For over four decades, Emily Mutai lived with the painful consequences of an injury she sustained during childbirth at the age of 18. Now 59, a farmer and mother of three from Bomet County, Kenya, Emily finally received life-changing repair surgery during a UNFPA-supported obstetric fistula treatment camp held in Kisii County in May 2025.

Obstetric fistula is a severe childbirth injury caused by prolonged, obstructed labour without access to timely medical care, such as a cesarean section. It leads to chronic incontinence and is often accompanied by persistent pain and recurring infections. Beyond its physical effects, fistula frequently results in stigma, social isolation, and profound emotional and mental health challenges, including depression and anxiety. 

Emily developed fistula in 1984, after delivering her first child at home with the help of a traditional birth attendant. The baby was very large — weighing 5.5 kilograms — and soon after the birth, she realized she could no longer hold her urine or stool. Although she went on to have two more children, both born in hospitals, the condition remained untreated for 41 years.  Throughout that time, she bore the burden alone. Her husband, who lives and works far away, offered little support.

“Having lived with the condition for so long, I refused to let anyone’s words define me, despite facing shame and stigma from my community — especially from women who often questioned me about my husband and our relationship. I chose to live with courage and hope, and I asked them to carry their own burdens and let me carry mine.”

Living with fistula affected nearly every part of Emily’s life. For years, even going to church required careful planning and came at a high personal cost. A devoted member of her church choir, Emily would go without food for two days before Sunday service to try to prevent leakage — the only way she felt she could attend. Now, after surgery, she says she is excited to eat freely and sing in church again with joy and confidence.

Emily heard about the fistula treatment camp through a community health promoter and was brought to the camp by her grandchildren. Just five days after her operation, she was already smiling and thinking ahead to how she could help other women living with fistula to access care. With her birthday approaching soon, Emily is looking forward to celebrating with her entire family — something she has not been able to do for decades. 

Obstetric fistula is preventable and, in most cases, treatable. Yet it continues to affect hundreds of thousands of women and girls around the world, especially in resource-poor settings. Globally, it is estimated that at least half a million women are living with untreated fistula. But these are not just statistics. Behind each number is a woman like Emily — a mother, grandmother, daughter, or sister — who has the right to quality maternal healthcare, to treatment, and to live a life of dignity, free from discrimination.

Since 2003, UNFPA has led the global Campaign to End Fistula, working with partners in more than 55 countries on fistula prevention, treatment, social reintegration and rehabilitation, and advocacy. The goal of the Campaign is to make obstetric fistula as rare in low- and middle-income countries as it is in high-income settings, where it has essentially been eliminated thanks to access to high-quality maternal healthcare, including skilled birth attendants and emergency obstetric care. 

In Kenya, UNFPA collaborates with national and county governments, NGOs and private sector partners, healthcare providers, and local organizations to reach women with critical fistula prevention and treatment services, strengthen health systems, and promote policies that prioritize sexual, reproductive, maternal, and newborn health.

Stories like Emily’s highlight the importance of sustained efforts to end fistula and childbirth injuries everywhere. Each successful treatment represents more than just a medical intervention — it is a step toward restoring dignity, health, and opportunity for women who have long been left behind.