Scars of FGM: Tiaty tales of pain and anguish

She sits pensively on a stone, under the scorching sun cast by the barren tree limbs, wiping away tears as she struggles to narrate how the birth of her third child in 2004, led to a series of surgeries that almost cost her life.

The mother of nine recalls the birth complication, 17 years ago, that exposed her to obstetric fistula that lasted two years, a harrowing ordeal she has never shared with anyone, save for her close relative owing to the trauma, shame and rejection she went through while seeking for treatment.

Irine Chesakam, 43, from the remote Barpello village in Tiaty West Sub-county underwent female genital mutilation (FGM) when she was barely 12 years. The practice, she says, is mandatory for girls from the Pokot community because it is seen as a girl’s transition to womanhood that culminates to the exchange of livestock as part of dowry after being forced into arranged marriages.

Although the government declared FGM illegal, it is still dominant among the Pokot, Ilchamus and part of the Endorois communities.

Ms Chesakam’s troubles started when she went into labour with her third child. That pregnant women here rely on traditional birth attendants, worsened the situation. 

“I went into labour but the birth attendant didn’t know how to handle a circumcised woman. I was, however, severed to save the life of the baby who luckily, came out unscathed,” she tells nation.africa.

Defying culture

She says the resultant situation of her being unable to hold her stool and urine was traumatising because some women claimed she was either bewitched or cursed.

“Some blamed me for giving birth to my two other children in a health facility, claiming I was cursed for defying the culture of being attended to by a traditional birth attendant,” she explains.

She got some jabs at the local clinic to relieve the pain, while her severed vagina was stitched. The procedure was repeated severally to remedy the uncontrolled release of faeces and urine. Her condition, however, worsened.

She was referred to the Baringo County Referral Hospital for specialised treatment incurring a bill of Sh45,000 after a month stay. Nothing changed.

Four months on, she sought treatment at the Moi Teaching and Referral Hospital in Eldoret, where she underwent seven other surgeries spending Sh70,000 after another month at the facility.

Her condition worsened and she sought further treatment at Ortum, in West Pokot County where doctors from Tokyo were treating fistula patients. She recovered after two months. She paid a bill of Sh70,000 fundraised by the community while the facility waived Sh30, 000.

“I swore that none of my daughters would be subjected to the cut. Never!” says Ms Chesakam, an anti- FGM campaigner. Her story of anguish and pain is that of thousands of women, especially in Tiaty.

The story of Ms Chesakam is that of thousands of women, especially from far-flung Tiaty, that of anguish and pain as Kenya’s ban on FGM enters its tenth year.

Kenya criminalised FGM in 2011 with a punishment of three years’ imprisonment and a Sh200,000 fine. The practice, however, persists.

Expectant women

Chepturo Kasimoto, lost three children due to birth complications brought about by childhood FGM.

“I lost my first child after undergoing labour for two days in the neighbouring Elgeyo Marakwet County. The health workers had never handled an expectant women who had undergone FGM. It was a still birth. I have lost three children,” says Ms Kasimoto, a traditional birth attendant.

Barpello Location Chief Irine Kosgei’s sister lost her baby due to birth complications a decade ago. Her sister had been hospitalised owing to a narrow birth canal that was severed when she underwent FGM. The baby died due to obstructed labour.

“I have vowed to rally women and young girls not to be hoodwinked into the outdated cultural practice,” says Ms Kosgei.

The administrator says many women who experience fistula, common in women who have gone through FGM, suffer from shame, low self-esteem while others are abandoned by their husbands and relatives to battle it out on their own.

“We have lost many expectant women and their children. The situation is worsened by lack of health facilities,” says the chief, who is also an anti-FGM crusader.

Banning FGM

Lilian Chepchumba, another anti-FGM campaigner from Tiaty says FGM has undermined the lives of women and young girls in the Pokot community.

“Despite the State banning FGM, women and young girls in Tiaty Sub-county have borne its brunt. Some have bled to death, while others have lost their babies during birth,” says Ms Chepchumba.

She regrets that the practice has led to high illiteracy levels because young girls are married off at tender age.

 “I have witnessed women suffering from fistula due to severed birth canals, worse still, some new-borns or mothers die during birth due to lack of emergency services,” says Ms Chepchumba, lamenting that parents now engage in cross-border circumcision.

“Some parents who fear being nabbed by the authorities make arrangements for their girls to visit relatives in the neighbouring West Pokot County for the cut,” she adds.

Women in this community (Pokot) have no voice and only seen as a source of dowry.

Canon Christopher Chochoi, a retired Anglican priest who has constructed a rescue centre for girls who flee from the vice, regrets that FGM has contributing to high illiteracy rates among women in the area where more than 80 per cent are not in school.

FGM is justified in the communities where it is practiced because there is a social consensus that if households do not perform it on their women, they risk exclusion, stigma or the household not finding suitable husbands for their daughters.

Endorois community

Traditionally, Pokot circumcisers would be compensated with a gourd of milk, were respected and held in high esteem; today, it is an income generating activity.

To date, married women from Endorois community who escaped the cut in childhood, are forced to get it to avoid ridicule from their peers.

Majimoto assistant chief Kibet Kupetpet, says a worrying trend has emerged in the area.

“In Kapyemit and Majimoto villages in Mogotio Sub-county, married women who escaped the cut in childhood are targeted,” says Mr Kupetpet noting that the women are rounded up and taken as far as Banita in Nakuru County for the cut.

Dr Fredrick Kairithia, an obstetrician and gynaecologist says when a woman undergoes FGM, the genital area is scarred, reducing the ability of the tissues to expand.

“Such women tend to suffer from obstructed labour and when the foetal head sits on tissues, they die, forming an abnormal hole which is called fistula. If the tissues can’t expand, there is a tendency to tear because of pressure from the contracting uterus, causing a union between the vagina and the anus, and leading to the leaking urine and stool,” says Dr Kairithia.

“These women also suffer from excessive bleeding caused by genital tears and excessive scarring. There is also the foetal complication, which happens when it’s subjected to prolonged labour. Some babies are born with severe distress, depriving the brain of oxygen; such children tend to have severe learning disability,” says the medic.

Obstetric fistula is a devastating condition affecting between two to three million girls and women across sub-Saharan Africa and Asia, according to records by the World Health Organisation.

It is estimated that between 50,000 and 100,000 women worldwide develop the condition annually, though it can be repaired surgically.

Birth complication

Nation.africa established that there are no records of such cases at the Baringo County referral hospital where most birth complication cases from the far flung villages are referred to because most go unreported.

Records at the District Health Information Systems (DHIS), however, indicate that Baringo County reported only one birth complication in December last year, and one case each in Elgeyo Marakwet and Garissa counties. There were no records for the previous years.

In October the same year, DHIS statistics recorded seven cases in Elgeyo Marakwet, one in Garissa and none in Baringo.