May’s edition of PMLiVE magazine features the piece ‘Good Pharma: Astellas’ Action on Fistula works to build surgical capacity and transform patients’ lives in Kenya’, for International Day to End Obstetric Fistula. The case study highlights Action on Fistula, the innovative partnership between Astellas Pharma EMEA and Fistula Foundation to transform the lives of women in…
Chepotyeltyel is a Pokot woman from rural Turkwel in northwestern Kenya. According to Pokot culture and tradition, she grew up and was finally married at the age of 20. In a community where wealth is measured by the number of children you have, Chepotyeltyel became pregnant soon after her marriage. Within 10 years, she had 10 children.
In 1967, she became pregnant with her 11th child. During her pregnancy, she went about her usual duties—taking care of her 10 children, having to build a manyatta (shelter) whenever they moved in search of pasture and water, and ensuring security whenever her husband went out to fight during tribal clashes. One evening, after a long day of fighting and killings, she went into labor.
“I quickly sent for our village traditional attendant who had helped me with the other 10 children,” she says, adding that giving birth at home was common because there was no hospital in the area. But after five days without progress, it became clear that she was in obstructed labor, and the birth attendant decided to pull out the baby with her bare hands. Chepotyeltyel lost her child. Three days later, she realized she was leaking urine—she had developed an obstetric fistula. She says the condition robbed her of her marriage.
“It was so tough for me to raise my 10 children on my own,” she says. Living with the threat of tribal clashes and violence made things even more difficult. In order to survive and ensure that her children had enough to eat, she was forced to give her young daughters in marriage when they were just 8, 9, and 10 years old. A few months later, all seven of her sons were killed during a tribal war.
At this point in her story, Chepotyeltyel breaks down. “I was left with a condition that limited me as woman, I was abandoned by my husband, I had to trade my beautiful girls with a few goats and sheep, my sons were all killed in one day!” she says.
Now 80 years old, after suffering with fistula for nearly 50 years, Chepotyeltyel was able to receive free treatment at our partner site Cherangany Nursing Home in July 2016. Following her surgery, she said, “I am glad that God kept me alive for me to have this opportunity to get treated so that when I die, I die a clean woman.”
- 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)