Medics link high fistula cases in Mt Elgon to FGM

Medics in Bungoma county have attributed the high cases of fistula in the Mt Elgon region to retrogressive practices among the community.

Janet Chebet, the medical superintendent at Cheptais sub-county Hospital in Mt Elgon cited Female Genital Mutilation, long obstructed labour and teenage pregnancy as major contributors to the high fistula cases being attended to.

“Most of the women who went through female genital mutilation suffer from fistula,” she said.

High teenage pregnancy contributes to fistula cases as the teen’s organs aren’t mature enough to hold pregnancy.

In a bid to end fistula in the Mt Elgon community, Chebet emphasised the need for pregnant women to attend antenatal care visits, deliver in the presence of skilled birth attendants and visit the health facility on time to avoid long obstructed labour.

Fistula condition is characterised by the formation of a hole between the bladder and vagina due to prolonged obstructed labour that leads to uncontrollable leakage of urine or stool. The World Health Organization states that obstetric fistula affects between 50,000 to 100,000 women annually.

More than 2 million young women live with this untreated condition in Asia and Sub- Saharan Africa, estimates show. In Kenya, two women get fistula condition in every 100 births, resulting in 2,400 new cases.

Sarah Omega, 49, a fistula survivor and champion, narrates that she stayed out of marriage for 12 years after she was hit by fistula.

Omega said she got pregnant while young. This ended as a stillbirth and left her with an injury that led to fistula. 

“I got fistula when I was 19 years old. The baby was huge and during birth it could not pass because the birth canal was narrower. The baby weighed about 4.8 kg,” Omega said.

The prolonged and obstructed labour she experienced resulted in the condition that sent her into depression.

“The moment it was confirmed that I was battling fistula, I rejected myself before I was rejected. I could not go out and do the things I used to do as a teenager. I felt I was trapped. The condition sent me into isolation.”

She also battled agonising pain.

“I could spend my nights crying because of the unbearable pain from the genitals. During the day you have to really starve yourself but with friction in the nights were moments of shedding tears because of the pain,” she said.

Suffering the condition 12 years led to depression, and Omega was taken to the Moi Teaching and Referral Hospital, where she also got to learn about fistula treatment.While still at MTRH, Omega underwent fistula surgery repair and her life was restored.

After healing, she became the fistula champion and formed an organisation named Let’s End Fistula Initiative, which she serves as Chief Executive Officer. Lefi is committed to ending maternal related complications with focus on obstetric fistula.

Over 2,000 women have been reached, received treatment and were healed. Out of these, 100 were from Bungoma.

The non-governmental organisation is currently active in nine counties: Bungoma, West Pokot, Vihiga, Kakamega, Siaya, Migori, Trans Nzoia, Uasin Gishu and Busia.

They roll out programs through four strategic focus areas: find and link fistula patients with treatment opportunities, economic empowerment, social integration and encourage survivors to become advocates.

The Lefi CEO says maternal deaths are caused by three delays; delay in making a decision on whether to seek medical attention, delay in getting to the facility and delay being attended to while at the facility.

To address these delays in bid to curb maternal deaths, Omega said they are working with the community as champions for safe childbirth, where those restored use their own stories and experiences to create awareness in their respective villages.

“We are focusing on the prevention messaging, focus on issues around expectant women utilising Antenatal services and putting emphasis on expectant women delivering under a skilled birth attendant.”