“You isolate yourself completely, even from your own family. You can’t focus, and you spend your days in darkness and crying.”
These are the words of Josephine Mitty, one of many women UNFPA met at the Kenyatta National Hospital in Nairobi during a free fistula repair camp held to commemorate the International Day for the Elimination of Obstetric Fistula.
Despite notable progress in maternal health, obstetric fistula remains a devastating condition affecting women in Kenya. The country records about 3,000 new cases each year, and fewer than 50% of affected women reach treatment. More than 100,000 women are estimated to be living with this injury across the country today.
This burden is fueled by late access to emergency obstetric care, reliance on unskilled birth attendants, and adolescent pregnancies. Harmful traditional practices also play a role, while weak referral systems and limited community awareness leave women without timely support.
Shame isolates. Pain condemns. Society looks away
Beyond physical suffering, obstetric fistula imposes daily social violence. Survivors often suffer shame, isolation, and discrimination, causing them to withdraw from society for fear of being judged or rejected.
For Josephine, her journey to the fistula camp was not only for surgery, but to reclaim her life. Her partner left because of her condition, leaving her to face isolation and a tremendous family responsibility alone.
Her story is similar to that of Felistas Syombua, who also underwent the life-changing fistula repair surgery at the camp. Her fistula developed in 2012, during the birth of her first child.
“For 14 years, I had to hide this condition from everyone, including my mother and friends. The only person I could trust with my secret was my husband, who always supported me,” she says, tears in her eyes.
When she gave birth again, stigma intensified her suffering. Some healthcare workers noticed but never informed her. Others informed her, and sometimes blamed her or cruelly suggested she should expect her husband to leave.
To survive at work and hide her ongoing incontinence, Felistas lived in constant anxiety, constantly running to the toilet. The pressure eventually cost her a stable job, pushing her into informal work to support her family. With her fistula repaired, she now hopes to fully reintegrate into society.
Josephine and Felistas: two lives, one demand
Through Josephine and Felistas, one truth becomes evident. While free surgery is essential, full recovery can only be realized through holistic care, which includes economic empowerment, psychosocial support, and community education to address deep-rooted stigma.
"Surgical intervention closes the physical wound, but a comprehensive, multi-sectoral systems approach is what restores the woman," says Dr. Pilar De La Corte Molina, UNFPA’s Deputy Representative and Officer in Charge in Kenya
UNFPA works collaboratively with partners to implement interventions aimed at eliminating obstetric fistula in Kenya by 2030. This includes strengthening maternal health systems and expanding emergency obstetric care for the prevention of fistula, as well as addressing underlying drivers such as early childbearing and FGM.
Through investments in prevention, timely treatment, and socioeconomic reintegration of survivors, women like Felistas Syombua are empowered to step out of isolation, leave the shame behind, and reclaim their lives.
