Street mother: After giving birth to 12 children, doctors cut my fallopian tubes
As we drive into Eldoret town past midnight, a young woman accompanied by ten children braves the heavy downpour and flags down our car. She has a baby firmly clutched to her back.
“My children and I have not had anything to eat for days now, have mercy on us,” she cries out.
Situated in the Rift Valley region of Kenya, Eldoret is one of the fast-growing towns in Kenya. It has dozens of street families.
These families are uncertain of what the dark chaotic streets hold for them. Without proper houses, the women live in constant fear about the safety of their children.
We stopped and ushered all of them into our hatchback vehicle.
The 31-year-old mother of 11 children introduces herself as Jane (not her real name). She tells us that she had 12 children but one of them died.
Jane says that after delivering her 12th child, she underwent a successful bilateral tubal ligation surgery where her fallopian tubes were cut to permanently prevent her from conceiving.
Family planning
“A local Non-Governmental- Organization took me through the family planning process because I was giving birth at the rate of one baby per year which is contrary to family planning recommendations that dictate that a woman who has given birth should get pregnant after a two-years lactating period,” she explained adding that most street families in Eldoret do not receive Universal Health Coverage (UHC) services like ‘Linda Mama’, a public-funded health scheme that ensures that pregnant women and infants have access to quality and affordable health services.
She says most of them cannot afford the services and are forced to give birth on the streets, in bushes and in garage backyards.
“At the health facilities within Uasin Gishu, we are not treated equally. Nurses say we are dirty and this makes most of us stay away,” she said.
But Jane is just one of the hundreds of women who hop from one street to another in Eldoret as they look for food for their families.
But how did she get her 12 children?
She fled home for the streets at the age of 14 in search of a better life.
An aerial view of Eldoret town in Uasin Gishu County on January 3, 2023.
“The conditions at home were not favourable for me because of the constant conflicts with my parents who did not agree with my desire to go to school,” Jane opens up.
She would then give birth to her firstborn just a year after running away from her parent’s home in Turkana.
“You see, the lack of family planning made me get the 12 children. We are sexually active like other Kenyans who comfortably live in their houses but those in authority seem to have forgotten that we exist too,” she said.
She said street mothers do not get enough education on how contraceptives work.
“Only a few of us who visit the health facilities have access to information on family planning. Most of us have never used family planning,” she told Nation.Africa.
“We are usually not given the best reception at the health facilities because we don’t look presentable, some of us go days without bathing and this is why nurses are reluctant to attend to most street mothers,” added Jane.
Despite the challenges they face on the streets, the number of street families keeps growing by the day.
This is a ticking time bomb that poses a huge problem in the country as most street children are associated with crime.
Rehabilitation centres
We take Jane and her children to a restaurant where we meet Mr Benson Juma, a reformed street boy.
He says the government should build rehabilitation centres for street families.
“The growing number of street families calls for the government to step in and put-up rehabilitation centres for street life is harsh. The children are brought up with no basic moral values, no proper shelter, no education and most of them end up being a threat to communities around them,” Mr Juma noted.
Elizabeth Ameri (in white dress) and other street families in Eldoret on January 2, 2023.
To control the rising number of street families, Mr Juma says the government should sensitise street mothers on the importance of family planning and ensure contraceptives are readily available to them.
Dr Caleb Wata who is a medical practitioner in Western Kenya said the increasing number of street families will frustrate the attainment of Vision 2030.
“The government needs to address several aspects including the reduction of infant mortality, maternal mortality and these family planning practices are some of the ways to deal with issues like unwanted pregnancies,” Dr Wata said.
Mr Dominic Makori, a social worker, agrees that taking care of street families is a big challenge.
“We don’t have systems that are helping these street populations and those that are there are either fragile or not working,” Mr Makori said.
According to a World Health Organization (WHO) report, young street girls are prone to unwanted pregnancies due to unprotected sex.
And because their reproductive system is not fully developed; they are prone to complications related to childbirth, such as premature delivery and obstructed labour. These can cause injuries or death to the baby and the mother. In addition, the baby born to such mothers may have a low birth weight and may be prone to infections and illness.
