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She first heard about fistula on the radio in 2000, when it was announced that hundreds of women had shown up to a local fistula clinic seeking repair surgery. Shocked by the high number, Cellina wondered if the report had been exaggerated. The issue of fistula remained in her heart and, in 2014, she decided to volunteer and undergo training in fistula outreach. Once she started working in the field, Cellina realized that the announcement on the radio had not been exaggerated at all – fistula is indeed prevalent in Kisii, and the need for treatment is great.
As a community health volunteer, Cellina helps find new fistula patients at religious functions, community events, and other social gatherings. She conducts a verbal pre-screening and then refers potential fistula patients for more comprehensive screenings and treatment. Village chiefs have been very influential and supportive in her initiative.
Cellina has now been in the field for three months and has already identified four women with fistula. Patient recruitment is particularly challenging in Kisii, where girls often undergo female circumcision between the ages of 10-14 years and are then traditionally expected to distance themselves from all men. Following their marriage, women will rarely (or never) discuss reproductive issues with their husbands and vice versa. This makes it difficult for women to find someone trustworthy with whom to discuss personal matters, particularly a condition as stigmatizing as fistula. Kisii is also a very rural area, making transportation difficult – Cellina has to travel by motorbike over treacherous dirt roads, which limits the number of people she can reach in any given day.
“Working in my community requires a lot of patience and persistence,” says Cellina. “Having been born, schooled, and finally married in Kisii, I know firsthand what my fellow women have endured for ages and therefore, the least I can do is serve them in the best way I can by helping to offload the health burden from their shoulders” Cellina says that she is motivated by the way the outreach program is structured, as it ensures women receive all of the support they need.
- Population: 45,010,056
- Average Births per Woman: 3.54
- Female Literacy: 84.2%
- Population Living in Poverty: 43.4% (less than $1.25/day)