May 23 is International Day to End Obstetric Fistula, and I’m reminded of that difficult experience all those years ago.
In 1997, I was a new medical resident working in West Pokot County, an underserved, rural region in northwestern Kenya.
One morning, a woman came forward with a condition I had never seen before: She was uncontrollably leaking urine through her vagina. While I did not realize it in the moment, my life’s path was set that day.
Over time, I saw more and more women come forward with this condition, but I didn’t know how to help. I came to understand that they had obstetric fistula, an injury caused by prolonged obstructed labor. This injury is preventable when a woman has access to emergency surgical intervention, like a C-section. But in West Pokot County – and indeed, in most of Kenya – women often give birth at home, with limited access to medical help when they need it most.
I eventually learned there was a surgeon in Nairobi who could heal them with surgery, but it could take a year or more for him to visit my facility. So, I sent my patients home to wait. Turning those women away was one of the hardest things I’ve ever done.
May 23 is International Day to End Obstetric Fistula, and I’m reminded of that difficult experience all those years ago. It changed me, and I decided to dedicate my life to helping women with fistula obtain treatment. I pursued my residency in obstetrics and gynecology, and learned to perform fistula surgeries at the Addis Ababa Fistula Hospital, a specialized facility in Ethiopia. For the past 16 years, treating fistula has been my life.
In 2011, in Eldoret, Kenya, my wife, Carolyne, and I co-founded Gynocare Women’s and Fistula Hospital by converting a small rental home into an operating theater and fistula ward. It was a dream come true to have our own facility where we could treat fistula promptly, without turning anyone away.
Yet, we quickly realized that we couldn’t treat fistula alone. It is a complicated process, and there are lots of components to high-quality care.
Many women suffer in isolation because of the odor and stigma, so this meant we needed outreach workers to start educating communities about fistula, and encourage women with fistula to come forward for help. Fistula surgery requires properly trained surgeons, or they could end up doing more harm than good. Finally, patients need counseling, support groups and reintegration back to society to allow them deal with the trauma of their injury, even after they are physically healed, so they can be meaningful members of society.
Four years ago, the Fistula Foundation approached me and my Gynocare team with an audacious goal: they wanted to end fistula within a generation. With seed funding from Astellas Pharma EMEA, the foundation and the pharmaceutical company were launching an ambitious plan to transform the way fistula was treated in Kenya by building a network of hospitals and community outreach organizations across the country.
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Since launch, Action on Fistula has provided more than 3,000 women with life-changing surgery and has doubled the number of trained fistula surgeons.
The results have been startling and changed the health-care landscape for women: More than 3,400 women from 43 of Kenya’s 47 counties have already been treated and more than 850,000 people have been reached through grassroots education efforts.
If this program had been available all those years ago when I was stationed in West Pokot, I could have referred countless suffering women to treatment right away. Their transportation, surgery, and rehabilitation would have been free of cost.
Needless to say, I am deeply honored to be a part of Fistula Foundation’s program. Today, Gynocare is its flagship hospital and occupies a newly constructed, three-story building. Together with our partner hospitals across the network, we perform thousands of surgeries each year.
I also train other surgeons to specialize in fistula surgery, and one of my pioneer trainee students has even opened a new hospital dedicated to fistula care. This joins several satellite fistula centers supported by Fistula Foundation. I am thrilled that a second countrywide network has been launched in Zambia with support from Johnson & Johnson.
This path-breaking program means I will never again have to tell my Kenyan sisters that they must wait for a surgery that could radically change their lives. On this International Day to End Obstetric Fistula, I am more thankful than ever to be a part of the solution.