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.