Migori Women Share their Tough Journey to Overcoming Obstetric Fistula: “Not a Walk in the Park”

 

Lonely patient sitting on the hospital bed (left) and obstetrician at Migori County Referral Hospital's Omire Godfrey (right).

Monica Auma lived a normal life like every other young woman in her early 20s until 2019 when she had her firstborn daughter, an experience that changed her life.   Coming from a rural area, Auma had everything planned for her delivery. When labour pains began, she walked into a facility in Migori with hopes of finally meeting her bundle of joy in a few hours. However, she had intense labour pains that forced medics to transfer her to another health facility, where she gave birth through a Caesarean Section (CS). 

 The procedure was the beginning of her nightmare with obstetric fistula, a condition that causes constant leakage of urine, faeces, and blood.  "It has not been a walk in the park, the stigma from the people around me made it worse i nearly went into depression" she narratesd to TUKO.co.ke. Three weeks after the delivery, Aumah began experiencing difficulty in controlling urine and stool. In the beginning, she kept to herself but later made a bold step to visit a health facility where she sought treatment. However, the cost was too high. What is the cost of fistula surgery? 

According to Omire Godfrey, an obstetrician at Migori County Referral Hospital, fistula surgery costs approximately KSh 40,000 in public hospitals and over KShh 100,000 in private facilities. The cost, however, depends on the type of the fistula.  "I survived this nightmare because of my husband. He was very supportive and caring,” she added. However, her husband, Ouma Nashon, initially admitted to being distant from her wife. "It was not easy accepting and dealing with the whole situation, but we had to adjust," Ouma told TUKO.co.ke. 

"I now fully understand after the doctors explained and gave my support, and I am glad our lives are back to normal," he added. It was almost a similar experience for Merab Atieno Otieno. Atieno, 38, who hails from Obama village in Awendo sub-county, told TUKO.co.ke that she started experiencing difficulty in controlling her urine after the birth of her fifth child in January 2023. Her situation followed prolonged labour that left her with damaged tissues between the bladder and the birth carnal. 

Subsequently, many of her friends abandoned her but she managed to stay strong thanks to her firstborn daughter, a medicine student who helped her to understand the situation.  Atieno had to rely on adult cotton diapers and regular cleanup to reduce the smell of urine leakage—tips shared by her daughter. But the situation did not last forever. She was lucky to be among the individuals Migori's first lady, Agnes Ochillo, reached out to during a free fistula surgery camp campaign. 

Migori women undergo fistula corrective surgery Auma and Atieno are among the over 800 women who have undergone corrective surgery at Migori County Referral Hospital in a medical camp organized by AMREF, Flying Doctors Society, Safaricom Foundation, and the Migori County Government. Most women with fistula suffer in silence if they don't get support from family members.  The patients were taken through a counselling session before the surgery. Dr Omire, an obstetrician at Migori County Referral Hospital, explained that fistula occurs whenever there is abnormal communication between two systems—the urinary system and the rectus—which causes leakage.

 "Most women get fistula during childbirth. It’s caused by forceful push during birth that is often a result of tearing in the birth canal," he said.  Due to stigmatization, lack of support, and knowledge by victims, most individuals with the condition opt to suffer in silence. However, the obstetrician called on the government to ensure there are sufficient fistula doctors to help those with the condition. “We have a scarcity of fistula expertized doctors, yet for a successful treatment, it needs to be identified and classified correctly by specialists and the right procedure carried out," Omire said. 

"Women suffering from fistula should not be uncomfortable within the society. Corrective surgery has ensured they can live with dignity,” he added. The condition is, however, rare among men. Data from the Ministry of Health shows that in Kenya, an estimated 24,000 women are living with obstetric fistula, with around 3,000 new cases reported every year. 

by  Sarah Zadock Joshua Cheloti