Source: The Star
There exists a very thin line between the joy of motherhood and childbirth complications. Dressed in a pink gown, 65-year-old Joyce Mumbi sits on a bed at Guru Nanak Hospital in Nairobi awaiting her turn to go to the theatre. She has lived with fistula for more than 30 years.
Mumbi had turned up for the free vesical vaginal fistula (VVF) camp organised recently by the Flying Doctors Society of Africa. More than 200 women benefitted from the corrective surgery at a cost of Sh10 million.
Mumbi started having complications after getting her second child at the age of 16. After examination, doctors said her vagina is torn and that she has fistula.
Mumbi was brought to the hospital by well-wishers from All Saints CPK in Muchatha, Kiambu county, where she is a member. Nurses at the hospital said she came in traumatised and not ready for the operation.
"We have had to take her through counselling to have her agree to the treatment," said Christine Muthengi, a nurse at the ward where Mumbi was admitted.
Hers has been a painful journey. All her eight children were born prematurely and all ended up dying. "I was giving birth at home and none of my children survived. None of them reached full term -- I was getting them between the sixth and the eight month," she explained.
She says she gave up after the eighth child died and accepted that her fate was to live without children. "I appreciate the support I get from my church members who decided to bring me here. Those are the people I look at as my children," she says, adding that she never feels alone since she is still married.
She admits that through the years, she has been mocked by many in her village. Sometimes people would move away from her in church and other public places because she at times stinks.
"Sometimes I have a foul-smelling discharge which makes me very uncomfortable," says Mumbi, who is a small-scale farmer and a bananas seller at a market in Kiambu.
Doctors say some of the home births must have been difficult which resulted in the damage of the vagina.
Adjacent to Mumbi sits another fistula victim, Emma Wambui, who is a mother of two. Wambui, who is in her twenties, has lived with fistula for two years. "It all happened after I got my second child. At first I thought the problem would disappear but it got worse with time," she said.
She says she has been visiting various hospitals and was meant to undergo an operation which would have cost her almost Sh40,000.
She says she is happy that the camp is doing free fistula correction and thanks the organisers for coming to their rescue. "I have not paid a coin for the treatment," said Wambui who had already had the operation done.
She is hopeful that she will now be able to enjoy her life all over again. "I want the bad smell to go and to stop wetting my clothes. I want to regain respect and dignity from the community and stop walking around with extra clothes," she said with a smile on her face.
Nairobi governor Evans Kidero's wife Susan Kidero, who launched the camp, called for an all-inclusive effort to free women from fistula.
"Poverty is one of the underlying causes as it is associated with early marriages, unwanted pregnancies, malnutrition and lack of access to medical care," she said.
Flying Doctors Society of Africa chairperson Eunice Kiereini expressed concern at rising cases of fistula and urged expectant women to seek medical attention.
"There are an estimated 3,000 new cases of fistula each year in the country and the main cause of the condition is obstructed labour," she noted.
This condition is the most devastating of all pregnancy-related injuries affecting more than 100,000 African women each year.
Annually, there are 5,000 cases of fistula in each East African country.
Fistula mostly affects poor women and girls who cannot afford skilled supervised deliveries at a health facility. It is caused by difficult and prolonged labour, according to Dr Khisa Wakasiaka, a VVF specialist.
"This happens when a baby is too big and the birth canal is too small. When the mother instills pressure to push the baby, tissues such as urethra, bladder and vaginal walls get trapped between the bones," he explained. He warns that the condition can only be treated through surgery.
While obstructed labour is the highest cause of fistula at 92 per cent, there are other causes among them violent rape, abortion, radiation from pelvic radiotherapy, pelvic surgery, severe forms of female genital mutilation and sexually transmitted infections.
Despite fistula cases being very high, there are only eight fistula surgeons in Kenya.
It is estimated that fistula leads to up to eight per cent of maternal deaths worldwide. The situation is worse among teenagers and first-time mothers due to under-developed pelvises. Fistula does not only subject the victim to physical harm, it significantly denies her dignity thereby contributing to families and marriages disintegrating and stigmatisation of the victim.
