Jane Mulewa Mwale 89, is a proud mother of 10 and a grandmother to many. For the last 42 years, her life has been marred with shame and isolation, as a result of living with obstetric fistula, a hole between the birth canal and bladder and/or rectum. “I delivered all my babies at home, and following the birth of my tenth child, I realized that I could not hold my stool or urine. That is when my life took a turn for the worst,” says Jane. 

Fistula is caused by prolonged, obstructed labour without access to timely, high-quality medical treatment. It’s hard for Jane to recall what went wrong during the birth of her last born child, but the long and painful journey to treatment is one that she recounts vividly. “At first I thought I had been bewitched, and later I thought I had contracted HIV. I went to the hospital many times, but no one could tell me what was wrong,” she says. Jane resorted to wearing many layers of clothes at once with the hope of masking the smell, and when this didn’t work, she decided to isolate herself from the community,  in order to avoid stigma from friends.

In 2023, Jane was listening to the radio when a public service announcement came on. “It was an announcement about a free fistula treatment camp, and the symptoms they listed were exactly what I was suffering from,” she says. Following a screening, she was diagnosed with fistula and underwent reconstructive surgery. Now living free from the condition, Jane has become a champion in her village of Kitise, Makueni County, raising awareness of fistula, and supporting women and girls in the community to access information and care.

As part of this year’s events to mark  International Day to End Obstetric Fistula, UNFPA partnered with the County Government of Makueni, Amref Health Africa, Flying Doctors’ Society of Africa, Mpesa Foundation, and Jhpiego to hold a free fistula camp at the Makueni County Referral Hospital.  More than 280 patients were screened with 87 admitted for further care. A team of fistula surgeons performed 83 successful fistula repair surgeries, restoring dignity to women and girls who have been living with the condition. 

“With only six years left to meet the global goal to End Obstetric Fistula by 2030, as called for by UN Member States, the burden of disease is still unacceptably high,” said UNFPA representative Anders Thomsen. “Investing in trained midwives, quality emergency obstetric and newborn care and comprehensive sexual and reproductive health services will bring us closer to the goal.”

With support from the UNFPA Maternal and Newborn Health Thematic Fund, thousands of women and girls have been able to access free fistula screening and treatment in Kenya. Fistula survivors have also received reintegration services, including psychological support, skills training and small grants to start businesses. UNFPA also supports the training of health workers, including surgeons, midwives, nurses and community health workers who play a crucial role in treating fistula and preventing its occurrence.  

“Fistula repair surgery changed my life,” says Jane. “As a survivor, I can only urge  other women with similar conditions to go seek medical attention and not to lose hope as it is never too late.”