For years, Tabitha lived with the condition not knowing who to share with her sufferings. As she aged it continued to worsen. One day she decided to confide in her daughter and her daughter in law of her condition. They were very supportive of her and sort to get her treatment. It was during their quest to get their mother treatment that they heard of Makueni Fistula camp for women leaking urine and stool. They went to their mother and brought her to Makueni Mother & Child Hospital.

On discharged sitting between her daughters, she is very happy that she is not leaking anymore and she laughs as she is being explained the exercise that she has to do to strengthen her muscles. She looks over to her daughter and tells her to keep reminding her of the same. She says “it was not too late for her; she has control of her urine and stool until the toilet”

In the late 2018, she was diagnosed with cysts, and the doctors recommended that she goes for surgery for the removal of the cysts. To her, the surgery was supposed to be a simple process. After the surgery, she noticed she started leaking urine. She went to sort treatment at Kabete Gardens in February 2019 and after repair was done it was still not successful. While still at the hospital, she kept talking to her children on phone who gave her strength to carry on. She was discharged and went home, with a fresh wound, being weak and having a 3 year old child carrying out simple house chores was an uphill task for her. It was not long before the husband burnt a few of her good clothes and chased her out of her matrimonial home. With no money, she sought the support of the brother in law who gave her fare to go to her sister’s place. While still at her sister’s place she heard of the fistula camp at Makueni her sister encouraged her to come and try her luck once more. She sits at the hospital bed with faith that all will be well. She will is consoled daily by the voice of her children and prays that she will stop leaking and be reunited with her family.

As the norm of the school for every girl discovered to be pregnant, suspension was imminent. She sort for guidance from her mother on the pregnancy and so she felt what she believed to have been labour pains but did not bother about it. She stayed home and the labour continued and lasted 7 days. While at home, she felt the urge and the pressure of the baby coming out and with all her strength she pushed the baby out delivering at home. The joy of looking at her baby boy overwhelmed her so much that she did not notice that she was damaged. Nobody had cautioned her on what to expect after delivery of her baby.

After a few days, she noticed that she could not control the gas that came through her birth canal. Being a teen mother, she decided to consult her mother and other elder women within her family for advice on what that could have been. Everyone gave her the same answer that it was a normal occurrence after birth; that the reason was that during the birth of her child, cold air must have entered her body through the birth canal and that, was the air coming out. She took their word as truth, after all, these women had been in that journey long before her, they therefore, knew better so she thought.

After several months, she vowed to herself that it was a matter of time and everything would go back to normal. Her urge to continue with her education led her to the decision to leave her child with her mother and go back to school to finish secondary school education. It was then, that she noticed that  all was not well, even after washing  herself, she noticed her under pant was not clean; stool was passing without her being able to control. Her body started having a stench and this lead her to lose her friends. She was eager and determined to get better. She sought for treatment from different clinics and all she was given was medicine that was meant to clear the smell. The medicine however didn’t help; she finally resorted to keeping to herself, finish her education.

After completing secondary school in 2014, she resulted to staying at home assisting in household and farming activities to avoid public interaction. She lost appetite of consuming food, with the mind-set that eating made the situation worse. During gatherings where it was mandatory for her to attend, she would attend but refrain from eating in order to remain clean. It was not until; the year 2019 that she saw an advertisement on Television for a fistula camp and recognized that the condition explained on the advertisement was what she was suffering from. She called the numbers provided but being miles away and with no job or income she could not afford to attend. She explained her predicament on phone and when she was told she will be facilitated with transport to attend the Nyeri Fistula Camp nothing could hold her.

Jennifer believes her life has been given back to her. Looking back at her child Daniel, now 8 years old, she is looking forward to normalcy to her life with no shame. She parts by saying “I thank Safaricom and The Flying Doctors Society for helping me, May God Bless you and may you continue doing the good work”

By Lesley C.

