Hope as Makueni introduces fistula care

The head of the Reproductive and Maternal Health Division at the Ministry of Health, Mr Edward Serem, and the head of the fistula unit at the Makueni Mother and Child Hospital Doris Mbithi walk across the hospital compound on March 27, 2023. Makueni County government has set up a specialised unit to handle fistula cases in the region.

Photo credit: PIUS MAUNDU | NATION

What you need to know:

  • The recent launch of the Makueni fistula unit came after a team of 11 medics received specialised training on management and care of fistula

Three years after she was successfully treated for fistula, Juliana* is still nursing the scars. She hangs her head in shame when in public. The condition had taken a toll on her self-esteem. In the 20 years she nursed fistulas, the peasant farmer in Makueni County stopped attending chamas and Sunday prayers.

“At some point, I even stopped going to the market. Everyone kept turning their heads whenever I passed,” she told Healthy Nation.

Women with fistulas in Makueni will not have to go through Juliana’s experience after the Mother and Child Hospital, a project of the county government, introduced fistula treatment.  

The recent launch of the Makueni fistula unit came after a team of 11 medics led by Doris Mbithi, an obstetrician gynaecologist at the hospital, received specialised training on management and care of fistula — a devastating injury on a woman’s reproductive system which is sustained during childbirth.

The facility is an initiative of the county government and Jhpiego, an organisation affiliated to Johns Hopkins University. 

The condition is caused by obstructed labour and characterised by leaking urine and uncontrolled bowel movement. The Makueni facility will be the first public hospital to offer fistula repair services in the region. 

“Women in this and the neighbouring counties will no longer have to travel to Kenyatta National Hospital for treatment of fistulas. Our team of medics is up to the task,” the head of the Makueni fistula unit Doris Mbithi said as she unveiled her surgical team which includes anaesthetists, nutritionists, counsellors, physiotherapists and general nurses.
Health executive Paul Musila revealed that a week-long screening for fistula cases in the county had yielded 40 cases. 

“Thirteen of them have successfully undergone surgery at the new fistula unit as the rest were treated,” he said, terming the new fistula unit a big step as the devolved unit moves towards improving the quality of maternal services. 
As a way of preventing fistulas, Dr Musila called on mothers to deliver their babies in hospitals. He asked community health volunteers to refer suspected fistula cases to the hospital. 

According to the Ministry of Health, approximately 3,000 women in the country are diagnosed with fistulas every year. Access to fistula treatment is limited due to shortage of fistula surgeons. 

Juliana is lucky as her family did not split. The husband stood by her throughout the hard times. Medics report increased cases of men abandoning their women after they sustain fistulas.

“The dehumanising condition leads to the ostracising of women, breakages of families and untold psychological trauma. However, it is treatable,” said Hillary Mabeya, an obstetrician gynaecologist, expert and trainer on fistula management, and the proprietor of Gynocare Women’s and Fistula Hospital in Eldoret.

He is among three fistula surgeons enlisted by Jhpiego to kick-start Makueni’s fistula management service. 
Mr Edward Serem, the head of the Reproductive and Maternal Health division in the Ministry of Health, challenged devolved units to put in place concerted efforts to prevent the condition through training medics and strengthening their healthcare systems.