{"id":116146,"date":"2018-06-05T22:47:41","date_gmt":"2018-06-05T20:47:41","guid":{"rendered":"http:\/\/www.myza.co.za\/suffering-in-silence-how-kenyan-women-live-with-profound-childbirth-injuries-the-conversation\/"},"modified":"2018-06-05T22:47:41","modified_gmt":"2018-06-05T20:47:41","slug":"suffering-in-silence-how-kenyan-women-live-with-profound-childbirth-injuries-the-conversation","status":"publish","type":"post","link":"https:\/\/www.myza.co.za\/press\/suffering-in-silence-how-kenyan-women-live-with-profound-childbirth-injuries-the-conversation\/","title":{"rendered":"Suffering in silence: how Kenyan women live with profound childbirth injuries | The Conversation"},"content":{"rendered":"

Suffering in silence: how Kenyan women live with profound childbirth injuries<\/a>: <\/p>\n

<\/span> Shutterstock<\/span><\/span><\/figcaption><\/figure>\n

Sasha is 22-years-old. She was married off when she was just nine and by the time she was 11, she was pregnant with her first child, and unprepared for childbirth. <\/p>\n

So when labour came, in the middle of the night \u2013 in her geographically isolated village in rural Kenya \u2013 she was unaware of the painful fate awaiting her. <\/p>\n

During childbirth, the baby\u2019s head was too big to fit through Sasha\u2019s pelvis, causing the baby to get stuck in her birthing canal. Traditional birth attendants tried their best to help Sasha but they were not skilled enough to handle the complications. She needed surgery, and quickly. But because she could not access emergency obstetric services, she spent the next six days trying to push out the baby that was stuck inside of her. <\/p>\n

In the end, Sasha delivered a dead, rotten baby in macerated form. She was not only in grief of her lost child, but was also traumatised by her experience which left her with profound injuries and a double obstetric vaginal fistula. <\/p>\n

An obstetric vaginal fistula is a tear between a woman\u2019s vagina and another body part \u2013 usually caused by obstructed or prolonged labour. It occurs when the baby\u2019s head is trapped against the pelvic bone and cannot descend further. As the labour intensifies, the blood supply is cut and the surrounding tissues die. Shortly after the baby dies and labour continues until the baby is pushed out.<\/p>\n

Across the world, there is an estimated two million women and girls just like Sasha who live with vaginal fistulas. There are up to 100 000 new cases each year. In Kenya, at least 3000 new cases are reported annually but research shows that only 7.5% are treated.<\/p>\n

But these statistics are bound to be grossly inaccurate due to under-reporting, poor and non-existent data keeping in most African hospitals. This is made worse by women feeling internalised shame which keeps them from seeking help for their fistulas. It means that the magnitude of the problem on the continent is assumed to be much higher. <\/p>\n

Sasha was one of the women I interviewed in my research which investigated how Kenyan women with fistulas negotiated the complexities of living with a body that leaks. This included the process of trying to get treatment as well as the journey to recovery from childbirth traumas that rendered their bodies abject, damaged and at times irreparable.<\/p>\n

My research revealed a lack of resources and the structural challenges that prevent women from getting the help they need. This is particularly prevalent in remote areas, where access to health services is not available or is very limited.<\/p>\n

It also reinforces what researchers and medical professionals in Kenya have established over the years. <\/p>\n

Negotiating the challenges around fistula<\/h2>\n

Kenya continues to face enormous challenges as far as dealing with vaginal fistula are concerned. The biggest is the lack of resources to treat fistulas along with a severe shortage of fistula surgeons. By 2014, Kenya only had three internationally renowned fistula surgeons and less than 10 surgeons who could perform simple obstetric operations.<\/p>\n

This has made it logistically impossible to treat all the women who seek treatment every year. It also means that many are left untreated for years adding to the ever increasing backlog.<\/p>\n

