30 years hiding, now smiling after surgery heals fistula

Shindano Kangota from Mikamini, a remote village 10km from Bamba town in the drought-stricken Ganze constituency, has never known happiness for all the three decades.

In fact, she had resigned to living a life of sorrow, neglect and stigma due to the ‘disease’, which unknown to her was curable.

What started as a happy marriage in her young adulthood ended up as trauma as she got pregnant but underwent an operation during childbirth due to complications, which ended up with her getting fistula.

Kangota is just one of the many cases of women who suffer in silence at their homes with conditions that are curable but that communities believe are as a result of witchcraft.

Normally the women suffer to death. But Kangota's ending is different. She can now afford a smile, even though she is still recovering.

She was among 31 other women who benefitted from a free fistula and gynaecological surgical camp organised by the Kenya Red Cross Society (KRCS) and Kilifi government in December last year.

COMPLICATED PREGNANCY

We witnessed most of the operations at the Kilifi County Referral Hospital, and later, together with a KRCS official, visited Kangota’s home in Mikamini village, an area which is very dry, with very high poverty levels.

“I got this problem of free urine fall (fistula) 30 years ago. I was pregnant and I underwent an operation to remove the child in hospital due to complications,” she tells us, adding that the child did not survive.

That was the beginning of her pain and suffering, living alone in a windowless house that was smelling of urine all through.

At the home, Kangota was seated outside the house with her mother, peeling leaves of vegetable to prepare lunch.

Due to the surgery she underwent, she can barely do any household chores, but at times, she has to do it because of the hardships at home.

Kangota does not know how to speak Kiswahili, so we converse in the local Giriama dialect, but she is also very shy and speaks a few words, something we learnt was as a result of the stigma that has made it difficult for her to open up.

She said her relatives could not afford to take her to hospital all those years, that’s why she suffered for the three decades until she was rescued.

Her house, a single room with a veranda, is empty as the traditional bed (Mwakishu) is drying outside, with an old, tattered, dusty mattress.

The house has no ventilation, too, making one wonder how the woman survived all those years in the stuffy house as a result of the fistula complication alone.

“I really thank the Kenya Red Cross for the help. But I still have problems. I am recovering well but I have no beddings, food, drugs. That’s why I spend the whole day outside here, counting boda bodas,” she said.

THE RESCUE MISSION

Phillister Sauti, a resident of Bamba who rescued the woman, said that on November 12, she was helping victims of hunger in the drought-stricken Bamba through an initiative called Okoa Ganze.

Sauti got a call that there was a woman who had not eaten for three days, and as she had some food stuffs from her initiative, she visited the home to help.

On the fateful day, she found her depressed and weeping due to the condition she was going through, with no hope of living another day.

“Upon visiting her the following day with food, I established that she had fistula and that it was not only hunger that was hurting her," Sauti said said.

It took her two weeks for her to get donors.

Initially, Sauti called Kilifi Deputy Governor Flora Chibule, who advised her to take her to Kilifi Hospital and she would be assisted.

In Kilifi, there was a medical camp going on and she managed to undergo surgery together with the other 30 who had fistula and other gynaecological complications.

Kangota underwent surgery on December 13 after admission and stayed there until she recovered before being allowed to go back home on December 23.

“We are so happy she is getting better. She has told me after the operation, her condition is turning back to normal,” Sauti said.

She said the cases could be many in Bamba or Ganze constituency at large, but they are hidden because of stigma and poverty.

Even when there are free medical camps, such patients cannot afford to go to Kilifi, Sauti said. She advised that in future, such medical camps should be done in Bamba.

“This is a patient who has suffered for 30 years with fistula, her first pregnancy is what caused the ailment. The child died so she has no child and is suffering,” she said.

Sauti also thanked Kenya Red Cross and the Kilifi government, the referral hospitals and the doctors who conducted the surgeries for giving her her life back.

She advised other people who were suffering to go to Bamba Subcounty Hospital to get assistance.

