The Flying Doctors’ Society of Africa (FDSA) will today launch a two-week-long fistula screening and surgical free medical camp at the Kisii Teaching and Referral Hospital (KTRH).

The camp, dubbed ‘No More Tears’ has traversed a number of remote areas in the country. A number of doctors and other medical personnel have so far confirmed attendance.

Two million women worldwide live with fistula, a devastating childbirth injury caused by prolonged labour. Tissue dies due to pressure from the baby’s head and a hole forms through which urine or faeces leak.

Many women and young girls are undergoing the agony at such an early age and have been living with the condition for years.

Enock Ondari, a gynecologist and KTRH acting chief executive officer, said ostetric fistula is preventable and treatable.

“It can be prevented if labouring women are provided with adequate and timely emergency obstetric care when complications arise. Once a fistula has developed, however, the only cure is surgical treatment,” Dr Ondari said.

UN agencies estimate that obstetric fistula affects 50,000 to 100,000 women every year, mainly in sub-Saharan Africa, largely because of stigma.

“One of our key goals, in addition to offering re-constructive surgery, is training local surgeons on fistula surgery. Fistula is still rampant in Kisii and Nyamira counties,” he said.

Obstructed labour

He noted that in developing countries, poverty and malnutrition in children contributes to the condition of stunting. Therefore a girl’s skeleton and pelvis do not fully mature. This stunted condition can contribute to obstructed labour, and therefore fistula.

Experts say that the root causes of fistula are grinding poverty and the low status of women and girls.

“Fistula is a shameful thing. Very few women declare that they have the problem. That is why it is quite difficult to know the number of women who suffer from the ailment," said Isabella Ongwae, a nurse at KTRH.

She said very few women in Kenya seek for medical attention despite the terrible circumstances in which they live.

“The need for institutional preparedness that will see an improvement in the quality of care at health facilities as well as effective referral systems,” said Ms Ongwae.

Fistula also occurs as a result of infections, trauma like in rape cases, complications during surgery, tumour of the cervix and exposure to radiation.

Ondari said almost 300 cases of fistula are reported at the facility every year, yet only less than 25 per cent of these undergo surgery due to the high costs involved. In Kenya, it is estimated that out of every 1,000 deliveries, between three and four women get fistula.

A United Nations Population Fund (UNFPA) report released in 2004 estimated the backlog of fistula cases to be as high as 300,000, with a projected 3,000 new cases of fistula each year in Kenya, with only 7.5 per cent able to access medical care.