In May 20 this year, the world observed the International Day to End Obstetric Fistula with the theme – End fistula, restore women’s dignity. How apt. Women and girls living with fistula are among the most marginalised and neglected, and it’s persistence is a grave illustration of the wanting maternal health in Kenya. Nampaiyio Koriata battled the condition for 12 years before getting treatment. She recounts her battle with obstetric fistula to LILY RONOH.

On August 7, 1986, the family of Mzee Koriata in Ololulung’a, Narok County welcomed a bouncing baby girl in their family. The girl was christened Nampaiyio Koriata. Twenty-nine years later, the girl, now a woman, sits across me at the interview table. She is here to tell me about her battle with obstetric fistula (read more about the condition on the Focus on Disease column) and in the same token raise awareness of the condition.

In 2002, sixteen-year-old Nampaiyio was lured into an illicit relationship. Having grown up in a community where sex talk is considered a taboo subject, she didn’t know much about sex and soon enough, she fell pregnant. She was then in class eight. But the pregnancy was not enough to make her drop out of school and she soldiered on, enduring suspicious glances from her classmates and community.

“I did my Kenya Certificate of Primary Education (KCPE) while heavily pregnant, but I am a courageous woman. I told my teachers to let me do my KCPE and gladly they did not have a problem. I stayed home for a month before the exams started,” reminisces the mother of four adding that she managed to get 262 marks out of a possible 500.

Two weeks after sitting her KCPE, Nampaiyio welcomed her bundle of joy. At the time, a girl falling pregnant early was not a cause for alarm and her parents took her in, caring for her and the baby. She would take the baby for checkups at a nearby dispensary but no one cared to check how she was healing as is the practice. Her torturous journey with obstetric fistula would start when the baby hit three months.

“One day, I felt the urge to answer the call of nature but I soiled myself before reaching the toilet. This did not stop and I would soil myself everyday. My mum at first thought it was a sexually transmitted infection,” she shares.

Her mother would always taunt Nampaiyio believing it was all doom and gloom for her daughter. But Nampaiyio is an ambitious spirit who, from a tender age, has always envisioned herself as a successful woman and not even the happenings at the time could dampen her spirit. She dismissed her mother’s fears and remained optimistic that whatever was happening would go away.

“I thought what I was going through was a normal thing after delivery. My relatives thought I was suffering from ulcers and would administer herbal drugs through cuts in my body. But the incontinence did not stop,” says Nampaiyio.

That is when depression set in. She would subject herself to solitary confinement in her bedroom shunning everybody. She purposed to hide the condition from all and sundry. During holidays, she would stay away from the rest of the family and wouldn’t answer when someone called her.

Anguishing in silence…

The urge to succeed gave her courage to come out from hiding. In 2004, she went back to school to pursue her secondary education. Her predicaments started right from day one – she soiled herself during admission and this set the pace for the rest of her school life.

She would be seated in class keenly attending to a lesson but then would pass stool and ultimately lose concentration in class. She would uncomfortably wait for the lesson to end and then dash out immediately the teacher stepped out of class. Other times, she would not know she has passed stool but then she would feel itchy and this would alert her.

This meant that she had to go to the dormitory to change her clothes. She also could not control passing wind and the moment the urge came, she would stifle her body, sometimes successfully and other times unsuccessfully. It was embarrassing. Many are the times she missed meals or avoided the company of other girls, as she did not want them to know of her embarrassing condition. And such was her life throughout her stint in high school.

Nampaiyio admits she is talkative by nature and those few times she dared engage with her colleagues were interrupted when she would suddenly soil herself, forcing her to stop mid-sentence and scurry away to go clean herself. In 2006 while in form three, Nampaiyio had had enough so she quit school. She was an average performer and no one really understood why she dropped out of school.

“My elder brother was particularly irked. He didn’t know what I was going through and he stopped talking to me. Others thought I was being naughty,” she recalls.

At home, it was easier to manage the condition. For example, if the incontinence happened while walking with friends, she would excuse herself, enter into the nearest homestead and ask the owners for a basin. She had learnt to always walk with an extra pair of panties and a well fitting short. She would then change and join her allies.

Her dream of succeeding in life did not die with her dropping out of school: she immediately ventured into small-scale businesses. She started by selling scrap metal, then went into the more lucrative business of selling charcoal and when she had saved enough, opened a hotel.

