Ending Fistula Within a Generation in Kenya

Ending Fistula Within a Generation in Kenya

By: Katie Weller, Marketing Communications Writer, Fistula Foundation


“Sit down, let’s talk to her,” said Joyce, nodding. She gestured to the hospital bed with a smile and a psychologist’s certainty.

We were now alone in a hospital room at Jamaa Mission Hospital—one of six facilities in the Action on Fistula program. From my comfortable desk over 15,000 miles away, I had read about the program’s groundbreaking model with the power to end fistula within a generation in Kenya. But now, here I was: face-to-face with a fistula survivor in her hospital room in Nairobi.

A group of well-wishers had just left, closing the door behind them. “What’s your name?” I asked.

“Mary,” she replied. We paused for a moment as our eyes met. A few tears lingered on her bottom lashes from the story she had just shared with the larger group.

The Problem: Obstetric Fistula

“When did you first develop obstetric fistula?”

Mary looked down at the baby in her arms. He had large, round eyes just like his mother’s. “When he was born,” she said. The child couldn’t have been more than a year old.

A fistula is a childbirth injury that occurs after a wrenching, prolonged labor, sometimes lasting days on end. Babies rarely survive. That terrible fact took new meaning sitting across from Mary, and my heart heaved. “What a blessing that he’s here!” I said.

“Yes, but not always,” she replied. Mary told me that the fistula’s effects had devastated her—she was left incontinent, unable to control her urine and feces. “There were things coming out of me that I did not know… I was stinking, I didn’t know what was going on.”

Mary’s eyes filled with tears again as she spoke. Before arriving at Jamaa Mission Hospital, she blamed herself for her injury, and thought that she was cursed.  She suffered so profoundly that she even began to blame the child, for the labor that had left her body broken and her future frightening and bleak.  

The Solution: Life-Transforming Surgery

Mary’s situation took a turn for the better when she finally learned that treatment was available. She wasn’t cursed, and her suffering wasn’t her fault—the condition had a name, and it was treatable! Mary underwent surgery at Jamaa Mission Hospital, and was now recovering under the care of Jamaa’s highly-qualified staff of doctors, nurses, and rehabilitation therapists.   

“Has your life changed now that you received surgery?” I asked.

“Oh, yes!” Mary exclaimed, wiping her cheeks. “Now I can make it from here to the toilet!” Before surgery, she hadn’t even been able to stand up without spilling feces on the floor.

“When was her surgery?” I asked Joyce, Mary’s psychologist, who was standing next to the hospital bed.

“On Monday,” Joyce replied, placing her hand on Mary’s shoulder. Five days. My heart heaved again as I counted in my head—it had been only five days since she stopped leaking feces with her every move. I reached for Mary’s hand, and she took it. The tears began anew as she told me how thankful she is to everyone who made her surgery possible.

The Breakthrough: Action on Fistula

In 2014, Fistula Foundation launched “Action on Fistula” and built something powerful: a nationwide treatment network with the power to end fistula in Kenya. This holistic model accounts for every step in a woman’s journey to recovery, including innovative outreach and community sensitization, a robust network of six hospitals, certified fistula surgeon training, and holistic post-surgery care and job skills classes.  The program emphasizes partnership and the integrated network allows surgeons, outreach workers, and hospitals to collaborate and share resources and information.  

Action on Fistula has already helped over 2,500 women receive life-transforming fistula repair surgery. It has trained six Kenyan surgeons, empowered 243 Community Health Workers, conducted 8,500 outreach activities, and built one flagship hospital—all in its first three years.   

Survivors like Mary play no small part in the program’s success. Now that she is healed, Mary wants to become an advocate.

“I’m talkative,” she beamed that day in the hospital room. “Now that I’m well, I want to look and see if I can find more women.” She was confident that her personality would be an asset in reaching others suffering with fistula in shame—the same way she had for so long.

Mary can now return to her community dry, hopeful, and restored. It fills my heart to think of the women who will be referred and treated because of Mary’s actions—and the cycle will begin again, even stronger than before.


Photo of hospital exterior: Katie Weller
All other photos: Georgina Goodwin

Learn more about Fistula Foundation here

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Fistula Foundation

Fistula Foundation is a recommended charity of The Life You Can Save. Fistula Foundation provides funding for fistula surgery and treatment worldwide. Obstetric fistula is a preventable injury that can occur during complicated childbirth, with often devastating consequences for women and their families.

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The views expressed in blog posts are those of the author, and not necessarily those of Peter Singer or The Life You Can Save.