Hoping for treatment, Anifa went back to the hospital with hope that she would find a solution to the newly found problem. Unfortunately, the cost of treatment was too high for her to afford, and she resigned to the fact that this was her new life. She gave up on finding a solution.

Resigned to her fate, Anifa found ways to manage her new status. She isolated herself from friends and relatives and only confided in her husband who was extremely supportive. It was their family’s secret. Anifa could not host, neither could she attend any social gatherings for fear of making a mess and embarrassing herself. She could neither work because of her situation which often left her reeking of urine. This therefore meant that she could not afford diapers to shield herself leaving her to use rags and pieces of clothe which often resulted in burns and sores in her private parts and limiting her movement. Anifa’s only consolation was that at least she had her husband’s support who would often help her clean up after making a mess and feign not smelling the pungent smell that often engulfed their house.

One afternoon while going about her day at home, Anifa heard on Radio Citizen about the medical camp in Webuye county. She decided to take a chance and call the number that was being shared. Upon making the call, she shared her problem and was invited to the medical camp, unfortunately she could not afford the fare and missed the opportunity. She however did not lose hope as she now knew there was a solution for her problem.  When she heard about the medical camp in Thika, she was determined to attend it. She arrived at Thika Level 5 Hospital on 10^th June. She was screened and approved for surgery. Anifa  successfully went under the knife on 11^th June 2024 and is overjoyed with her progress.

She is grateful to M-PESA Foundation, the Flying Doctors Society of Africa, and Royal Media Services for the help she and women like her have received.  She regrets not speaking up to get the correct information earlier and urges all suffering from fistula to be open and seek help.

At the time her husband had just finished form four and she was waiting to join a tertiary institution for higher education.

“I was a young girl and I happened to get pregnant out of wedlock. Unfortunately, I was not attended by a professional birth attendant instead, I used a traditional birth attendant,” she says pointing at this as the genesis of her woes.

Since that day Mary says her life has never been the same again as she realized she would no longer hold either long or short calls.

“Initially I didn’t know where I was ailing but I knew all was not well as I couldn’t hold a call of nature,” she says.

Mary describes the condition as painful and shaming as rarely does one concentrate on a work that involves people.

“Fistula is like disability. It hinders you to live life. It suppresses your esteem and alienates you from society,” Mary notes thoughtfully.

She notes that since the time she realized she was ailing from the condition she has lived a reserved life. “I am lucky my husband has been a pillar. She has supported me. I don’t know how life would have been without him while I am in this condition,” Mary wonders.

She notes that most men would abandon their wives if they ever found them in such a situation since being around them sometimes might be heartbreaking.

“Everyone wants a person who is accepted by society but sometimes it’s discouraging when people are kind of sidelining your partner. As a human, you can be tempted to separate from a person with an issue. It takes God’s hand,” she says.

According to Mary’s husband Mulwa Mulei, there is a need for the private sector to partner with the government to help women suffering from such conditions.

“I am not a man of means. I am still young and it’s overwhelming when you have a partner with such a condition. A person suffering from fistula might not be able to focus on her work means most of the time she ends up being at home mother hence support,” remarks Mulei a B.O.G teacher in Kitui County.

He observes that there are a lot of people in such a quagmire, and they are in dilemma on the next step.

“Some might not be suffering from fistula but are in a trap. It’s a responsibility of the government and the society to help people who are stuck especially in health-related issues,” he urges.

He further urges the media to look for health-related content to educate people in the comfort of their houses.

For now, Mulei are grateful for the assistance they have received from the Flying Doctors Society of Kenya, Safaricom Foundation and the Royal Media services for their services.

“When we serve the people well, it is also a way of serving God,” Mulei concludes noting this as the greatest service a person can offer.

Growing up, Isnio was charming and friendly. She loved being in crowds but her once happy life was cut short by a condition she didn’t have knowledge about. She has been forced to live a quiet life. She doesn’t congregate with other women. According to people in her community, she is a bad omen.

“I got a fistula in 2017 during the delivery of my firstborn. At the time I had just turned 21 years old,” Isinio kicks off the interview.

She explains that at the time she didn’t know about fistula leave alone she was ailing from it.

“Like most women in my area, I delivered at home through traditional midwives and therefore I didn’t know immediately that there was something amiss. I realized I had an issue after,” explains Isinio.

Isinio says that initially, she thought it was normal to have injuries after birth although she was not sure of the extent of damage. “I was shocked that I was not able to control my bladder and it was a persistent challenge. I enquired about it from my mother and sisters and they couldn’t understand it. It’s here I decided to seek medical advice,” says Isinio a Garissa County resident.

“It’s at the health center, she visited, she first heard about fistula. I had neither heard about that before nor had I come across someone suffering from it,” she narrates.

“The health center I visited didn’t have facilities to treat the condition they therefore referred me to another bigger hospital but unfortunately, I didn’t have the resources to go for treatment,” she speaks.

After a while, she realized some of her friends and neighbors were not comfortable with her and this saw her withdraw from them. “I knew I had a problem, and I didn’t want to be a burden to anyone. I decided to pull out from crowds,” she notes.

Isinio says how uncomfortable fistula patients are as they rarely know when they have soiled on themselves.

“Most of the time I would spend time alone in the house as I couldn’t do a lot in this condition.

Fistula cripples a person. It not only affects your social life, but it also affects you physiologically,” she notes.

Although the society alienated her, she is happy that her husband stood with her during all that time.

“Relatives didn’t have an issue with me. They gave me their support. They were understanding and they would always look for opportunities to help me,” adds Isinio.