“Due to my condition, I was restricted behind the counter.  I also limited my interaction with men because I knew no man would want to be with a woman like me. By then, I still hadn’t known that I was suffering from fistula and thus was anguishing in silence. I wish I had known. My parents could have afforded my treatment,” says Nampaiyio adding that she would also suffer from rampant attacks of urinary tract infections.

An activist is born…

Her depression found an outlet in activism and she became involved in many activities in her locale. She reminisces of a time during the 2007/2008 post-election violence when two groups from different communities were pitted against each other. She says she rushed to the scene and started chanting “Kila mtu aende nyumbani” (everyone go home). People around her picked the chant and they all started shouting “Kila mtu aende nyumbani.” The young men all turned and each went their separate ways. She proudly admits that that was what prevented the violence in her area.

It was also during this time that she started working as a volunteer with various non-governmental organisations in Narok County as a civic educator.  In September 2009, Christian Partners Development Agency (CPDA) gave her the role of a facilitator handling pertinent issues such as the Agenda Four (one component of Agenda items of the National Accord Reconciliation Agreement that was signed on February 28, 2008 after the post-election violence) in her community, as well as leading other volunteers in uplifting the living standards of her people.

By then, she had known how to manage the condition by going to the toilet in the morning before leaving the house, checking on her diet (she had known which foods made her stool light and she avoided them), listening to her body and wearing panty liners so as to ease the cleaning up process in the event she passed a stool.

“I had also realised that when stressed, I had more incontinence than when I wasn’t, so I tried to avoid being stressed up. In meetings, I would be the last one to get out of the room and would take advantage of any noise to pass wind. I also avoided standing up as much as possible because I couldn’t control passing wind whenever I was standing,” she shares.

She became more involved in CPDA and it is from there that she met the love of her life. Since obstetric fistula hit her, Nampaiyio learnt to become exceptionally clean, which helped her to conceal the condition. So much so that her husband did not know about it.

Unlike many women with obstetric fistula who cannot give birth, Nampaiyio gave birth to her second child towards the end of 2010. The doctor who helped her deliver did not realise that she had fistula despite telling Nampaiyio that he reckons she has “two holes.” She was advised to do kegel exercises, which she says helped tighten her muscles. She went on to get her third child without the doctor again noticing she had fistula. She admits that she always passed stool during her deliveries but no one paid any particular attention.

But it would be during the birth of her fourth child in March last year that her condition came to light. The sister who helped her deliver broke the news to her. “She asked if I knew I had fistula. My mind ran to a signage at Kenyatta National Hospital that has been inscribed the word fistula. I knew fistula is associated with passing urine uncontrollably but did not know that passing stool the same way was fistula,” she shares.

The sister gave the report to her husband who was shocked that his wife had fistula. He sympathised with Nampaiyio. She is grateful for the support he showered her afterward even researching on the best treatment.

A new lease of life…

In June last year, as the couple were watching television, they saw an advert on a campaign to fight obstetric fistula. They decided to seek help. In her mind, she thought the procedure was simple, a one day affair. Contrary to her belief, she learned that it involved a series of procedures. She couldn’t undergo surgery since the baby was still very young and she decided to postpone it.

In June 24 this year, Nampaiyio was given a new lease of life through surgery to correct the fistula. “I feel as if I have been born again. For 12 solid years, I have battled with this condition. I still get panic attacks thinking I have soiled myself or fearing that I may pass wind in front of people, but nothing,” she says, her face lighting up.

Nampaiyio admits that her life would have been very different were it not for the condition but is appreciative of the fact that all things work for good for those who trust in the Lord. She says she decided to open up and champion for awareness of obstetric fistula since there are thousands of women who are suffering in silence yet there is a solution.

Has she succeeded in her dream of being a successful woman? “I am well on track. And now that I am healed, the sky is the limit,” she says in conclusion.

lily@parents.co.ke

The Freedom from Fistula Foundation, Consolidated Bank, Royal Media Services, Kenyatta National Hospital (KNH) and the Flying Doctors Society of Africa conducted a three-week medical camp in July in which 205 women from all over the country benefitted from free fistula surgeries. Other camps will be held in Embu County on August 17 to 21, 2015 at Embu Level 5 Hospital and Kisii County from September 13 to 20,  2015 at Kisii Teaching and Referral Hospital. Women can still continue to receive treatment at Clinic 66 at KNH for free. For more information, they can be reached on 0722205084, 0718100100, and 0737100800.