Rwanda: From Fistula to Recovery - One Woman's Journey After a C-Section

When Julienne Nyirandinabo delivered her third child by C-section in 2018, she never imagined the operation would lead to a life-altering medical condition.

The 40-year-old resident of Nyabikenke in Bumbogo Sector, Gasabo District, developed a vesicocutaneous fistula after the surgery, causing urine to leak through her surgical wound. Doctors inserted a catheter to help her pass urine.

After being discharged, Nyirandinabo began experiencing severe pain within days. Her husband rushed her to the University Teaching Hospital of Kigali (CHUK), from where she was referred back to Kibagabaga Hospital, where she had given birth.

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Her condition worsened as urine continued leaking through the wound, which became infected and started discharging pus.

At the time, few specialists in Rwanda could treat her condition. She was eventually informed that a team of experts from the United States would handle her case. She spent six months confined to a hospital bed waiting for their arrival.

The prolonged illness took a heavy toll on her physical and mental health. Her weight dropped from nearly 90 kilograms to 30 kilograms, and she struggled with depression. Seeing other women facing similar challenges, however, helped her come to terms with her situation.

Throughout the ordeal, she relied on support from her husband, nurses, and well-wishers who provided food and other necessities.

"My husband was a great support. He would do labour work, earn some money, buy food, cook and bring it to me. My children sometimes missed school. It was not easy for him to provide for the family and handle all the household responsibilities alone. I didn't even know about fistula until I got it," said the mother of four.

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In October 2018, specialists from the International Organization for Women and Development (IOWD), a U.S.-based nonprofit that partners with Rwandan medical professionals to provide free specialised surgeries to underserved women, arrived in Rwanda and prepared her for surgery.

Doctors told her the fistula could be repaired through surgery, although full recovery would take about two months. She underwent the procedure, with treatment fully covered by Community-Based Health Insurance (Mutuelle de Santé).

Nyirandinabo remained in hospital for 15 days as she recovered. Once the catheter was removed, she was able to urinate normally again.

"After the operation, the happiest moment of my life was being able to urinate