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HARI SREENIVASAN: Next: one 
effort to address a humiliating 
medical injury that afflicts

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perhaps one million women in the 
developing world who lack access 
to safe medical facilities.

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Fred de Sam Lazaro 
reports from Kenya.

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It's part of his Agents 
for Change series.

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FRED DE SAM LAZARO: In a 
new hospital in Eldoret, 
Kenya, these women are 
awaiting surgery to

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fix a condition that's widely 
misunderstood and reviled, 
one that's made them outcasts,

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often in their own families.

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It's called obstetric fistula, 
an injury to the birth canal 
caused, in most cases, by

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prolonged labor that 
leaves a woman incontinent.

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Perhaps one million women in 
the developing world suffer from 
fistulas, a condition virtually

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wiped out in industrialized 
nations with better 
access to prenatal care 
and medical facilities.

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At least once a week, these 
patients hear a message of 
hope from a woman who knows all

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too well their suffering; 
41-year-old Sarah Omega was just 
19 when she was raped and became

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pregnant.

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SARAH OMEGA, Fistula 
Survivor: I was so scared.

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I didn't want to secure an 
abortion because of my faith, 
yes, so I kept the pregnancy.

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FRED DE SAM LAZARO: Omega 
eventually spent 38 hours in 
a difficult labor, much of it

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at home.

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In the process, the 
baby died, and she 
suffered a large fistula.

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For 12 years, Omega 
says she was subjected 
to isolation and shame.

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SARAH OMEGA: I 
attempted suicide twice.

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Every night, I would go to bed.

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I would say, God, please don't 
allow me to see tomorrow, 
because my tomorrow, every day,

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I would wake up in the morning, 
see the sun, I would cry 
because I knew it was another

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day of pain, of humiliation, 
of suffering in isolation.

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FRED DE SAM LAZARO: That anguish 
landed her in a psychiatric 
ward, and it was there that

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a visiting doctor 
came to her bedside.

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SARAH OMEGA: He assured 
me that my problem 
was going to be fixed.

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And I remember that day 
he told me: "I'm seeing 
a lot of hope in you.

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I want you to get healed."

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FRED DE SAM LAZARO: That doctor 
was 49-year-old Hillary Mabeya, 
a gynecologist and surgeon

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who has devoted his entire 
practice to women with fistulas.

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This 88-bed hospital was built 
for his use, as part of a broad 
campaign by the California-based

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Fistula Foundation.

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DR.

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HILLARY MABEYA, Gynocare Fistula 
Center: These are patients who 
need care, they need support,

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and they need a 
lot of counseling.

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They suffer so much from society 
because of their condition.

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FRED DE SAM LAZARO: It's 
difficult to pinpoint 
how many women suffer 
from fistula in this

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country, in part because most 
of them are kept isolated by 
their communities and even

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their families.

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But in recent years, 
since the campaign began 
to raise awareness of 
fistula, awareness that

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it is treatable, some 7,000 
women have emerged from hiding 
each year seeking surgery.

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Fistula awareness groups have 
taken to the streets to educate 
others about the condition,

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and where to get help.

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We watched as these women, many 
of them survivors themselves, 
fanned out through the Western

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city of Mumias, and 
encouraged women suffering 
from incontinence issues 
to get free screening

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offered by the campaign.

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Organizer Habiba Mohamed 
said people still have many 
misconceptions about fistula.

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HABIBA MOHAMED, Community 
Organizer: Maybe she 
has been bewitched.

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Maybe she was promiscuous and 
had a relationship outside 
marriage when she was pregnant.

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FRED DE SAM LAZARO: 
Mohamed's group, WADADIA, 
recently arranged the 
transportation and treatment

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for 35-year-old Rachel Juma 
Wasamba, who lives in a remote 
village in Western Kenya.

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Wasamba was lucky.

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Her husband stayed 
with her throughout her 
condition and treatment.

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Many husbands abandon their 
wives in such situations.

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Amina Mushele says that's 
what happened to her.

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AMINA MUSHELE, Fistula Survivor 
(through translator): My husband 
couldn't take it anymore, so he

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left me to marry another woman.

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FRED DE SAM LAZARO: She had 
surgery one year ago, and now 
makes and sells goods in the

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town marketplace, using 
skills she got from a training 
program sponsored by WADADIA.

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The training, ranging from 
hairstyling, to seamstress 
work, and computer skills, helps

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reintegrate women back 
into their community.

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HABIBA MOHAMED: The moment 
someone has been treated, and 
she has healed, you can be able

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to see a significant change in 
her life, and not only in her 
life, in her family, in her

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children.

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So, it has a ripple effect 
to an entire family and 
the entire community.

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FRED DE SAM LAZARO: Back in 
Eldoret, Dr. Mabeya is kept very 
busy at one of the few places

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where fistula surgery 
is performed and 
offered free of charge.

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Working six days a week, he 
operates on 45 women a month.

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Since that's just a 
fraction of the new cases, 
he is also training other 
doctors in the region,

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and he is working to prevent 
fistulas in the first place.

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DR.

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HILLARY MABEYA: Fistula is 
almost 100 percent preventable.

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In developed countries, 
it's not even there.

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FRED DE SAM LAZARO: He says 
fistula can be avoided if 
adequate prenatal and emergency

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care is made available 
when complications 
arise during pregnancy.

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More than half of all 
Kenyan women still deliver 
their babies at home.

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For her part, Sarah Omega says 
her healing became complete 
when she able to give birth

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to a health baby daughter, 
Jade, who recently turned two.

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SARAH OMEGA: She means 
just the whole world to me.

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I remember at some point, I 
would pray and say, God, if 
you give me a baby, that baby

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will erase the pain I have 
gone through in this life.

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FRED DE SAM LAZARO: And Omega 
continues to help other women 
erase the pain of fistula.

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SARAH OMEGA: I decided to change 
the pain I had gone through 
into something beautiful,

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something that will help 
me reach out to other 
women, something that 
will allow other women

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to live a normal life like me.

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FRED DE SAM LAZARO: She 
travels frequently to talk 
about her experiences, 
but, more regularly,

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her advocacy happens at 
the bedside of women at 
the new fistula hospital.

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For the "PBS NewsHour," I'm Fred 
de Sam Lazaro in Eldoret, Kenya.

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HARI SREENIVASAN: Fred's 
reporting is a partnership 
with the Under-Told 
Stories Project at the

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University of St. 
Thomas in Minnesota.