Source: Nairobi Star
Every year, tens of thousands of women and girls in Africa suffer from Obstetric Fistula, a preventable childbirth injury that results in uncontrollable flow of urine and/or faeces.

Commonly referred to as fistula, the condition is predominantly caused by long obstructed and strenuous labour during childbirth. The soft tissues of the birth canal are compressed between the descending head of the infant and the woman's pelvic bone. Therefore, the lack of blood flow causes the tissues to die creating a hole (fistula) between the woman's pelvic and the bladder (Vesico-Vaginal Fistula or VVF) or between the vagina and rectum (Recto-Vaginal Fistula or RVF) or both, leading to the uncontrollable flow of urine and/or faeces. Apart from obstructed labour, there are other factors that lead to fistula's including Female Genital Mutilation, sexual abuse like rape, surgical trauma (iatrogenic fistula), gynaecological cancer, teenage pregnancies because the pelvic bone is under-developed among others.

In Kenya, at least 1,000 new fistula cases are reported annually mainly because of poverty, the status of the health care system, malnutrition and ignorance. They end up being shoved into a dark corner of their homesteads, treated like outcasts, abandoned by their husbands and family. They are stigmatised. Unlike the developed world, childbirth in Kenya is a blur line between the joy of motherhood and disaster. Women are exposed to risks that can end up fatal, explaining the ever high numbers of maternal mortality in the country.

A fortnight ago, the Kenyatta National Hospital in conjunction with Amref launched the sixth National Obstetric Fistula Medical Camp to offer free surgical treatment to women with this condition. At the tents set up at the hospital grounds, women, old and young, were streaming in to be registered for treatment. And from banners to t-shirts adorned by the Amref and KNH staff, the message was clear: 'Stop leaking urine and stool after childbirth, reconstructive surgery will restore women dignity'.

Amref and KNH have done over 4,500 fistula corrective surgeries since the project was started in 2007. It costs about Sh20, 000 to 30,000 to treat one fistula repair procedure.

A pungent smell, of concentrated urine filled the air. The women, some cuddling their babies perhaps recounting their ordeals with the condition quietly gazed at on-going activities, including a Kenya Prison Services band that was rehearsing to entertain the guests.

Twenty-three-year-old Belinda Akoth from Busia and a mother of a 4-year-old boy has been suffering from the condition for two years now despite making unending trips to hospital with her latest visit to Nyanza Provincial General Hospital. "I have spent a lot of money to go to hospital but every time they give me tablets to swallow. It never gets any better," she says in Kiswahili. I ask her whether the doctors have diagnosed her condition and she says, " Hapana. Daktari hawajawahi niambia shida yangu. Maisha yangu imebadilika na wakati mwingine unaona aibu kukaa na watu kwa sababu unanuka (No. The doctors have never told me where the problem is. My life has changed and at times, I am ashamed to sit near people because I smell)," she breaks down in tears.

Soft spoken and smartly dressed Alice Alutsachi, 41, from Kakamega is a mother of two. Alice started experiencing the problem after a miscarriage in 2004. She visited hospitals in her hometown but all they did was give her medication and told her the problem would stop. "After swallowing the drugs, the flow would stop for about two years and it has been on and off and has adversely affected my way of life as well as my business. I heard about the camp and I decided to get help," she says. "Women should not be ashamed and they should come out to get treatment. I am so grateful to Amref for starting this initiative."

Fistula is seen as a "woman's burden" but men too have a role to play to alleviate the suffering. Gabriel Kipsegut Chabasero had brought her daughter Joan Chepkoech 18-years-old, who started the complication after she lost her baby early this year. Accompanying them was Charles Chebochok, Joan's brother. Charles heard about the fistula camp on national broadcaster KBC and vernacular radio station Kass FM. "I know my sister will get help because she is still young and needs to make a family in future," said Charles.

This year's camp was a wake-up call to those women suffering to get help. There were testimonies of five women who had benefitted from corrective surgery. They called themselves the Ambassadors of Fistula. Purity Kageni, 31, had lived with the condition for 12 years. She underwent corrective surgery at the hospital and the beam and confidence she exudes is testimony enough that fistula is reparable.

Also gracing the occasion were Nominated MP Sophia Abdi, Paul McNeil, director of Freedom from Fistula Foundation (FFF) worldwide, Lucy Mwangi of FFF Kenya, Director of Health KNH Dr John Ndumbi.

It is estimated that fistula leads to up to 8 per cent of maternal deaths worldwide. And the situation is worse among teenage and first-time mothers due to under-developed pelvis. Fistula does not only subject the victim to physical harm, it significantly denies her dignity thereby contributing to families and marriages disintegrating and stigmatisation of the victim.

The Amref and KNH campaign is supported in different capacities by among other groups the Freedom From Fistula Foundation, the Soila Maasai Girls Centre, Ann Gloag the founder of Jonathan Gloag Academy DANIDA and Diplomatic Women Club.

This year's campaign has been dubbed as a call, not only to the suffering, but also to members of society who may know a woman suffering from fistula to seek medical care because fistula is reparable.

-Additional reporting by Henry Kibira. 

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