A friend will ask, how are you? Often we reply, am OK. But inside we’re not fine at all. We are all created as beautiful vessels. But sometimes the vessels break. We break, emotional, spiritually or physically. Others can be mended, others take long and others suffer silently alone without being mended.

A woman is a beautiful vessel, made by God. We are strong vessels but life can be so hard and leaves us broken. Though broken a woman can smile and takes care of her baby and family, carrying the wound and scar for years. I thank God that this scar wasn’t on our face, coz all women could be ugly, and we carry this scar for our families, our clan, our community, and our country. Without this scar there are no people, no presidents, no CEO’s, no Doc’s, no life on earth, this is the scar of ‘life’, scar of pride, scar of honor.

Today we come out to honor our scars, to heal our scars and to tell the world we are still the most beautiful and strongest vessels made.

We thank our Almighty Potter, who is mending our hearts and our scars through the gifted hands of our surgeon’s through the Flying Doctors Society, Created by our own children brought into this world by the scar.

Fistula doesn’t choose the vessel to destroy, whether you are poor, or rich, educated or not. It’s like any other disease but carried by shame and stigma.

Let’s lift our pride high women. This is a Scar of pride and Honor. We were beautifully and wonderfully made. Let’s shine and dance with Pride & Honor.

We call upon our children, our husbands, brothers & sisters. Don’t abandon us as we struggle to bring forth humanity.

GOD BLESS US. WE ARE PHENOMENAL WOMEN, GOD’S OWN CREATION

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.

See Photos here

FDSAs key intervention in the area of Medical Outreach is in conducting of surgical repairs for a condition known as Obstetric or Vesico Vaginal Fistula. This intervention is done in the form of VVF Surgical Medical Camps held periodically throughout the year in various hospitals.

Kenyatta National Hospital, being the largest VVF repair centre in the country receives over 400 VVF related cases each year, close to half of the 1,000 VVF cases nationally. The funding is earmarked for a project, run by FDSA aimed at reclaiming women’s dignity as well as protecting families and marriages from disintegration – a key consequence of VVF. A significant part of the project includes training of local specialist gynecologists, surgeons and registrars in fistula surgery as well as building capacity on the ground to handle Fistula.

Obstetric (or Vesico Vaginal) fistula is a devastating condition affecting poor rural women and girls. It manifests as an abnormal communication between the urinary bladder and vagina, which leads to uncontrolled, continuous leakage of urine and/or fecal matter. The condition most often occurs as a complication of obstructed labor but can also be caused by radiation, surgical trauma or accidents.

Inadvertently, majority of VVF incidences occur due to lack of access to qualified health care personnel during the labor period especially in cases of obstructed birth process.  The situation is usually worse off for new mothers, especially teenage mothers because their pelvis is still too small for the baby to pass through. Obstructed labor can therefore lead to injuries to the mother, child or both. This condition has perverse effects on the emotional well-being of the sufferer and completely destroys the individual’s social capacity. Obstetric fistulas affect women of all ages and account for 8% of maternal deaths worldwide.

The Flying Doctors’ Society of Africa (FDSA or The Society) was established in 1971, to raise funds for the spread of Medical Outreach in Africa through a membership scheme which guarantees free evacuation services to paid-up members. The Society also raises funds through fundraising activities, selling branded merchandise as well as donations. The Society is a charitable organization which puts to good use all unutilised subscriptions not spent on evacuations by funding Charity Evacuations and Outreach Programmes that ensure Medical facilities are accessible across the region. Since its inception, the Society has contributed the equivalent of 1 billion shillings to the spread of Medical Outreach in Africa.

FDSA works hard to ensure people all over East Africa have access to life saving medical attention. Part of the proceeds from membership subscriptions are used to help people like Rose. Become a member or donate today and help by being part of the solution.

This condition is estimated to affect over 2 million women and this includes young girls. What is even more shocking is that, these numbers keep escalating by the day. Fistula can occur when good care is not administered especially to those women who give birth at home, when the birth process is spearheaded by traditional healers, and when women give birth at a tender/early age.

