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.

Sandra suffered fistula in 2015. She was unable to seek any medical attention when she lost her baby. It can be assumed that because of the advanced stage of the pregnancy and lack of medical assistance. Sandra suffered extensive tears which resulted in incontinence of stool.

Prior to getting sick, Sandra was a casual labourer. The condition forced her to stop working. “I was unable to control myself. No one was going to employ me. I therefore remained unemployed until I could get help,” she narrates. Being a single mother, she struggled to get by and provide for her two children. She retained only a few friends as not many people wanted to be around her because of the stench she emanated from time to time.

Luckily for her, in 2019 she was able to get free corrective surgery from the Flying Doctors Society at the Kenyatta National Hospital (KNH). Sandra was able to resume her normal life. It was, however, short-lived because six months later she was unable to pass urine. A blockage had formed. This caused her a lot of discomfort and pain. It affected how she navigated her day-to-day life.

In January 2021, Sandra proceeded to seek help at a medical facility in Nairobi where she underwent further corrective surgery. Unfortunately, her relief was short-lived as the blockage of urine recurred.  In May 2021 she went back to KNH hoping to get relieved of her pain and discomfort. Once more through the Flying Doctors Society she underwent corrective surgery.

She is hopeful that she will make a full recovery. She is also grateful to the Safaricom Foundation and Flying Doctors Society for offering free medical services.  “I look forward to resuming work and being able to provide for my children and myself” she remarks.

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!

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.