Of every 10 fistula patients who visit Kenyatta National Hospital, one is a man.
The attention the condition has received has brought more men than expected to health facilities, and experts have been forced back to the drawing board for a new strategy.
A medical camp held at KNH on June 16 and which targetted 200 women with obstetric fistula, turned away several men who unexpectedly showed up.
The campaign was by KNH, the Safaricom Foundation, the Freedom from Fistula Foundation and the Flying Doctors’ Society of Africa.
One of the men was a 47-year-old furniture dealer, name withheld, in Nairobi’s Gikomba market. He hoped to get treatment as “the problem has turned my life into a nightmare.”
He was diagnosed with rectotaneous fistula, an abnormal opening between the rectum and the skin around it.
The condition may be as a result of trauma, pelvic fracture, a foreign body being inserted in the rectum, abscess, or surgery. Fecal material may be discharged through the skin or wounds.
The father of three said although he does not have a problem getting an erection, he has been in constant high doses of medication because of severe pain.
“Right now, my inner pants are already soiled with pus. I can feel the wetness. It makes me feel uncomfortable. I can’t place a bandage to ease the pus from coming out because I’ll have difficulties moving around. There’s nothing I can do for now — only waiting for treatment,” he said. “This condition has seriously affected my livelihood. My mobility is constrained. I can’t sleep at night. Nothing seems normal anymore. What keeps me going is the belief that God will heal me.”
Dr Kennedy Ondede says fistula is not common among men and this leads to stigma. “The nature of the condition is such that few men have come out regarding their experiences due to stigmatisation, embarrassment and being shunned.”
Fistula exists in various forms. Anal fistula is a small channel that develops between the end of the bowel and the skin near the anus. It can cause pain, bleeding and discharge when passing stools.
Urethrocutaneous fistula is an abnormal opening anywhere along the urethra. Vesicovaginal fistula is an opening between the bladder and vagina, usually due to prior surgical operation.