The report further says that pregnant street girls may feel pressured into terminating their pregnancy as coping with infant babies’ demands is difficult in the streets.
In addition, they often have no one to turn to for support and advice, and they may not have access to reproductive health services for safe termination of pregnancy.
These young girls end up seeking abortion services from unqualified persons. Unsafe abortions could lead to infections, bleeding, or even death and forceful termination may cause damage to the reproductive organs and eventually cause infertility (inability to have children).
The stress of the experience could also lead to psychological problems as well as mental health issues like depression.
According to Ms Atelo, young girls living in the streets fall victim to men who promise to take them in and improve their lives only to get them pregnant and abandon them.
”Many young girls in the streets are pregnant but those responsible for these pregnancies are nowhere to be seen. Most of these pregnant girls are forced to offer sex in exchange for food, an act that eventually leads to pregnancies and they are now forced to raise the newborn alone in the cruel streets,” he added.
The mother of 12 says that had she been given good guidance on family planning, she would not be subjecting her children to the cruel life on the streets.
“I had personally been using injections but whenever I would forget to go for a renewal of the same, I would get pregnant,” she said.
“ Sometimes we get overwhelmed thinking of where we will get food and where to sleep, this makes other things like family planning slip our minds and we end up getting unwanted pregnancies,” she added.
Her youngest child, who is barely six months old, is already being subjected to harsh street life. The baby has no warm clothing and is exposed to many diseases including pneumonia and malaria.
In the neighbouring county of Bungoma, the situation is not so different. We meet 24-year-old Nicole who is also a street mother of two.
“Abstinence in the streets is no option for us, as most of the men we associate with demand unprotected sex. If we had permanent family planning solutions and contraceptives we would avoid so many unwanted pregnancies,” said Nicole.
Unprotected sex has led to an increase in HIV cases and other sexually transmitted diseases among street families.
The WHO report published in November 2020 further indicates that out of the 1.9 billion women of reproductive age group (15-49 years) worldwide in 2019, 1.1 billion need family planning; of these, 842 million are using contraceptive methods, and 270 million have an unmet need for contraception.
The need for family planning satisfied by modern methods, Sustainable Development Goals (SDG) indicator 3.7.1, has stagnated globally at around 77 per cent from 2015 to 2020 but increased from 55 per cent to 58 per cent in Africa.
Condoms
Only one contraceptive method, condoms, can prevent both pregnancy and the transmission of sexually transmitted infections, including HIV.
The use of contraception advances the human right of people to determine the number and spacing of their children.
It offers a range of potential non-health benefits encompassing expanded educational opportunities and empowerment for women and sustainable population growth and economic development for countries.
The number of women desiring to use family planning has increased markedly over the past two decades, from 900 million in 2000 to nearly 1.1 billion in 2020.
Consequently, the number of women using a modern contraceptive method increased from 663 million to 851 million, and the contraceptive prevalence rate increased from 47.7 to 49.0 per cent.
An additional 70 million women are projected to be added by 2030 to gender-based barriers to accessing services.
As these barriers are addressed in some regions, there have been increases in demand satisfied with modern methods of contraception.
Amid these interventions, there is also concern over the quality of healthcare they receive, especially when a global pandemic is ravaging communities.
"Uasin Gishu County and the national government should come up with a budget to help these street families," Pastor Joseph Mukolwe who is based in Eldoret told the Nation.
Last year, former Uasin Gishu governor Jackson Mandago assured that his government would collaborate with the children's department to take all the street children to the rescue centre.
"We will give them food, medical support and even educate them. Those with parents will go back home,” said Mr Mandago.
While county governments are struggling with the increasing number on the streets, many community-based organisations have started engaging street families in family planning, especially girls.
"There is a need to bring them together and sit them down and talk about sexual reproductive health, and it should include the male partners because, in the street, the issue of family planning has been left to be handled by the females," explains Dominic, a social worker based in Eldoret.
As the world continues to encourage and support family planning across many nations, street families in sub-Saharan Africa continue to be ignored by stakeholders.
This, according to experts, is a danger that can only be solved when the welfare of this group is handled on time.
