Obstetric Fistula Power Meetings

My project work has really taken off! I am thrilled with the connections and work that has been happening. I will start with the power meeting you can see from the featured photograph. This meeting has some key stakeholders: Jane (nurse from the hospital, who has been instrumental in this program at the hospital level), Carren (a fistula survivor), Elizabeth (the Reproductive Health Coordinator at the county level), me (volunteer to bring us all together and learning from everyone 🙂 ) and Dorcus (a nurse at the hospital who also is the CHEW (Community Health Extension Worker)). These backgrounds and titles are key because what you see represented in this meeting are not only power women but those who are internal and external stakeholders for this project to help educate and mobilize a community around Obstetric Fistula. In the past this project has mostly focused on getting the doctors and hospital staff trained to repair these clients. Now, the project is moving to prevention; the need to educate the public, reduce the stigma and reach more women suffering. I am honored to be able to work with these women and help them find ways to make a difference. You will see from the blog where we are currently with the project and the importance on communicating and staying connected to many roles within the system.

So how do we do this? Welcome to the CHW and CHEW roles! (I shared some of this on a previous blog but am putting this in as a reminder with additional information)

photo of CHW in kiboswa

The CHW (Community Health Worker) and CHEW (Community Health Extension Worker) are roles through the county that link the communities to the hospital. They are on the front lines going door to door to educate the community, refer patients and help increase the access to healthcare. The CHEWs oversee and support around 10 CHWs- each CHW has about 100 households or more they are responsible for with an average of 5 people within each household. Just think about these dynamics for a moment. These CHWs are mostly volunteers out supporting these households and also trying to find ways to make money for their families. This means they are spending part of their time trying to keep food on the table and a roof over their heads (and family) while they are also trying to reach these families. This is not an easy job! I had the privilege of spending a day with a couple of the CHWs (check out the pictures!). None of them have cars; they are reaching these home visits by foot or public transportation. They have minimal materials, are not getting paid and are trying to reach as many households as possible while recognizing they also need to make time to actually make some money as well. I was in awe of these people and the passion they have to support their communities.

photo of Abraham Kisumu West CHWphoto of Kiboswa CHW

Currently, I have been working with these roles to gain their input and feedback to help develop a 3 day training and Obstetric Fistula IEC (Information, education and communications) materials (check out the picture of the start of our materials!). photo of fistula prevention materials

While these plans are in place my thoughts go straight to sustainability. How does this effort continue when I leave? I have been working with all parties to ensure they have ownership over the curriculum. I have also been working with the county to ensure they choose the people who will train all of their teams who will be part of the program- not every CHW or CHEW will be part of this program. I will not be delivering the training. I will only be running a T3 (Train the Trainer). This will allow for accountability of the information and continuous development of their training skills. I plan on attending each of the training sessions being held in the 3 counties we will be supporting: Kisumu, Kisii and Homa Bay. This will enable me to provide each trainer feedback and to tweak the curriculum for the next training group. I am excited about this plan because in the past we have been the ones to create and deliver the training. My hope is to create this ownership so the work continues to be done and these teams realize they truly have the skills and ability to move this forward.

Aligning to the stakeholders internally and externally will be the North Star for this project to be successful and sustainable. As I reread this blog I can’t help but ponder over the people who are basically volunteering their time and having to find ways to make ends meet on top of this service work. So, I ask you to think about the abundance that surrounds you and how grateful you are for what you have instead of focusing on what you don’t have. It isn’t always instinctive to think this way but is essential for a reality check. The intention for today Friday, August 8th is: “The ocean of Life is lavish with its abundance.” This is so true.. it doesn’t take much to realize just how much abundance surrounds you! Please leave me a comment on what is abundant in your life and how do you celebrate it!?
In munay-

intention for Abundance



  1. I’m always so inspired by your blogs and the work that you and the local population are doing. Your presence, skills, and energy are so vital to the success of the program, Michelle!

  2. I have an abundance of great friends and co-workers. I do practice regular gratitude, but I do not reflect on how fortunate I am to be surrounded by such great people. Thanks for helping me remind myself to do so.

  3. I am proud of you! Thanks for sharing your insights and the contributions you are making on behalf of the “greater good”.

  4. I finally went to fightfistula.org to read more about what you are up against. I am so proud of you for the work that you are doing. I just cannot comprehend the trauma of these women. My 4 year old daughter woke up yesterday not being able to walk. She refused. When she did, she was limping terribly. We took her in to the doctor right away. She basically had a virus that settled in her hip. She will be just fine. After reading your blog, I realized how much I take our healthcare system for granted. We have SAME DAY access to highly skilled and trained doctors. We have immediate and 24 hour access to pharmacies. And we have a wealth of information on the internet. Thanks as always for your great attitude and insight. You are a blessing.

  5. I have an abundace of many things, many of which i take for granted. I’m lucky to live in a beautiful old house but often catch myself wanting something newer/bigger/fancier. Other than the creeky floors that wake up Adler when i creep out of the room, I really wouldn’t change a thing about it – when i stop and reflect. Also I was promoted to SVP after you left and have an abundance of money…jk 😉

  6. I am enjoying a small window into the work you are involved in. Thanks for sharing the progress and pathway with us. . .
    Be well.

  7. Your work is amazing! i love your passion to help people in need and tackling something people always fear to bring out or even discuss! thats fistula….go go go anyango!

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