Shame thrives on secrecy. For women living with obstetric fistula, shame can be as crippling as the condition itself because it convinces a woman that her suffering is hers alone to bear. It is this invisible chain that keeps her isolated from family, friends, and even the possibility of hope.

For more than two decades, this was the prison that 44-year-old Teresa (Not her real name) lived in. Her shame took root in 2002, when giving birth to her first born. The nearest hospital was too far for her to make the journey, forcing her to give birth at home with the help of a traditional birth attendant. After more than twelve hours of painful labour, she delivered her child, but what went unnoticed in that moment of relief was a devastating tear that would quietly alter the course of her life. It was days after giving birth that Teresa realized she could no longer control her urine.

At first, she told herself it would pass. But as the leaking continued, Teresa began to live in fear of smelling and being discovered. So, she adjusted to this new reality by keeping to herself. Most painfully, she told no one. Not her closest friends, not even her mother.

“This must be what women go through after childbirth,” she told herself. Since no one spoke about it, Teresa believed every mother endured the same. So, she joined the leagues and began carrying her shame like a second skin.

This shame morphed into fear, and fear shaped her decisions in the years that followed. She delayed another pregnancy, terrified of what her body might endure. And when she did eventually have more children, she insisted on cesarean births, determined never again to relive the horror of that first labour.

In 2017, a flicker of hope reached her as she listened to a radio program that spoke about obstetric fistula. For the first time, she dared to imagine that what she had endured might be unusual. She gathered her courage and visited a hospital, explaining her symptoms. But the doctors dismissed her and told her there was nothing wrong. Their words silenced her all over again, pressing the chains of shame tighter around her. If even doctors could not see her pain, Teresa thought, perhaps it was truly her cross to bear.

Then, in 2025, eight years after this erroneous consultation, came a turning point. One morning, Teresa’s phone lit up with an SMS from Safaricom PLC. The message, sent as part of MPESA Foundation’s partnership with Flying Doctors Society of Africa to reach women across Kenya, announced a fistula camp at Busia County Referral Hospital. The words on that screen felt like they were written for her, describing the very symptoms she had carried in silence for twenty-three years.

After making her way to the hospital for a screening, a doctor looked her in the eye and named her condition: obstetric fistula. In that moment, the weight of decades lifted. The issue she had been enduring all these years was in fact, not a regular part of motherhood. Teresa was so unprepared for this diagnosis, certain that it would end in another dismissal, that she had not even readied herself for a hospital stay. When the doctors informed her that she could have reparative surgery, she hurried home, packed her essentials, and returned, ready at last to shed the burden she had carried for nearly half her life.

Today, Teresa is no longer bound by shame. Through FDSA’s support, she has reclaimed her dignity, and with it, her voice. This has set in motion a ripple far greater than one surgery. In breaking her silence, Teresa has broken the silence for others. Her voice now reaches the women who still believe, as she once did, that incontinence is a private burden of motherhood.