More than two million women in Kenya suffering from fistula complications face long delays before treatment due to a shortage of experts and facilities. Fistula is a tear in a woman’s bladder or rectum that causes leak in urine or feaces.

Thousands of new fistula cases are recorded among women every year with the main causes being prolonged labour, botched caesarean sections and sexual assault.

Most of the victims suffer pain and stigma and many fear seeking treatment. Such cases are high in parts of North Rift, Western and Nyanza regions.  But there is now a glimmer of hope for the women in the region following the establishment of a fistula treatment centre in the region. It is located at the Kisumu East District hospital. Similar centres have been set up at the Cheranganyi Nursing home in Kitale and at the Jamaa Mission Hospital in Nairobi.

The Fistula Foundation has helped establish the centres. Lindsey Pollaczek, the foundation’s programme director, says many affected women were forced to wait for the free medical camps organised once a year in Nairobi or Eldoret. Janet Anyango, 24, from Nyabondo in Kisumu County, says she has suffered fistula for the last 12 years.

“It’s so painful and stigmatising to live with the fistula condition. At time I wished to die instead of suffering such pain,” she says. The problem affects many women living in rural areas most who cannot afford the cost of surgery.

“I could not even afford transport to go attend the free medical camps leave alone paying the cost of surgery,” said Anyango, whose problem started in 2002 after giving birth. She was 12 years then and was therefore not well developed for a normal delivery.

Anyango is now among the first patients waiting for the fistula corrective surgery at the new center established in Kisumu.

Another patient is 30-year-old Selphin Kerubo from Nyamira County. She developed the complication after undergoing a caesarean delivery at a rural hospital four months ago. She says poor handling of her delivery resulted in obstetric fistula.

“It’s embarrassing to talk about what I have gone through. I developed a hole in my private parts where I have been passing urine and feaces uncontrollably. It’s a painful condition,” she said.

Many women who have this condition are not even aware that it’s treatable. Some suffer and die without ever seeking medication. Some even associate it with witchcraft and opt to try traditional ways of handling the problem.

Kerubo calls on those with the complication to seek for medical treatment.

The new fistula center has given hope to many women but the shortage of medics to handle the surgeries is still a major challenge.

According to Habiba Mohamed, an outreach manager at the Fistula Foundation, the country has eight trained fistula surgeons and every year, they identify 500 new patients in the Western, Nyanza and sections of North rift. About 300 of them access treatment.

Nationally about 1,000 women are operated annually in some hospitals. There are however ongoing efforts to train more experts.

“We are also in the process of setting up a Fistula Centre and also working with partners in healthcare to train more experts including nurses and doctors who will help to deal with Fistula,” said Dr John Kibosia, the CEO of the Moi Teaching and Referral Hospital in Eldoret.

Dr Habiba says stigma has forced them move door to door forced to identify fistula patients.

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