November 20

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“We take care of our women…..Tell everyone you know”

Five of the Most Influential People I Have Met in Kisumu Kenya: Part III“. Not all that surprisingly, the 3rd person on my list of 5 of “the most impactful people I have met in Kisumu” is a woman. However, she is not from Kisumu, nor is she from Kenya, or from Africa. “We take care of our women……….Tell everyone you know” Michelle Soto tells her audience at one of her obstetric fistula awareness and education sessions in the community of Kiboswa (12 km north of Kisumu). I actually met Michelle at my first day of PULSE orientation training in Philadelphia (May 2014). I (along with herself) had just found out that she was also going to be placed with us at the OGRA Foundation in Kisumu, Kenya.
Survivors 5
Michelle was born in St. Louis, MO, US, completed primary and secondary school between DeSoto, MO, 2 areas in Chicago, IL and 2 areas within Pittsburgh, PA. She attended Penn State University where she obtained her B.A in primary education. Happily married and mother of 2 young teens, she began as a teacher for close to 5 years, before changing her life for a career in sales starting with Bayer Pharmaceuticals and eventually securing a position in sales at GSK in 2002.
Couple After a total of about 13 years in the field educating the medical professionals with 8 of those years on the GSK product lines, she transitioned into her current role in Commercial Capabilities, training, supporting and developing materials to support the GSK Vaccine and Critical Care divisions. Her placement into her PULSE assignment is such a natural fit for Michelle, a blend of responsibilities and objectives supported through the Fistula Foundation and Direct Relief, and initially in part through the OGRA Foundation. She has several goals to achieve during her 6 month assignment, increase the number women being treated for obstetric fistula repairs, educate and mobilize community awareness about fistula, help hospitals create a process to accommodate an obstetric fistula client flow within their system, map out a Community Sensitization Outreach Program and find ways to monitor and evaluate its effectiveness and utilization of funds, create a 3 Day CHW (community health worker) Training curriculum to educate CHWs about fistula and the process for obtaining intervention, treatment, repair and community mobilization (sensitize communities through churches, religious leaders, village chiefs and community centers), mobilize fistula survivors and help create IEC (Information, Education and Communication) materials for the CHW’s community efforts.
Survivors 2
Obstructed labor accounts for up to 6% of maternal deaths. Each year between 50,000 to 100,000 women worldwide are affected by obstetric fistula, a hole created in the birth canal. The development of obstetric fistula is directly linked to one of the major causes of maternal mortality through obstructed labor. Women who experience obstetric fistula suffer constant incontinence, skin infections, kidney disorders, shame, social segregation and many other health problems. It is estimated that more than 2 million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa. Most fistula cases occur among women living in poverty, in cultures where a woman’s status and self-esteem may depend almost entirely on her marriage and ability to bear children. Obstetric fistula is preventable; it can largely be avoided by: delaying the age of first pregnancy (60% of all fistula cases occur in girls under the age of 18); the cessation of harmful traditional practices (i.e., female circumcision), and timely access to obstetric care. Preventing and managing obstetric fistula contributes to the Millennium Development Goal 5 of improving maternal health.
Although fistula is a women’s health issue (from prolonged and intense labor), one of Michelle’s goals is to also educate and mobilize men to support their women to seek help and treatment. Through education, Michelle is developing a sustainable education curriculum that will enable others to embed and implement her program after her assignment is completed at the end of 2014. In other words, she is teaching the teachers, those people who will continue to teach and develop a sustainable process. “We take care of our women!”
Survivors 3
Michelle points out that fistula repair is funded through OGRA and the Fistula Foundation. And there is help for those women who are suffering in silence, Michelle’s support groups and awareness sessions are telling women that “We can help you!”. The community health care workers (CHW’s) can help with the referral process, and the education and treatment steps that occur once individuals are identified and supported internally within the program.
“We need to educate our young!” Through education, women are being taught about fistula preventative measures, and more importantly, are encouraged and empowered to stay in school longer, wait longer before getting married. Elevated risk factors for fistula formation are explained through education, whereby elevated risk factors for fistula formation is that girls are getting pregnant too young, and their bodies are too small and underdeveloped to give birth, they become malnourished, all key factors that can promote fistula formation during prolonged, strenuous, and stressful child delivery. Pregnant women are being encouraged to visit health care clinics for antenatal checkups and education. This helps develop the connection to the health care system, and provides a preparedness plan for a hospital delivery where a stressful and intensive labor can better be indentified and more carefully managed.
Michelle is spreading the community word to help support women with fistula repairs, that pregnant women need to go to the hospital for evaluation and if necessary, repair and recovery, and to help reduce the negative stigma when they return to their communities following the lengthy repair and recovery process. This helps bring each woman a sense of dignity and respect within their communities. With proper screening during pregnancy, and soon after, proper treatment can be prescribed whereby the body can heal itself.
“Stop suffering in silence”, ask your community to help those who require help, get her the care, treatment, and support needed. Community efforts can help watch her family and her children during her recovery period. Each woman spends so much time taking care of others that she often does not take care of herself. Through public speaking, through educational programs, through posters and booklets, Michelle is enhancing an awareness of a problem that has impacted many in developing country communities. She is influencing the way women (and communities) think about themselves, talk about key health issues, especially those that are afflicted and suffering in silence. She is teaching those who will become the next generation of teachers, and through continuous education and elevated awareness and maintaining a voice that is heard throughout, these efforts will remain sustainable well after she returns to GSK enabling others to ‘Be The Change’.
Rusinga with a smile
Michelle is the absolute best fit to represent PULSE/GSK on this assignment. I had the very good fortune to have spent time with her during our months in Kisumu. To know Michelle is to feel her energy, her excitement, and her endearment to her job and her purpose, and most especially to her “women” every day. So, when asked what excites and motivates her, she replies simply: “Life. It may sound trite but especially after this experience I realize more than ever the excitement I cultivate everyday in all I do and the people I come into contact. I am motivated by many things: the desire to be better each day, my family and friends, realizing how fortunate I have been in my life and wanting to share this abundance by giving back and people.
Equator
There have been many personal challenges we all must manage during our PULSE assignments, and Michelle has taught me to search within myself, to recognize and confront my personal demons. And she told me she has been successful doing so through personal healing by “being vulnerable with others, learning to take both the good and bad things in my life and gain value from them to move forward and be able to better relate and connect with others, being open enough to realize my children are teaching me often times and maybe not the other way around  and finding a way to face some of the fears that hold me back in relating to myself and others. Lastly, being humbled by others and learning to love who I am. (These are not easy and I have many bruises and scars  and the journey is not even close to being over) I do want to put out a disclaimer and that is these are successes on some days and still challenges on others  but I keep trying.”
Kakamega
And lastly, Michelle’s personal comment to all of us is really quite simple, one we can all learn from and practice in our everyday lives: “One of the hardest things is to accept ourselves and others. All of our power and resource is within each other; we truly are all connected. So, the more times we can find a way to help each other, relate to each other and build each other up the better we feel, our communities feel, we feel at GSK and across the globe. The only way we are going to truly make a difference and be a part of the change we want to see is to start with ourselves in all we do and say. It isn’t easy but it is worth the effort and it is okay to fail because there is always an opportunity to keep trying.” Thank you Michelle
“Remember most of the time it is the small things you do” – Albert Einstein