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Negotiating the challenges around fistula.

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.

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.

But for most women with fistulas, the damage is not only physical, it's 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.

The women I engaged with explained how their fistula diagnosis threatened their social and intimate lives. They explained how having a 'leaking body' was constructed as being dirty, deviant and contaminated.

Many described that the way they went about their lives was primarily occupied with finding ways to protect themselves from being 'outed' or shamed for the pungent smell that they carried with them.

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.

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Publication:The Star (Nairobi, Kenya)
Geographic Code:6KENY
Date:Jun 6, 2018
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