“Community should not stigmatise such patients because they can die due to depression. For her case, the operation took only five hours and she was healed,” she said.

Sauti said there are community health workers in the grassroots who can be informed about it so that donors or well-wishers can help.

She is happy that her Okoa Ganze initiative not only made an impact on the people affected by famine but also made a positive impact on Kangota, who shall now live a healthy life.

“The state I found her in, crying here due to the disease, is different from how I found her today. She is smiling and it makes me happy,” she said.

Robert Chengo, a resident of Bamba, said Kangota suffered silently because the community did not want to disclose the ailment.

Chengo, who is part of the initiative of Okoa Ganze, said had it not been for him and Sauti, she could still be suffering.

He emphasised that the community should not stigmatise or hide such patients in their homes as they can be assisted.

“The state at which I found Kangota two months ago is different today. She is full of joy and she is happy, at least she has hope of life,” Chengo said.

He said at one time, Kangota had said she was ready to die, which means she had lost hope.

Most communities, he said, have negativity on such diseases as they associate them with witchcraft, forcing the patients to remain in homes.

I would urge residents to know that fistula or gynaecological diseases are ailments that can be cured. For Kangota, a surgery of five hours saved her from 30 years of agony

SEXUAL REPRODUCTIVE HEALTH

Zipporah Kuria from Kenya Red Cross, who had visited Kangota, too, said in December they organised a gynaecological medical camp and 31 benefited with surgeries.

“Today, I have visited one of them, Shindano Kangota, and I am happy that she is going on well. When we found her in December, she was in a sad state. The ailment of more than 30 years had made her lose hope,” she said.

Kuria said before the operation she was very weak but now she was going on well and her health has really improved.

The Kenya Red Cross official said she was happy because the surgeons really assisted Kangota.

“I would urge community members and residents of Kilifi to know that fistula or gynaecological diseases are ailments that can be cured. For Kangota, a surgery of five hours saved her from 30 years of agony,” she said.

Kuria said the main goal of the project is to enhance the uptake of sexual reproductive health services in Kilifi county for women of reproductive age and to enhance Gender based Violence outcomes.

The surgical operations, she said, were meant to transform the lives of women and change their lives for the better.

She said in Kilifi county, many women suffer from fistula and other gynaecological conditions, but due to their poor financial conditions, they cannot meet the cost of treatment.

“They have been suffering for a very long time, that’s why we saw the need to come in as Kenya Red Cross and partner with the county government Department of Health to support these women undergo operations,” she said.

She said those conditions have been a barrier for the women to engaging in economic activities, and it has limited the quality of life they are living.

Such women suffer because the diseases make them unable to work to be financially independent and have to rely on other family members, which increases their vulnerability, she said.

She said they expect to change positively the lives of the beneficiaries so as to live normal lives.

Kuria said the project is being implemented in Kilifi North and South subcounties in three community units of Mtwapa, Mtepeni and Sokoni.

“In all these community units, we are dealing with 30 community health volunteers (CHVs), and it is through their routinely household visits that they come across these conditions that women are suffering from,” she said.

She said it is through the CHVs that they established women are suffering from gynaecological problems and are stigmatised, that’s why they do not come out to seek help.

She thanked the Department of Health management, together with the entire health providers who really supported them in making the medical camp a success, and appealed to other organisations to organise more medical camps so that women can be helped.

Dr Eric Wanjala, a specialist in obstetric surgery and gynaecology at Kilifi County Referral Hospital, said they operated on 30 patients, adding that the camp was beneficial to the patients.

He said the problem of fistula is caused by inadequate skilled personnel in deliveries, and unfortunately leads to social stigma.

Kangota is just one of the cases of survivors who can help others come out and seek treatment instead of suffering silently at home.

If people could end stigma for such patients in villages and more medical camps are organised to treat the ailments, at least we could bring an end to such complications and ensure our women live healthy lives.