Most (if not all) of the women with fistula suffer rejection from their families and the community at large. The psychological and social consequences can be very devastating and so, these women end up keeping to and isolating themselves due to the embarrassment that comes with the condition.

However, there’s good news to all women/girls out there! In up to 90% of cases, fistula can be surgically repaired…meaning, fistula is treatable/preventable and so this would restore our women’s dignity!

I joined AMREF as the Outreach Manager for the Programme in November 2003. During my tenure, I have overseen the expansion of outreach in terms of number of hospitals and number of patients benefiting. Due to funding from FDSA, outreach has tripled in their projects (FDSA used to give 4 M in funding every year, and now they give about 14 M per year). We were only visiting a total of 35 hospitals in Kenya and Tanzania, but currently we go to over 150 hospitals in 8 countries. Outreach has grown from USD 700,000 in 2003 to USD 4M currently.

What are the key milestones for the Outreach Programme?

Expansion of outreach meant more funding and this was made possible after FDSA tripled their funding and our budget as well. VVF development centres were set up (e.g. in Kenyatta National Hospital) for reconstructive surgery, and Dr. Khisa (who is in charge of VVF) was hired and in turn trained a lot of doctors. About 5 hospitals used to be visited in Muhimbili (Tanzania) and now we visit 15 hospitals. From 2007, 1,000 patients get treated as compared to 200 and 300 from previous years. Not only do we repair a huge number of recently acquired Fistuli, but also Fistuli from decades ago.

What is the current VVF prevalence?  Give statistics.

An obstetric Fistula is the most devastating of all pregnancy related injuries and affects more than 100,000 African women each year. It is estimated that there are over 5,000 VVF cases reported in East Africa each year. This condition mostly affects poor women and girls who cannot afford skilled supervised health facility delivery. Over 90% of the cases are caused by difficult and prolonged obstructed labour. At Kenyatta National Hospital alone, 400 cases are reported each year.

What more do you feel can be done?

I feel that we need to prioritize disability repair and rehabilitation in both women and children. Because of distance, especially in reaching those who have no access to proper healthcare, we have to fly to reach our patients and that is very expensive as our programmes mainly depend on donors and well wishers. In addition, the population in Kenya has multiplied and exceeds economic growth. Demand for healthcare is therefore much higher.  If the government was to pay for health insurance (about Kshs. 2,000 per family), then majority would have access to clinics.

If given the ability, what would you change?

If given the capacity, I would invest in more reproductive health programmes which in turn would help reduce Fistula. These programmes include training (Midwives), Family Plannning and Ante-natal services, among others.

Which programmes or areas of intervention would you introduce if given the resources?

As mentioned earlier, there is a need to prioritize more on disability repair and rehabilitation in women and children. These areas include injuries, congenital malformations, burns, Cleft lip, Fistula and maternal child health.

What is your vision for the VVF programme?

Unfortunately, VVF is there to stay in Africa. Because of poor healthcare, many women are delivering at home. Fistula repair will continue to contribute to better quality of life and empowerment for the disadvantaged women of Kenya and Africa. There is a need to not only sustain the Fistula programme, but to also expand it. Currently, we are being invited to go to Mogadishu, Somali land, South Sudan, among other countries. The number of repairs awaiting reconstruction in Mogadishu alone is thousands, while there is no money (1 repair costs USD 300). Fistula repair is women’s empowerment-the, most important empowerment opportunity to offer women.

VVF FACTS

Vesico-Vaginal Fistula is an abnormal connection between the urinary bladder and the vagina, the result being constant leakage of urine. Recto-Vagina Fistula is an abnormal communication between the rectum and the vagina, the result being leakage of stool. These patients smell of urine or stool all the time. An obstetric Fistula is the most devastating of all pregnancy related injuries and affects more than 100,000 African women each year. It is estimated that there are over 5,000 VVF cases reported in East Africa each year. This condition mostly affects poor women and girls who cannot afford skilled supervised health facility delivery. Over 90% of the cases are caused by difficult and prolonged obstructed labour. Their pain is constant, and their shame makes them outcasts in the society. Most of the time, the child they struggled so hard to deliver will be still born.

