Fistula surgery transforms lives in Kenya

[darnkatz]

What a truly incredible thing that this organization is doing. I cannot imagine the horror and shame that these women experience daily.

Fistula surgery transforms lives in Kenya

One Kenyan doctor offers free operations for women suffering from the condition, which often makes them outcasts.
Abigail Higgins | Last updated: 23 May 2014 10:36


When Dr Hillary Mabeya visited a condemned home in Eldoret, Kenya in 2009
and said, "This kitchen is going to be an operating room," he raised
more than a few eyebrows.


Yet last month, Mabeya performed his thousandth surgical operation in that kitchen, which is now part of the Gynocare Fistula Centre. Mabeya is the only surgeon at Gynocare, a centre that performs the most fistula surgeries in Kenya, at no cost to the patient.


May 23 marks the second annual International Day to End Obstetric Fistula. Fistula is a tear in a woman's bladder or rectum that causes her to constantly leak urine or feces. At least two million women suffer from the condition, with 50,000 to 100,000 new cases occurring each year. The main causes are prolonged labour, botched Caesarean sections and sexual assault.


"I've heard women say to me: 'I wish I could have died in childbirth rather
than live with this condition,'" Lindsey Pollaczek told Al Jazeera.
Pollaczek works in Kenya as a senior programme manager for Direct Relief, an international organisation that supports Gynocare's work.


Most women with fistula live in remote areas, and are unaware that they can
be healed with surgery. "They can't participate in family life, in
social life, they can't go to church, no one will buy their vegetables,"
said Pollaczek. "Because they smell like urine, they become pariahs in
their society, they lose a lot of self-respect, they feel like they've
done something wrong to deserve this," she said of the devastating
condition.

On a typical day last spring, Gynocare's patients included an 11-year-old
raped by her neighbour, an 80-year-old woman who had fistula for over 60
years and a 19-year-old named Irene. Irene gave birth at age 13 and
suffered from one of the worst fistulas Mabeya had ever seen.


Irene is from West Pokot, a remote region in western Kenya where, during
medical school, Mabeya first dedicated his life to fixing fistulas. West
Pokot has particularly high rates of fistula, due partly to the
prevalence of child marriage and female genital mutilation, which raise
the chances of complications in childbirth.


"These are very poor women who don't even [have enough] money to pay for
transportation to surgery," Mabeya told Al Jazeera. "Their misery and
the smell of their urine and stools - this touched me so much and I
thought I should do something about it."


A man possessed


Mabeya became a man possessed, throwing himself into learning as much as he
could about fistula. "During medical school I would sneak out of the
house to do fistula surgeries. I almost failed my exams because I would
skip school to do fistula surgeries," he said.


After medical school, Mabeya treated an infant who was raped during Kenya's
2009 post-election violence who developed fistula. He decided that Kenya
needed a hospital dedicated exclusively to the condition. When a
colleague told him about a dilapidated house for sale, he knew he had
found his start. Funded entirely by his own savings, Mabeya delayed
opening the hospital as he slowly collected enough scissors, sutures and
needles to do surgery.


Once Gynocare was up and running, Mabeya visited West Pokot again and met
Irene. She had been in labour for a week before she was brought to a
hospital where she was informed that her child was dead. The doctor
removed the foetus with crude forceps, further mangling Irene's already
damaged reproductive and digestive systems.


Irene returned to her village leaking urine and feces. Her family and friends
thought she was cursed, and her father refused to acknowledge her as
his child. Like many women with fistula, she was chased away from home.

Mabeya couldn't operate on her in West Pokot, but told her that if she could
make it to Eldoret, he'd do everything he could to help her. Irene
walked for three days from her village to get to the nearest road. From
there, she hitched a ride with three different cars, then took a bus,
and then two motorcycle taxis to get to Gynocare.


Over the course of several years, Mabeya operated on Irene five times, her
fistula improving incrementally with each surgery. But Irene was a
classic example of what is often misunderstood about fistula patients:
Treating the physical effects of the condition is only the beginning.


Emotional trauma


In addition to her physical pain, Irene was emotionally traumatised. Her
ebullience and openness gave way to volatile mood swings. Mabeya wasn't
the first person who tried to help her, but he was the only one who
refused to give up on her. "You can't give up on Irene. She'll die,"said Caroline Mabeya, Dr Mabeya's wife and a social worker at Gynocare.


Gynocare sets itself apart as a medical facility by providing holistic care to
patients that includes post-surgery counselling and job training. The
Mabeyas enrolled Irene in their job training programme, where she
learned to be a tailor. Caroline Mabeya counseled Irene, trying to help
her cope with depression and her sense of isolation.


"I believe that I'll be okay someday. I'm thankful to God my life has
changed. I hope I'll finish my training and make men's shirts and
trousers. I think I'll be successful in life," Irene said last year
after her fourth surgery.


In his house one evening last spring, Mabeya reached down and silenced his
phone during dinner. "I have an old patient who calls twice a day. They
get so attached," he said, shaking his head.


At his wife's insistence, Mabeya has cut back from operating seven days a
week, but his personal and professional lives still flow freely
together. They pay the school fees of particularly needy patients, and
their home in Eldoret is full of poems and letters from patients whose
lives he has changed.


"Other doctors have told me that I'm going to die poor because I've chosen to
specialise in fistula surgery. You have to love what you're doing to do this job," he said.


This week, Mabeya proudly announced that Irene's most recent surgery was
successful. She has returned to her village where she built a small
house, and now supports herself as a tailor. 


"I think fistula surgery is one of the most life-transforming surgeries
that a woman can get. When they come [to Gynocare] they're downtrodden,
they're feeling little self-worth," said Pollaczek.


"When they're able to be repaired and go home to their community dry for the
first time, its absolutely life-transforming," said Pollaczek of the
thousands of women like Irene whose lives have been restored.

[Jermys]

There are humans on this earth who deserve everything good for the rest of their lives. This guy is one of them. What an amazing man.

[underwaterrhymes]

This choked me up. What an incredible person.

[ttt]

If anyone wants to donate, here is an organization that provides financial support to him:

www.directrelief.org/2013/03/dr-hillary-mabeya/

[PinkSquirrel]

A Walk to Beautiful used to be on Netflix.  I just checked and it's not there anymore, but it was a really great documentary about similar fistula surgeries in Ethopia.