Launched in 2014 thanks to support from Astellas Pharma EMEA, Action on Fistula has provided training to increase the number of surgeons treating fistula in Kenya, developed a countrywide network of hospitals offering free treatment, and has delivered free reparative surgery to more than 2,500 women suffering from this devastating childbirth injury.
Halima* is a soft-spoken 25-year-old from Baidoa, in south-central Somalia. In 2013, she went into labor at home and was attended by a relative. This was the fifth child she had carried, although at the tender age of 23, already three of her children had died. She was in labor a long time without any progress—many days, it seemed—before she was eventually taken by her relatives to the nearest health facility.
While at the facility, her experience turned from bad to horrific when fighters from al-Shabaab, the terrorist network operating in Somalia, stormed the health center and started shooting the doctors and staff who were attending to the women. She remembers being assaulted by al-Shabaab fighters who claimed they could deliver her baby and then attempted to do so. Halima could barely speak about this terrifying episode, but she remembers eventually escaping the hospital, without her baby—the child had been stillborn—only to realize that she was constantly leaking urine. She had developed a fistula. Injured and traumatized, it took her four months to be able to walk again.
Halima was abandoned by her husband due to her condition, and she now lives in Kenya with her only surviving son, 7-yeard-old Mohamed. Seeking treatment, she traveled first to Ethiopia—more than 700 miles away—and eventually to Somaliland. But after traveling over 1,000 miles and undergoing multiple surgeries, she had no relief. She decided that going to Dadaab, located near the Somali border in northeastern Kenya, would be her best hope for medical treatment and maybe a better life. Dadaab is the world’s largest refugee camp, home to more than 300,000 people. Most are refugees from Somalia, who, like Halima, have been displaced by years of conflict and famine at home.
It was here in Dadaab that Halima was screened for fistula. Since May 2015, Action on Fistula has provided fistula repair surgery for 52 women from the Dadaab and Kakuma refugee camps in Kenya. Through a close partnership with Jamaa Mission Hospital in Nairobi and with logistics support from the National Council of Churches of Kenya, women have traveled from the camps, where there is no fistula repair capacity, to Nairobi, where they can be treated.
Awaiting treatment at the hospital in Nairobi, Halima seemed very nervous that the repair would be a success and wiped away tears when she thought of the prospect of going through surgery again without a better result. The difficult reality is that not all fistulas can be completely repaired.
But several weeks later, in the feedback from the hospital, there was a short and simple word next to Halima’s name. A word that carries enormous importance for changing the course of her life: “Dry.”
*Name changed for privacy reasons.
- 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)