Meet Patricia Akinyi, a 25-year-old lady from Mfangano Island, Homabay County in Kenya. She is a beneficiary of the recently conducted free fistula camp hosted by Amref Health Africa in Kenya in collaboration with UNFPA, Mpesa Foundation, Beyond Zero Kenya, and the Flying Doctors Society of Africa at the Homabay County Referral Hospital. The camp offered screening, treatment, and surgery to affected women to restore their dignity. Patricia had endured fistula for more than five years; her gloomy face spoke louder!
During her upbringing, Patricia’s family faced significant financial struggles that made her unable to attend school. However, a compassionate neighbour offered to take her in and continue her education. Unfortunately, at the age of 16, the woman’s son took advantage of her naivety and got her pregnant, consequently dropping out of school. This unexpected turn of events forced her to return home and live with her parents, but they were not financially stable enough to support her education moving forward. As a result, Patricia’s educational journey was cut short, leaving her with an incomplete grade-six education.
When Patricia was due to give birth, she was advised to visit the Homabay County referral hospital for skilled delivery. However, due to her young age, a natural delivery was not possible, and she needed a cesarean section (CS). Unfortunately, the family could not afford the financial implications of the procedure, so she was forced to give birth at home. As a result of the prolonged labour and the struggle of giving birth, she developed an obstetric fistula. This debilitating condition left her isolated, sad and with little hope of becoming the woman of her dreams.
Even after developing fistula, Patricia gave birth to four more children, worsening her condition. She narrates that, according to her, she thought it was normal for a woman to leak stool after giving birth. She suffered in silence, undergoing stigma and ostracizing from her community members, who could not understand why a grown-up lady like her could wet clothes and walk around smelling urine. At this point, even though her husband was not informed that his wife was suffering from fistula, he had made up his mind that Patricia would live with the condition forever.
When Patricia learned about the free fistula camp at the Homabay County Referral Hospital through her local radio channel, Ramogi Radio, she visited the hospital to seek help. As a housewife, she had no source of income, and her husband struggled to provide for their daily needs. They lived from hands to mouth. Patricia sold maize from her small wooden store to raise the fare for the journey to Homa-Bay County Referral Hospital. The next day, she embarked on a journey of hope and determination to restore her dignity and self-worth.
As she lived on an island, her travel options were limited to water buses and boats that could ferry her across Lake Victoria to her neighbouring world. The water bus operated on a strict schedule, visiting the island only once a day. Patricia was not lucky to catch the water bus on the first day as she arrived late; her condition did not allow her to walk fast or use a motorcycle on the rough terrains. She had to camp close to the lake shore to catch the water bus early enough the following morning. Her remarkable journey through the calm waters of Lake Victoria filled her with an indescribable feeling. Her pulsating heart was in rhythm with the water waves that appeared like sealed glass. The horizon represented her hope for a lifetime!
Patricia was admitted to the hospital and underwent surgery. She stayed in the ward for three days for close monitoring and healing. After being discharged, she couldn’t immediately return home to her family due to financial constraints. Consequently, she had to stay with a friend in Homabay town for two additional weeks while her husband looked for the money needed to take her home.
Amref Health Africa, working alongside like-minded partners, is committed to changing the narratives of women like Patricia suffering from fistula. We aim to restore hope and bring back the smiles on their faces. Women who suffer from fistula often face social isolation, neglect, and discrimination. This makes it difficult for them to participate in social and economic activities. In addition to repairing the physical damage caused by fistula and restoring their dignity, we are exploring additional options to ensure that they are financially stable. We support psychosocial support and empower those previously running businesses and those who aspire to run businesses by providing them with entrepreneurial and business skills to manage their ventures effectively.
We ensure that those participating in village learning and saving schemes are back and actively participating in those schemes. This approach serves as post-treatment and post-traumatic care so that they can heal properly. We also onboard men and boys at the household level to ensure women are welcomed back home.
Patricia’s experience reminds us of the drivers of obstetric fistula (sexual gender base violence, teen pregnancies and early and forced marriages), delayed and obstructed labour and traditional birth attendance (TBA). Other social determinants of health, such as financial constraints, remote and inaccessible areas, myths and misconceptions and patriarchal norms, continue to impede women’s access to RMCNAH services.
Author: Noah Wekesa – Communications (KCO/HQ), Amref Health Africa.