotionally narrates how the nurses did not assist her to deliver the baby fully. She was assisted to only deliver the baby’s head and was left in a most uncomfortable position all night. When the attending doctor came the following morning, he pulled out Celina’s 7.8-kilogram baby. At this time, she had already developed fistula.

This traumatic delivery left Celina unable to control her flow of urine. Having separated from her husband and moved back to her father’s home, she had no choice but to fend for herself. Celina resorted to wrap herself with pieces of clothing to try and manage her situation so that she could farm to get some food and income for herself.

Due to lack of funds or anyone to assist her, Celina has been unable to receive any medical assistance. She heard about the clinic on radio and came to hospital hoping to get relief. 7^th October 2021 will be a turning point for Celina. She is happy to receive treatment and looks forward to life after recovery.

Gladys Masiembe is a 52-year-old woman. She comes off as very confident and open. She narrates that she is married and has eight children. She first suffered fistula in 1995 after having her first child.

Gladys had prolonged labour and delivered a generally heavier than average baby. The baby was four kilograms heavy. She laboured for two hours before finally delivering her baby. Gladys narrates that during her previous pregnancies, she laboured for less than an hour, therefore the two hours was an unexpected delay. She was labouring at home with the assistance of a local midwife as the nearest hospital was too far for her to arrive in time. The healthcare system had failed her.

After delivery, she realized that she was unable to control her flow of urine. She sought medical help at the local hospital where she received prescription medicine after presenting her problem. The attending doctor gave the prescription without examining her to access the extent of the problem. She took the medicine hoping to get some relief, hoping that her problem would be solved and that her life would resume normalcy. She religiously took the medication and her situation improved and she was happy with the effectivity of the medication. This joy was, however, short-lived. as soon as she completed the dose of medication, her problem recurred.

She visited a different hospital after the recurrence and hoped to get a permanent solution. The attending physician at that hospital examined her and diagnosed her with fistula. Again, she received a prescription and was sent home. The medication she received only offered temporary relief because as soon as she completed the dose she reverted to her previous condition. She managed her situation and accepted her fate.

After six years, Gladys delivered another baby. During her delivery, the baby did not come through the birth canal. The local midwife attending to her had to push the baby back into her uterus so that it could come out through the birth canal. This made the situation persist. Again she was put on medication but as soon as she completed her dose, the problem continued.

Gladys was unable to work. Before she developed fistula, she was a farmer. She would till her land to feed her family and sell the produce for some income. Since suffering fistula, she was unable to do either. Further, her social life was severely curtailed. She could not associate or socialize with her friends and family due to her condition. She felt embarrassed and lonely. Luckily, her husband never abandoned here. Despite having to sleep in separate bedding, he did not chance her away or mistreat her.

In 2018, Gladys heard about fistula treatment in Webuye on the radio. She visited the medical facility offering the service and was given some medication which did not treat her.

On 15^th September, 2021, Gladys received a phone call about treatment for fistula from Bungoma’s First Lady’s office. She prepared to travel to Webuye for surgery on 4^th October 2021 when she was scheduled to go under the knife.

Gladys sounds relieved to be able to resume her life before fistula and is hopeful that she will make a full recovery. The highlight for her is that she can resume enjoyable activities such as attending church. When coming for the surgery, she invited two of her friends suffering from fistula, but they refused to accompany her because of the myths and misconceptions about surgery. She looks forward to going back home and sharing her success story and also intends on sensitizing other women on fistula and encouraging them to seek help. She is grateful to the Flying Doctors Society of Africa for putting an end to her misery.

Caroline Naliaka Wafula is a 30-year-old mother of four living in Sikanga village in Bungoma County. She sounds aloof but agrees to proceed with the interview. Having dropped out of school in class five, Caroline got married at an early age and resultantly bore children while still young. She had her first child in 2011 while she was 20 – years old. She developed fistula in 2018 while delivering her third child.

After delivery, Caroline realized that she was unable to properly control her stool flow. Whenever she felt the urge to pass stool, she could not hold it and had to relieve herself to avoid soiling her clothes. She knew she needed to get medical attention but could not seek any help as she could not afford it. She thought that she was having a stomach upset and constantly took Flagyl, an over-the-counter antibiotic. Needless to say, the medicine did not remedy the situation.