At Kenyatta National Hospital alone, 400 cases are reported each year, with AMREF being the only organization which is currently involved in the surgical treatment of VVF patients in East Africa (since 1992) through their Outreach Programme. FDSA has been funding the Fistula repair activities-an initiative that restores the dignity of the affected women and improving their lives.

To learn more about the outreach programme click here

Kenyatta National Hospital, East Africa’s largest referral hospital alone receives 400 cases annually of Obstetric fistula, which is known to be the most devastating of all pregnancy related injuries.

Here we met, 32 year old Purity Kageni, one of the thousands who suffered for eleven years from Obstetric fistula. Prolonged labor is one of the main causes of Obstetric fistula. So destructive is the injury that later it leaves the woman in constant pain as she almost continuously leaks urine and fecal matter.

The result is the unbearable odor of the condition that becomes a deadly curse, that saw Purity live as an outcast in her own family, loose several jobs, and eventually attempt to take her life twice.

Obstetric fistula can be treated with surgery, but thousands remain ignorant of the available treatment and the condition itself. Beatrice Muthoni, an HIV patient is also another survivor of fistula, who despite living in Nairobi city, suffered for two years.

With health facilities available, Beatrice claims that even the health workers in public hospitals didn’t tell her that the solution to her condition was surgery. She perhaps is just one the few lucky African women, who had her husband stand by her, but also underwent self isolation as she never spoke of her condition to anyone.

According to the African medical and research foundation, AMREF, It is estimated that in East Africa alone there are over 5000 new fistula cases each year. In Kenya, the condition mostly affects poor women and girls in remote and rural parts due to a severe shortage of health facilities.

Many women are forced to walk in labor for long distances in order to find a skilled supervised health facility to deliver, and often its too late for the baby.

Health workers in Kenya have in the past complained of a shortage of trained health workers, cited low wages and poor work conditions and are currently on a strike. The Kenyan government has in return sacked at least 25000 health workers in the country in the face of an existing shortage with no replacement.

With 400 cases reported every year in Kenyatta hospital, only 25 % are operated on. The cost for a single surgery is on average 300 $, a reason why many stay back at home due to lack of money.

For Purity, it was sheer luck after years that she underwent surgery during a free AMREF fistula camp. Later she tried reconciling back with her family only to realize that she was tagged for life as an outcast.

Thousands of women are reported with fistula every year, but the biggest loophole remains the access to information. This is one of leading causes of maternal mortality in east Africa, where government systems have failed to provide adequate health facilities and personnel to manage a curable and preventable condition. Experts believe that fistula is here to stay unless something is done soon.

Source: PressTV

The KNH Director flags off the VVF walk

For six years running, AMREF in partnership with KNH have been conducting National-wide VVF camps lasting two weeks.  This year’s camp was held on 10^th to 26^th June 2011 following media sensitization campaigns in the month preceding the camp and a VVF walk held on 10^th June 2011. As is the case in the previous camps, patients came from far and wide, with representation from all the regions in the country.

The OF patients turnout was largewith 320 women being screened and 102 repaired. KNH fully designated clinic 66 for VVF screening and surgery on routine bases and the theatre rooms renovated by AMREF are now operational. 45 medical staff were trained including 15 doctors and 20 nurses both KNH and the rural district hospitals.

Sofia Abdi, nominated Member of Parliament (MP) who hails from Ijara, one of the safe motherhood sites graced the occasion and pledged to lobby the government to play a bigger role in fistula treatment and prevention.

Drs Musomi and Khisa lead the MP through a tour of clinic 66

Drs Musomi and Khisa lead the MP through a tour of clinic 66

Participants also included five previously repaired and healed patients, who recited poems during the walk and launch of the camp.

Mothers who turned up during the camp at the far end

Previously repaired patients during the walk

To read some of the patients’ case studies, click HERE