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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.