On May 23, the International Day to End Obstetric Fistula, we kicked off the day with a lively procession through the outskirts of Mumias, a town in western Kenya. Our group was about 75 strong—including advocates, community health workers, local politicians, and fistula survivors—walking together in solidarity to raise awareness about fistula.
We had been walking for more than two hours in the beating sun when I thought I saw her out of the corner of my eye. Her tight spiral curls were bouncing up and down in rhythm with the marching band and her bright red Action on Fistula T-shirt matched the beat. Then she turned and flashed her brilliant smile—a smile I will never forget. It was Mary.
I had last seen Mary 10 months before at Cherangany Nursing Home, one of our busiest fistula treatment centers in western Kenya. Mary had arrived at the center after living with fistula for seven years. Like many women from her rural West Pokot community, she had gone into labor at home, with the help of a traditional birth attendant. She labored for three days before she was finally hoisted onto a homemade stretcher and carried on two men’s shoulders to the nearest facility. The walk took three painful hours, and by the time she reached the hospital it was too late. Her stillborn baby was removed and soon after she began leaking urine uncontrollably. Mary had developed a fistula.
She returned to a very cold reception from her husband, who refused to cover her hospital bills and blamed her for not being able to give him a baby. He threw her out. Embarrassed and ashamed, she returned to her parents’ home, where she lived for seven years. She felt lonely, bitter, and trapped. Before, she had been one of the lucky few girls in her community to attend primary school; now, it seemed as if all her luck had vanished.
But Mary is a fighter. After some time she, resolved to stop mourning her condition and do more with her life. Even though she struggled gravely with fistula she did the best she could to sell cereal in a local market—just enough to help her buy soap and petroleum jelly, which she needed to care for the sores she developed as a result of the continually leaking urine. She was overjoyed the day she finally received information from a WADADIA community health worker, who advised her that her condition could be treated and directed her to Cherangany Nursing Home.
Less than a year later, Mary had left her hospital gown behind and was now proudly donning a graduation gown. After the processional and celebration in Mumias, six women changed from their red T-shirts into graduation cap and gown. They are the first class of graduates to complete the six-month residential skills training program coordinated by our partner WADADIA. Mary and the other former fistula patients received intensive training and support to help them learn a vocation and empower them to earn a living for themselves and their families. Talking with Mary’s instructors, I learned that Mary was the top student in the class. She was also helpful to her peers, just as I remember her being in the hospital, helping translate for other Pokot women in the ward who did not speak Swahili. It was thrilling to see Mary on stage, beaming proudly, and to witness the transformation she had undergone in just 10 months.
Mary told me she was excited to go out and use her new skills to become an ambassador for fistula treatment. If you keep this information to yourself, she said, then other people will suffer. She doesn’t want anyone to suffer like she did. Planning to work with church groups and women’s groups, Mary is ready to spread the word about fistula and how treatment is available and free to women in need.
I am proud of Mary. Six months ago, I hung a framed photo of her on my office wall—for me, it was a reminder of the resilience so many women with fistula have in the face of great suffering, and of the transformative power of surgery that I could see through Mary’s stunning smile. I sent WADADIA a copy of the framed photograph to give to Mary as a thank-you gift, but I came to realize that it had not yet been delivered to her. How thrilling it was to give this photo to Mary and witness the striking juxtaposition of her in hospital gown and now graduation gown.
The possibilities for Mary are wide open. Fistula treatment has helped her regain her health and self-esteem, and the skills training has empowered her and allowed her to dream about a brighter future. But it is her inner strength and determination that will allow her to transform her own life. I am rooting for Mary.
By Lindsey Pollaczek, Program Director