Maria* is a 53-year-old woman from the rural area of Kabuoch in western Kenya. She developed an obstetric fistula – or a hole in the birth canal that results in chronic incontinence – following a difficult vaginal delivery when she was 18 years old. Following three days of hard labor Maria made it to the hospital in Homa Bay where she delivered a baby boy with the help of forceps. Unfortunately for Maria, her baby was stillborn. Not long after delivery Maria began leaking urine.
Maria’s husband attempted to get her help but fistula repair services were essentially non-existent in the 1970s in rural Kenya. Shortly thereafter, Maria’s husband died. She never remarried, never had any more children, and did not receive help for her fistula. Maria had difficulty walking, she was depressed, she stopped socializing with other people, and her friends and neighbors stopped visiting her. Maria’s overall health began to deteriorate.
In June 2013, Maria’s 23-year-old nephew David heard an advertisement on the radio discussing the availability of screening, surgical treatment, and follow up care of women who may be leaking urine and/or feces who may be diagnosed with obstetric fistula. David took her to Jaramogi Odinga Oginga Teaching Referral Hospital (JOOTRH) where fistula screening and repair was being done by a small team headed by Dr. John Mbogo, Mr. Sylvester Alloach and Sister Margaret Odhiambo. Funding was provided by the Fistula Foundation and Direct Relief.
Dr. Mbogo examined Maria and determined that she had a vesicovaginal fistula, or hole between the bladder and vagina. He was concerned that the repair may not be successful due to the length of time that Maria had suffered with the condition—35 years. He was also worried that she may have developed vaginal stenosis, or narrowing of the vaginal walls, making the surgery difficult. However, Dr. Mbogo is truly dedicated to helping women with fistula and scheduled Maria for surgery. The surgery was a success. In follow up visits it was confirmed that Maria was no longer leaking urine.
Six months following her surgery, Dr. Mbogo, Mr. Alloach and I paid Maria a visit. We were delighted to see that Maria was healthy, happy and was once again a part of her community. She had once again returned to church and was now visiting friends and family. She welcomed us and told us that her health had improved tremendously and that she was happy after many years of being miserable.
This was a great day for me having been assigned to assist on the fistula project. It served to show that no matter how long a woman has suffered from fistula, there’s still hope. It is difficult to locate many of these women because of the stigma attached to the condition. They do not want to come forward because they are ashamed. I am happy that we are reaching these beautiful women even if it is one woman at a time. It made a difference in Maria’s life and the satisfaction of seeing how happy and content she was certainly made this project and the work that this team carries out truly worthwhile. I loved every minute of the time that I spent with Dr. Mbogo, Mr. Alloach and Sister Odhiambo. My life has been truly enriched following this experience.
*Name changed to protect privacy