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Second chance: How hope was restored for runaway teenage mum after devastating childbirth injury

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Second chance: How hope was restored for runaway teenage mum after devastating childbirth injury

calendar_today 02 June 2023

A happy ending. Margaret Kumwenda with her daughter, Jacqueline.
A happy ending. Margaret Kumwenda with her daughter, Jacqueline, now 17 and healed from her traumatic fistula. Her grand daughter, 2, miraculously survived the difficult birth. © UNFPA Malawi

NKHATA BAY, Malawi – Margaret Kumwenda was worried. Her teenage daughter, Jacqueline, had been missing from home for two weeks. “She used to be a very good girl but this changed when she started hanging out with the wrong crowd at school,” she said.

Her 15-year-old daughter’s disappearance was not her first, however, and when she returned, she refuse to disclose where she had been. Ms. Kumwenda later learned that her daughter was in love with a boy from another village, and it was to him that she went when she ran away from home.

“I reported the boy to the police, but they told me that he was still a minor, and all they could do was counsel him and Jacqueline,” she said.

We tried looking for her, but to no avail.

The counselling worked for a while, as Jacqueline stopped returning home late and she was always studying. But this didn’t last long.

The day came when Ms. Kumwenda returned home to find Jacqueline’s room was empty of all her belongings. “We tried looking for her, but to no avail,” she said.

Later, she learned that Jacqueline and her boyfriend had moved to Mzimba district, but she could not find out their exact location.

After a difficult childbirth when she was just 15, Jacqueline developed an obstetric fistula that kept her housebound. She was repaired with the support of UNFPA, through the Spotlight Initiative. © UNFPA Malawi

A mother’s love

For two years, she had no word from her daughter. “I tried all I could to locate her but it seemed she didn’t want to be found,” she said.

Just when she had given up hope of ever finding her daughter,  she received an anonymous phone call alerting her that Jacqueline was unwell. Too afraid to face his mother-in-law, the girl’s husband had relayed a message through someone else that Jacqueline wanted to return to her mother.

When Jacqueline arrived home, she was not in good health. She told her mother that she had started leaking urine and faeces soon after giving birth. For months, she stayed indoors – until her husband decided to send her back to her mother.

Seeing the physical and mental difficulties her daughter was experiencing devastated her. “I didn’t know what to do,” said Ms. Kumwenda. “I remembered that there was a woman in our community who always talked about a similar condition, and how she can help to get it treated.”

She visited the woman, who is a fistula ambassador under the Spotlight Initiative, funded by the European Union, and the woman agreed to help her daughter. “She agreed to come to our house the next day,” she said.

Ms. Kumwenda accompanied Jacqueline to Nkhata bay district hospital for a clinical assessment, which showed that her daughter had an obstetric fistula. This is a hole that forms between the birth canal and bladder or rectum, after a long, obstructed labour, resulting in the uncontrollable leaking of urine and faeces.

Thankfully, Jacqueline’s fistula was not a complex one, and the repair could be handled at the district health office. After successful surgery, Jacqueline’s is finally free from fistula. She has been healed.

Healing fistulas through surgery

In Nkhata bay, many adolescent girls and young women marry at an early age, which leaves them vulnerable to physical violence and harmful practices. This increases their chance of unintended, mistimed and higher-risk pregnancies. Recent statistics show that than one in two girls are married before the age of 18, which increases their risk of developing a fistula. 

Through the Spotlight Initiative, UNFPA, the sexual and reproductive health agency, is working with Nkhata bay district council to help empower adolescent girls and women with knowledge and skills on sexual and reproductive health, and gender-based violence, to make informed decisions and to exercise their rights. In 2022, Nkhata bay district, with support from the Spotlight Initiative, supported the repair of 11 fistula cases.