Sometimes, trying to have a baby can turn you into a leper. I
wish I was exaggerating, but I am not.
- Woman in the river. Photo by The Advocacy
Chero is one example. Everything went fine with Chero's
pregnancy, but when she went into labor with her first baby, things
did not go as they should. Despite hours and hours and hours of
contractions, the baby did not come. Chero was out in a village in
rural Kenya where most women deliver their babies at home, with a
midwife to help them. The hospital is far, far away.
Chero had obstructed labor. Obstructed labor is bad for babies
and bad for mothers. Babies often die, as Chero's baby did. And
Chero's problems during childbirth led to permanent damage to the
insides of her pelvis and to a childbirth injury called a fistula.
Once you have a fistula, you start leaking urine or feces from your
vagina. Once you have a fistula, you are a leper.
You stink, you leak, you are shunned. Your husband often rejects
you. Your family may do the same. No one wants to be near you. They
may called you cursed or bewitched. You are isolated and scorned.
And as you do your best not to eat or drink too much - anything you
can think of to stop the terrible leaking - you may become weak or
sick with infection. You probably will never have another baby. You
may well be left to die.
Over 2 million women in the world right now live with fistulas.
Most of them live in Africa and Asia - shunned and silent. Modern
lepers, just as truly as those I often talk about who are
stigmatized by HIV.
Your chance of having these childbirth complications is a lot
higher if you were married young, if you tried to have a baby
before your body was ready. Your chance of having these
complications is higher if you live in a poor place where you don't
have access to C-sections or medical attention when you are giving
birth. Your chance of having these complications is higher if you
live in a place where tradition maintains that your genitals are
cut. In Africa, especially, too many girls live in places where
marrying very, very young, having female genital cutting, and not
having access to healthcare are the norm. Chero had all of these
conditions. So do many of the women of Kenya. And many become
lepers because of their fistulas.
But here is the amazing thing - these fistulas can be fixed. A
surgeon with the right skills - and dedication to fixing the
problems of shunned, silent women - can completely change the story
of women like Chero.
This week, I had the pleasure of talking with one of my heroes
here in Eldoret, a Kenyan surgeon who specializes in fixing
Hillary Mabeya has devoted much of his life to helping women and
girls with fistulas. Women and girls injured in childbirth,
injured in sexual assaults, injured in ways that many people don't
want to talk about. This is a doctor who works for the voiceless,
for the despairing, for the stigmatized. I am proud to have him as
colleague in AMPATH and at the Moi University School of
Dr. Mabeya works late into the night, works on weekends, works
in remote parts of the country - all to help these silent and
shunned women and girls. In 2009, he opened a center in Eldoret called
Gynocare that provides, not only the much-needed surgeries for
these women and girls at no cost to them, but also provides
rehabilitation throughout their recovery and psychological
From young girls who develop fistulas after early arranged
marriages and childbirth problems to old women who have suffered
through rejection and stigma for decades, the Gynocare wards - and even Dr.
Mabeya's home - are full of women who suddenly have the chance to
stop living as pariahs. Women for whom life suddenly has hope
again. Almost 5,000 of them, Dr. Mabeya
estimates. They come from the most remote parts of Kenya - and
from Somalia, from South Sudan, from Uganda. Coming for a chance at
hope, a chance at healing.
- Dr. Mabeya, Photo by Direct Relief.
I talk a lot about those stigmatized and suffering with HIV, but
this is another condition of stigma and suffering -- one that
affects girls and women in the world's poorest places. If I was a
surgeon, this is what I hope I would be doing. Giving these women a
second chance at life is one of the best investments I can think
of. If you want to change Chero's story, think about a donation to
Dr. Mabeya's Gynocare
Centre or to the organization A Little 4 A Lot which
supports his work.
There is nothing I love more than seeing solutions for the
problems of the broken, the poor, the forgotten. I love seeing how
Dr. Mabeya changes the story for East Africa's suffering women and
- Transformation on the wards of Gynocare.
Photo by A Little 4 A Lot.