KILIFI, Kenya – Decades ago, Jumwa Kabibu Kai was pregnant with her second child in the small village of Kidutani. The area was poor and isolated – her nearest neighbour was 3 kilometres away – and there was no easy access to a health facility. But Ms. Kai did not know these circumstances would initiate a 50-year nightmare, as she would later describe it.
When she went into labour, Ms. Kai was alone in her hut. She walked around the yard to try to relieve the pain, but it quickly became overwhelming – and seemingly unending.
Her labour lasted for three days, the sign of a major problem. And still, the baby did not come.
When Ms. Kai’s sister arrived for a visit she realised her predicament and ran to fetch the neighbours. They rushed Ms. Kai to hospital.
But the news was not good. Ms. Kai did not understand what the matter was “but something was definitely wrong,” she said.
Sadly, her baby did not survive.
“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 said.
The prolonged, obstructed labour had produced an obstetric fistula, a traumatic birth injury that causes incontinence, pain and other serious problems.
“I [thought] a bad spell was cast on me,” she said. “How can this be happening to me? I remember the bad smell, feeling wet, the shame and worst of all, the disappointment I saw in my family. The feeling was too awful.”
Obstetric fistula is a sign that health systems are failing women. The condition is both preventable and treatable, yet it continues to plague women around the world. It is estimated that thousands of women in Kenya are afflicted by this injury.
And its effect on women is devastating. Many are cast out from their homes or ostracized by their communities.
“I was completely isolated by family, friends and my whole community due to my condition, with some attributing it to witchcraft,” she told UNFPA. “Sadly, my husband left after I began suffering [this condition]. I lived alone in a hut on the outskirts of the village, with minimal contact with anyone.”
Ms. Kai sought help where she could – from traditional healers, local dispensaries and religious groups – without success.
“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 said.
But earlier this year, Ms. Kai’s 28-year-old granddaughter, Mwafungo, learned that a one-week fistula camp would be held in Kilifi County in May.
The event – organized by UNFPA with the Kilifi County Government, the Flying Doctors Society of Africa, and the Freedom from Fistula Foundation – brought doctors to the county hospital to provide free surgical fistula repairs. Maendeleo Ya Wanawake, a women’s organization, and the musical group Them Mushrooms, helped raise awareness of the condition.
UNFPA boosted the hospital’s capacity to treat and prevent fistula, procuring maternal health equipment and training 35 nurses and 19 community health workers.
During the one-week fistula camp, 65 women were screened and 30 procedures were performed. Ms. Kai was one of the women healed.
Ready for love
Obstetric fistula has been virtually eliminated in affluent countries. The same could be true for developing countries if all women were able to give birth under the care of a skilled birth attendant, such as a trained midwife or doctor, and had access to emergency obstetric care.
But this means countries must address the root causes of this condition, which are “gender inequalities, the denial of human rights and poor access to reproductive health services,” according to a report of the United Nations Secretary-General, which was presented at the UN. It called for intensified efforts to eliminate obstetric fistula within a generation.
For Ms. Kai, the end of her ordeal has changed her life. She has become an advocate in her community, raising awareness about fistula, its treatment and prevention.
“The past 50 years was hell on earth for me,” she told UNFPA shortly after her surgery. “I feel like I have a new lease on life.”
She said she feels ready to find love again. “I feel great. I feel young. I feel beautiful and wanted.”