She kept her condition to herself and told only her husband. She tried to maintain a relatively normal life but was keen to listen to her body and rush to relieve herself whenever she felt the urge. She went on with her work as a farmer and socialized with friends though at a very limited rate. She was very conscious of her condition and did not want to embarrass herself. On several occasions she would have to rush to the bush to help herself, an act that she was not proud of or keen to perform whilst amid her friends and family.

Caroline took her baby to the clinic in early 2021. While there, the doctor asked her if she would be interested in cancer screening, and she answered in the affirmative. The doctor checked her and informed her that she had fistula. He informed her of the possibility of having surgical treatment at the hospital and took her contacts with the promise to call her when the clinic began.

The doctor kept his word and called her. On October 4^th, 2021, Caroline received treatment and is currently in recovery. She is excited to resume normalcy and promises to tell other women about fistula to ensure that none suffers like she did.

Caren is a ball of energy and confidence.You can tell from her speech. Life has, however, not been a bed of roses for her. She gave birth to eight children unfortunately, she has only four living children.

Caren has been living with fistula for the past 33 years. She was 14 when she became ill. Her case of fistula can be attributed to the fact that she gave birth at a very young age and did not seek medical assistance at the time. She says when she realized something was wrong, she took it as a birth defect and accepted her new condition and told no one about it. She assumed that she had suffered a tear while giving birth and that it was normal to experience incontinence after delivery. “I took it as being normal for me and therefore did not tell anyone” she states. She tried her best to keep her condition a secret even though she would occasionally stink due to the incontinence. Whenever she began to smell or pass gas she would be abused, and people would avoid being around her.

Caren went on with her work as a casual labourer. One of her employers once told her that having delivered too many children was the cause of her condition. She narrates that she was once fired from a job because she kept passing gas and her employer was not too enthusiastic about letting her continue serving guests.

Caren is currently in her second marriage. Her first marriage broke down when her then husband found it impossible to put up with her condition. Caren recalls that her marriage was a living hell. “I really suffered in the hands of my first husband” she says indignantly. Her husband was neither understanding nor supportive at all.  He ridiculed and hurled insults at her due to her condition. She was emotionally and psychologically traumatized.

Having wrongly accepted her condition as a birth defect she sought no medical assistance. In May 2021, Caren got extremely bloated. The bloating caused her intense stomach pain for which she sought medical assistance at the gynaecological clinic at Kenyatta National Hospital. During one of her clinical visits, the doctor examined her and referred her to Clinic 66. She dutifully visited the clinic. This is when Caren learnt for the first time what she had been suffering from was fistula.

The word fistula was not foreign to her. She had heard it on the radio but had never associated it with her condition. The nurse attending to her told her that her level of fistula was quite advanced, but it could be treated, nevertheless. To say that she was excited is an understatement. That day, Caren and her husband slept at the bus stage at KNH. They could not afford the bus fare back home and neither did they want to miss out on the opportunity for treatment. On 27^th May, Caren received the corrective surgery and says that she noticed the change immediately.

She is grateful to the Flying Doctors Society and their partners for offering free medical services to women with conditions like hers. “I pray that God expands their territories to allow them to assist other women like me” she joyfully tells. Caren recommends that there should be more awareness within the community so that more women can speak up and not suffer in silence. She further encourages other women to seek medical assistance when they notice any changes in their bodies.

Elizabeth is a 38-year-old mother of three who lives in Kilifi. She delivered her last-born child in November 2018. She delivered normally but suspects that she suffered extensive tears because at the time of delivery she had to be sutured. She did not inquire from the doctors. She led a normal life after her delivery until October 2019 when she began suffering from incontinence of stool. This forced her to stop operating her business. She was, however, able to get someone to hold fort while she sought treatment.

In December 2019, Elizabeth unsuccessfully underwent corrective surgery at a hospital in Mombasa. The surgery left her in tremendous pain and with a sinus to deal with. In February 2020, she underwent further surgery which healed her wound but left her still suffering from incontinence.

She sought medical treatment from private clinics but did not successfully receive any treatment. In June 2020, she was diagnosed with hyperthyroidism and in August 2020 she was also diagnosed with lupus. One can only imagine the amount of stress she went through. “I am lucky that my family and friends have been extremely supportive” she states.

After going through a great deal of medical treatment, Elizabeth was advised by a relative to attend Clinic 66 at Kenyatta National Hospital. She visited the clinic on 17^th May and was enrolled into the Flying Doctors programme. She was able to receive corrective surgery and is hopeful that she will make a full recovery.

