The end of 50 years of a long nightmare

Chonyi, Kenya - At the bloom of her youth, 50 years ago, Jumwa Kabibu Kai, a resident of Kidutani, a small village in Chonyi, Kilifi County, Kenya, was psychologically prepared for the birth of her second child.

As she went into labour, Jumwa was all alone in her small hut crying her heart out but no-one was in sight. This is because her nearest neighbour lived three kilometres away. Kidutani is generally a marginalized area with poor infrastructure, including accessibility to a health facility.

Jumwa found relieve walking around her compound because in her heart she knew her neighbours would finally either hear her or come visiting. This went on for three days when her sister came visiting. Immediately, her sister mobilized a few neighbours who rushed Jumwa to hospital.

Jumwa could not comprehend what her doctor was explaining to her hours after the delivery “but something was definitely wrong”, she recalls. She had lost her baby, too.

“I returned home after a day at the hospital, extremely disturbed by the loss of my child. Then almost immediately I began passing urine uncontrollably,” she narrates. “I didn’t take it very seriously because I thought it was something normal. In any case, there were other women in the village with the same condition,” she adds. This according to her was “the beginning of 50 years of a long nightmare.”

Unknown to Jumwa, she had developed obstetric fistula – a hole between the birth canal and bladder or rectum that is usually caused by prolonged obstructed labour. It is both preventable and treatable, but fistula plagues the lives of thousands of women in Kenya every year, leaving them incontinent for urine or stool or both.

“I knew a bad spell was cast on me,” she states. “How can this be happening to me? I remember the bad smell, the wetness, the shame and worst of all the disappointment I saw in my family. The feeling was all too awful,” she adds.

After a while, and out of desperation, Jumwa began to seek help - any help from traditional healers, local dispensaries and religious groups, but without much success. In 2009, she heard of possible fistula treatment in Coast General Hospital in Mombasa, but she was late therefore she did not get the assistance. This devastated her losing all hope she had.

Signed a new lease of life
“At some point, I convinced myself that my condition didn’t have a cure, and so I had to learn to live with it,” she says. She would later learn through her 28-year-old granddaughter, Mwafungo, that she indeed was suffering from fistula and help was possible. Mwafungo, married and a mother of two, heard about the one-week fistula camp held at the Kilifi County Hospital in May 2016.

The camp organized by UNFPA, the United Nations Population Fund in partnership with the Kilifi County Government, the international non-governmental organizations Flying Doctors Society of Africa and Freedom from Fistula Foundation, the musical group Them Mushrooms, which partnered with the Campaign to End Fistula to raise awareness, and the Kenyan non-profit voluntary women's organization Maendeleo Ya Wanawake gave a once in a lifetime opportunity to women and girls, like Jumwa to receive free fistula repair as well as create awareness in the community about fistula.

“The past 50 years was hell on earth for me,” Jumwa, now aged 77, narrates. “I was completely isolated by family, friends and my whole community due to my condition, with some attributing it to witchcraft. Sadly, my husband too, left after I began suffering. I used to live alone in a hut in the outskirt of the village, with extremely minimal contact with anyone,” she adds.

Fifty years later, Jumwa cannot hide her joy and sparkling smile after the surgery.

“To be honest, I feel like I have signed a new lease of life,” she states. “I feel great. I feel young. I feel beautiful and wanted,” says an excited Jumwa before jokingly adding that now with her groove back, she expects to bump into a hunky single old man like herself and taste love one more time.

“I appeal to all women suffering with this condition to seek medical help. Fistula indeed is treatable,” she poses rather seriously.

During the one one-week fistula camp, 65 women were screened, while 32 patients were admitted and 30 surgeries done. Many of these women had faced discrimination and stigma with some being ostracized from the community they once belonged to.

Strengthening the health system

Kilifi County has one of the highest teenage pregnancy rates, which together with poor access to emergency obstetric and newborn care may lead to increased risk for obstetric fistula. To this end UNFPA is working with other stakeholders including the community leaders and the County Government to encourage girl-child education, prevention of child marriages and gender based violence.
UNFPA has built the capacity of Kilifi County Hospital by procuring maternal health equipment for both basic and comprehensive obstetric care, including equipment for fistula repair. UNFPA has also invested in the training of 35 nurses on emergency care and screening of patients as well as care before, during and after surgery of fistula survivors. This team will also act as mentors for their colleagues in the respective health facilities. Nineteen community health workers were trained in identification of fistula survivors and community sensitization. These community health workers are also acting as key architects in reintegration of the fistula survivors within the community.

The story was published first on UNFPA’s Kenya Country Office website.