Overcoming Fistula: Khamis’ Story

by Amref Health Africa

Two years ago, Monica Khamis Soka was pregnant with her first child. When she went into labour, she could not seek medical attention on time. Monica lives in a village with no midwife or access to a health facility that offers delivery services. The nearest hospital is 30 minutes away and sometimes, the roadblocks on the way makes the journey even longer.

At the clinic and after a prolonged, painful and obstructed labor, Monica gave birth to a healthy girl. Soon after leaving the hospital, she started leaking urine continuously, which developed to obstetric fistula. Fistula is an abnormal opening between a woman’s genital tract and her urinary tract or rectum caused by prolonged, obstructed labor without access to timely, high-quality medical treatment. (WHO, 2018).

While trying to cope, Monica would mostly isolate herself from crowds or social gatherings due to the unpleasant odor resulting from her inability to control her urine. “I became withdrawn and shamed. Because of low self-esteem, I kept quiet,” she narrates.

Many women are shunned by their families and community members because of the foul smell. For, Monica, she was abandoned by her husband and some of her friends. “I had to stop selling tea – my only source of income, because people were not comfortable staying around me,” she recalls.

For one year and a few months, she continued to experience incontinence while patiently waiting for a free fistula camp.

A critical turning point in her life came when she received a call from Hayat Peter, a nurse at Juba Teaching Hospital in South Sudan’s capital who informed her about a free medical camp for women living with obstetric fistula organised by Amref Health Africa in South Sudan.

After screening, Monica qualified to go through surgery to fix her condition. A surgical procedure was successfully done to correct the condition.

Life after Fistula.

Monica is now happy and dry. She has reclaimed her confidence and her life. A Lot of opportunities have opened up for Monica. She went back to work and her business is booming. She can socialise, interact, and attend functions such as weddings. “I can comfortable make tea for my clients, I no longer worry about the urine,” she confirms.

She is looking forward to having more children but due to the surgery, she will have to wait for a few years to forget the pain and all she went through. “Children are blessing, but I have to wait a little to forget the experience,” she said.

Just like Monica, many fistula survivors require emotional, economic and social support to fully recover from their ordeal.

Soon after she was completely healed, her husband reunited with her. Monica urge men to support and encourage women who have fistula. “Women should not silently suffer with obstetric fistula because there is a cure for their condition and men should not neglect them,” Monica said, her voice filled with emotion.

For the last two years, the project has restored the dignity of 61 women in Juba. However, the work is far from finished, the Ministry of Health estimates that there are still 60,000 currently living with obstetric fistula in South-Sudan who are in dire need of surgery that could transform their lives. In addition, the sporadic camps is unlikely to the keep pace of the huge backlog of cases and the increasing numbers of new patients.

Amref Health Africa’s Intervention

Working with the Ministry of Health in South Sudan, Amref Health Africa in South Sudan in partnership with United Nations Population Fund (UNFPA) is supporting women through free fistula repair surgeries for those with urine and stool incontinence.

The camps also treat mothers with other birth complications arising from labor and delivery such as perineal tears, genital prolapse, and other incontinence of urine or stool that is not associated with fistula. Health workers from various states of South Sudan are also supported with mentorship, training, and setting up fistula repair teams.


By Maureen Cherongis

Media and External Relations

Amref Health Africa [email protected]

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