She recommends that the Flying Doctors Society expand their services to reach indigent women in other parts of the country. Having the services centralized in Nairobi may deny other women the opportunity to receive the necessary specialized treatment. She is however grateful for having been lucky to have received information on the medical camp.

Marie has been suffering from fistula since June 2019. She had been living a difficult life until she received help through the Flying Doctors Society of Africa. Marie did not know she had a problem until two months after delivery. She would often pass gas through her vagina and only thought of sharing the problem with her mother after another two months. Her mother told her that she was passing gas because she was not eating well. On hearing this, her church members began cooking and delivering food to her, but, of course, the problem did not go away.

Her husband began mistreating and hurling insults at her. “Our marriage was already sailing through troubled waters, but things got worse when I became unwell. He refused to talk to me or even eat the food I cooked. He would only speak to me when he wanted his conjugal rights fulfilled.” Marie states bitterly. She says that during this time her then 7-year-old daughter would console her and tell her that everything was going to be okay.

Marie’s husband refused to get her any medical assistance or provide for any of her needs. She had tried to get her family members to intervene, but it had all been in vain. Being a housewife, she did not have any source of income to cater for her medical needs. She also could not get any employment because of her condition. “Who will employ me while I constantly pass gas?” She asked. She first shared her problem openly with her spiritual mother in February 2021. Her biological mother had suggested that she waits for COVID-19 restrictions to ease, after which she could travel to Rwanda to seek medical assistance. In Rwanda, H.E. First Lady Jeannette Kagame has a programme that assists women with fistula.

While waiting for COVID restrictions to ease, Marie began experiencing incontinence. This was in April 2021 and she knew she needed to act fast. She was not ready to continue living in the hell that her marital home had become neither could she afford diapers which would be necessary if the problem persisted. Her spiritual mother encouraged her to go to Kenyatta Hospital to seek medical help. The church would cater for the medical expenses. She began going for clinical visits on 10^th May unaware that there was a medical camp for fistula patients.  There were several medical tests required which she could not afford. She tried to reach out to her husband’s family for financial assistance, but her begging calls fell on deaf ears.

While attending the medical clinics she had to leave her children at home with their father who was not the best caregiver. Getting back home to hungry, dirty and crying children was not uncommon. Her eldest child even missed school on several occasions. She was constantly worried about the well-being of her children while she received treatment.

When she learnt about the medical camp a week after first attending the clinic she was elated. She ensured that she arrived on time for admission to the program. Lucky for her, her spiritual mother took her children in for the duration that she was in hospital for the surgery.

She looks forward to resuming a normal life and is grateful to Safaricom Foundation and Flying Doctors for the assistance she was accorded. She is further looking forward to getting a job and supporting herself and her children. She states that a problem shared is a problem half solved. She urges other women to speak out often and share their challenges; they never know who could be their source of help.

After delivery at Maragwa Hospital, the doctors noticed that there was a problem when she was unable to control her stool and urine flow. She went for a second surgery which revealed that she had fistula. To remedy the situation, the doctors inserted a catheter and referred her to Kenyatta National Hospital (KNH). At KNH, she was unable to get any assistance as she could not afford the costs of the corrective surgery. Being an orphan, she needed to seek help elsewhere. After being asked about the whereabouts of the baby’s father, Mary revealed that she got pregnant after being raped. She had no hope of getting any help from him.

From KNH, she was referred to Jamaa Hospital where she was subsequently referred to Eldoret Teaching and Referral Hospital. She was, however, unable to travel to Eldoret because of lack of funds. During this period, she met a good Samaritan, one of her church members who took her in. The good Samaritan also paid for her weekly hospital visits to Jamaa Hospital to have her catheter changed.

During the period of illness, Mary lost many people she considered friends. “I was abused and harassed. My friends abandoned me and hated me. Even where I reside, they made fun of me. No one bothered to assist me. I did my own laundry and other chores. Whenever the neighbours brought me food, they gave it to me with a lot of contempt.” Mary narrated.

While attending Jamaa Hospital, Mary was taken to KNH and was fortunate enough to find out about the Flying Doctor’s free clinic. She was included in the list of patients to receive the constructive surgery she desperately needed.

Mary is eternally grateful to the Flying Doctors Society of Kenya and looks forward to moving on and living a normal life. She hopes to make new friends and acquire new skills that will help her improve her economic situation. She further urges other women to speak out and seek help when faced with situations like hers.