A Problem that Must End

Sometimes, trying to have a baby can turn you into a leper. I wish I was exaggerating, but I am not.

Photo credit: The Advocacy Project
Woman in the river. Photo by The Advocacy Project


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, much like those living with HIV.

Today is the International Day to End Obstetrical Fistula. Truly, this is a problem that we must end.

Fistula is a problem of the world's poorest girls. 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.

One of my heroes in Eldoret is a Kenyan surgeon who specializes in fixing fistulas. Dr. 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. He fixes their injuries; he heals their shame. 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 Medicine. I was SO EXCITED to see him honored and awarded life-changing financial support on this international day of awareness.

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 support.

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 from Direct Relief.
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 girls.

Transformation on the wards of Gynocare. Photo by A Little 4 A Lot.
Transformation on the wards of Gynocare. Photo by A Little 4 A Lot.

"Fistula is fully preventable when all women and girls have access to high-quality, comprehensive sexual and reproductive health services [...] Let us join forces to eliminate this global social injustice."

UN Secretary-General Ban Ki-moon

Posted at 10:41


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