\"\"
Women awaiting fistula surgery at the Gynocare Women\u2019s and Fistula Hospital in Kenya, which is the only private facility which specifically treats fistulas for free.<\/span> Direct Relief\/Flickr<\/span> <\/figcaption><\/figure>\n

But for most women with fistulas, the damage is not only physical, it\u2019s also psychological. They negotiate rejection and social exclusion on a day-to-day basis which can have severe psychological consequences. This can be more destructive than the actual fistula.<\/p>\n

The women I engaged with explained how their fistula diagnosis threatened their social and intimate lives. They explained how having a \u201cleaking body\u201d was constructed as being dirty, deviant and contaminated. <\/p>\n

Many described that the way they went about their lives was primarily occupied with finding ways to protect themselves from being \u201couted\u201d or shamed for the pungent smell that they carried with them.<\/p>\n

Their stories revealed the structural and sociocultural challenges that explain why women in Kenya are at risk of developing vaginal fistulas and then having adequate treatment delayed or denied them. This is particularly prevalent in remote areas, where there are transport barriers, impassable roads, and limited or unavailable access to health services or emergency obstetric care. <\/p>\n

Responding to fistulas<\/h2>\n

In the last decade, the Kenyan government has initiated a programme under which local health workers train traditional birth attendants working in remote areas to mitigate maternal casualties. But despite the fact that the training includes skills to manage birthing complications, some women require immediate medical intervention. <\/p>\n

Kenya also rolled out other public health campaigns to end maternal deaths. One was the Beyond Zero campaign which was initiated by Kenya\u2019s First Lady, Margaret Kenyatta to raise funds and awareness on issues of safe delivery, and obstetric injuries that lead to vaginal fistulas. <\/p>\n

Although the initiative was heavily criticised as an attempt to provide a quick fix to structural problems, it raised national awareness about vaginal fistulas and mobilised resources for free surgeries for women with the condition. <\/p>\n

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Read more: Better maternal care in Africa can save women from suffering in childbirth <\/strong> <\/em> <\/p>\n

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The criticism reflects the importance of addressing the underlying causes of fistula. These causes have been summed by one of Kenya\u2019s most renown fistula surgeons Dr Weston Khisa, who says<\/p>\n

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Medically, fistula is caused by obstructed labour, but the underlying causes are obstructed transport, obstructed family planning, obstructed emergency care, and obstructed human rights.<\/p>\n<\/blockquote>\n

Ending fistulas means eradicating both cultural and structural obstacles that put women at risk of developing preventable tragedies such as fistulas. It requires a complete overhaul of health infrastructure in Kenya to ensure that maternal care and women\u2019s reproductive health are prioritised \u2013 and that no woman has to lose her life while trying to give one.<\/p>\n

\"The <\/p>\n

Kathomi Gatwiri does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.<\/span><\/em><\/p>\n

Source:<\/strong> The Conversation \u2013 Articles (AFRICA)<\/a><\/small>
\n<\/p>\n

Read more on The Conversation<\/a>.<\/p>\n

Join the fun:<\/strong> Add Your event<\/a> | Submit a Press Release<\/a> | Add your listing<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

Suffering in silence: how Kenyan women live with profound childbirth injuries: Shutterstock Sasha is 22-years-old. She was married off when she was just nine and by the time she was 11, she was pregnant with her first child, and unprepared for childbirth. So when labour came, in the middle of the night \u2013 in her […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","ngg_post_thumbnail":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[4584],"tags":[13631,8890,1178,9105,2856,30771,7786,12007,87],"class_list":{"0":"post-116146","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-africa-news-2","7":"tag-childbirth","8":"tag-conversation","9":"tag-injuries","10":"tag-kenyan","11":"tag-live","12":"tag-profound","13":"tag-silence","14":"tag-suffering","15":"tag-women","16":"entry"},"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/posts\/116146","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/comments?post=116146"}],"version-history":[{"count":0,"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/posts\/116146\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/media?parent=116146"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/categories?post=116146"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.myza.co.za\/press\/wp-json\/wp\/v2\/tags?post=116146"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}