Elaine (not her real name) is a 51-year-old mother of three (3) living in Nairobi County. She developed fistula in 1992 while delivering her first child. Elaine had a traumatic delivery, she delivered at the hospital reception area and did not have a chance to even rest on a bed after delivery even after having an episiotomy. Elaine sat on a concrete slab at the reception until morning when the doctor on duty told her to take her baby and go home. When she inquired about stitching of the cut, the doctor discharging her told her to just sit in warm salty water and she would be fine. Not having any experience, she did not ask any further questions. She took the doctors word and went home. Upon reaching home she realized that she was unable to control her urine and stool flow and that she was passing stool and farting through her vagina instead of her anus. Elaine had suffered a recto-vaginal fistula.

Not knowing any better, Elaine kept her situation to herself and managed it. In 1994, she delivered her 2^nd child and suffered tears which were not stitched. She was once again advised to sit in warm salty water and she would be fine. She listened to the advice and went home. She still was unable to control her urine and stool flow. By this time, Elaine had adapted to her new status and had devised ways if managing. She did not eat too much or away from home to reduce the bowel movements. She also limited travel to only when it was extremely necessary. She also had to be very alert to avoid making a mess and even slept with a bucket under her bed as the houses she lived in had shared washrooms. When she had to travel, she would use a sanitary pad to avoid soiling her clothes and when she couldn’t afford a sanitary pad, she used tissues, wipes and cotton clothes. She often suffered burns in her private parts due to the challenge of having limited access to proper sanitary products. With all this going on, Elaine kept her casual jobs and tried to maintain high standards of cleanliness to avoid attracting any suspicion that there was something wrong with her. She would be extremely cautious.

Her situation was exacerbated when she delivered her 3^rd child. Elaine had gone to the village to live with her mother-in-law during her pregnancy for support. When she went into labour, she had to walk a long way to the main road to get a vehicle to take her to hospital unfortunately she did not make it to the main road and delivered on the way there. Her mother-in-law had called a few women from the village to help her, and they supported her through her delivery. After she delivered, instead of taking Elaine to the hospital for check-up, she insisted that they go back home that she would be fine.

Elaine soldiered on with her condition without seeking any medical attention until one day in 2022 when she heard about fistula on Citizen TV. She took down the number and decided to call and inquire about what fistula was. Whenever she made the call, she pretended to be asking the information for her friend and not necessarily for herself. She made several calls before revealing that it was, she that needed the treatment. She was informed about the medical camps in Webuye and Makueni but because she could not afford to cater for her bus fare she did not attend either.

When she was informed about the medical camp at Thika Level ‘5’ Hospital, she made sure to attend. Elaine successfully went through surgery on 10^th June and is over the moon. She is extremely relieved to be free after 30 years of keeping a secret. She is grateful to M-PESA Foundation, the Flying Doctors Society of Africa, and Royal Media Services for the help she has received. She recommends that screening for fistula should be done when women take their children to the clinic after delivery and to increase awareness within the community as several women are suffering from fistula in silence.