Relief…

For now, Isinio’s life has changed after undergoing surgery to treat the condition. “We have community health workers in my village and it was during their usual visit when they broke the good news about the medical campaign to treat fistula,” she says happily.

“First, I was worried since I thought it was a paid medical camp, but I felt a sigh of relief when they told me it was a free campaign,” she notes.

Isinio says that her husband is not a man of means and they couldn’t have raised the money even in a decade. “They told me about the campaign. I came, I was checked, and doctors found out that

I had a problem. I had been treated and now I am I well,” she remarks.

Isinio urges the government and other humanitarian organizations to look at issues affecting poverty-stricken people and make a difference in their lives.

“I am very grateful to The Flying Doctors Society of Kenya, Safaricom Foundation and The

Royal Media Services for restoring our dignity,” she concludes.

A lot of married women who are not lucky enough to bear children of their own are in most cases divorced. They don’t get the respect they deserve in society.

This was the case with Faham Muhamed. Faham 27, got married for four years but she was not lucky to have a child of her own.

“I am a divorcee. I was married for four years but I wasn’t lucky to have a child” says Faham a

Garissa County resident.

Her lack of a child saw her husband flee leaving her at Kakuma Refugee Camp. “We are refugees leaving at Kakuma refugee camp,” she says.

Faham recalls that it was during her marriage that she realized she had another condition that stirred her marriage woes, perineal fistula.

What’s Perineal Fistula…

Perineal fistula is a malformation that involves a misplaced anal passage that is often narrowed.

This kind of malformation is generally present from birth. Its causes are not known, however,

Researchers say environmental factors such as drug use may play a role.

Children with the condition may exhibit this kind of symptoms; not passing stool on the first day after birth or two, passing stool through a misplaced position, swollen belly and missing or misplaced anus.

Seeking help…

“After two years of marriage I realized all was not well I decided to look for traditional and religious intervention but this didn’t work. It’s here I decided to visit a hospital for advice and I learnt that I have Perineal fistula,” she remarks.

The fact that she didn’t have cash saw her go back into the house and wait for the day that her God will send an angel to heal her.

“Treating this condition is too expensive for people without a stable income. I couldn’t afford it,” she speaks.

Faham notes that she had lost hope of getting treated until she saw a text message from

Safaricom invited her to a medical camp.

“All women are invited to attend this medical camp, where relevant health discussion on fistula will be done, and free treatment will be given to fistula patients. Tell a friend to invite a friend as we all work together to overcome fistula,” read the invitation text.

Faham notes that she was used to living with the condition. “Yes, it was affecting me, but I didn’t have an option,” she notes.

“I went for the treatment. Got diagnosed with perineal Fistula and I got treated,” says Faham happily.

Faham is grateful that she is back on her footing. She points out that the treatment by The Flying

Doctors Society, The Safaricom Foundation and The Royal Media Services as the best gifts she has ever received. “I will now be able to look for a job and at least live a life,” she states.

She observes that most women suffering from rare conditions such as fistula are belittled and despised by the community members. “There is a need for civic education among people in the village. The elderly and the ailing need to earn their respect. Despising the sick breaks, them hence making the situation worse,” she says.

Fahim says she will now go look for casual jobs and at least manage to feed herself as she gets clear on what she wants to do with her life.

Rahab, a mother of one, describes her last two years as hell on earth. “For the last two years I would not leave the house and engage in communal activities,” says Rahab.

Rahab says she thought her fate had been sealed. She never believed a day would come and win her freedom of movement and interaction back. She felt short-changed. She had done nothing with her life when fistula struck her.

“I was married off in my teenage hood. Going with our culture, this was normal. Most girls get married off earlier. Girls are equated with wealth,” says Rahab 20.

“I conceived and when the time to deliver came I went to the hospital, and I was happy to get a gift of a baby girl,” narrates Rahab.

But her joy was short-lived as it was in her first month, she realized all was not well. “I had an issue with controlling urine and even long calls. I would reek of urine. People would avoid me like plague,” she says adding this gave her husband a license to divorce her.

“He didn’t understand that it was not my fault. A fistula is like an accident that can happen to anyone,” she points out.

She adds that some people thought she was cursed and that’s why she was leaking feces and urine, hence avoiding her.

“I had a difficult time. I would stay indoors, and I wouldn’t attend events. Apart from close relatives’ other people would avoid me,” she explains.

Although the withdrawal methods would work for her, she points out its not dependable as there would come a time circumstance that would force her to be in people. “No man is an island. You can avoid people sometimes but not at all times,” she remarks.

For now, Rahab’s story has taken a new twist after attending a fistula camp held by the Flying

Doctors Society of Kenya in collaboration with the Safaricom Foundation and the Royal Media

Services.

“I heard about fistula camp through a health community volunteer who used to visit us. At first, I thought they would charge us, and I was worried because I was not sure I would manage to raise the required amount of money,” she says.

“I visited the camp where I was treated and now am well. I am grateful for this team for they have restored my life,” she says.

Rahab encourages women suffering from fistula not to fear to speak out and look for help. “I would like to encourage women to be their sisters’ keepers. We need to check on each other to live a healthy life,” she says.

Way forward….

“I am grateful. I will be able to hold hands with other women in development-oriented activities,” she says.

While fistula is rarely life-threatening, it can decrease a person’s quality of life. Women and girls with fistula are often unable to work, and many are abandoned by husbands and families and ostracized by their communities, driving them further into poverty vulnerability and decreasing their quality of life.

According to research by the World Health Organization, WHO, most women with obstetric fistula lose their source of income due to their incontinence and become an economic burden to their families. This pushes them to poverty, leaving them in bitterness, trauma, and depression and suffering disappointment.

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.

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.