Send Off to the Field

The third and final day of training began with several songs, which various participants led. As we have every morning, we allowed some time to review the previous day’s topics and ask for comments and questions. Then, we reviewed the forms that the Regional Representatives will use to keep track of activities they lead as well as the women they refer to Gynocare and follow-up with. We had everyone fill out a post-training survey so we can garner feedback from the participants about the training. Then, everyone signed an agreement to take on the responsibilities of a Regional Representative and join our Western Kenya team. We distributed cell phones so that the representatives can communicate with one another, community members, women living with fistulas, and Sarah Omega – phones will be vital to their community outreach and referral work. Everyone exchanged words of thanks, from the facilitators and One by One to the participants and from the participants to Sarah Omega and One by One. Of course, before boarding matatus back to their respective communities we had one last celebratory lunch all together. The Regional Representatives left cheering “One by One Let’s End Fistula. Moja kwa moja Pamoja Tukomeshe Fistula.”

Asante sana to our 31 Regional Representatives!

Day 2 of Training

On the second day of training, the Regional Representatives met in small groups to discuss their personal plans of who they were going to contact in their respective communities to start their outreach work. They jotted down ideas of specific people to speak with, such as religious leaders, chiefs, politicians, women’s group leaders, coaches, and teachers, in order to organize educational outreach activities. Volunteers were given resources to help them with public speaking and to organize their presentations to include personal stories as well as the information they have been taught on the prevention, causes, and treatment of obstetric fistula. Presenting to their communities is one of the many ways that One by One is addressing prevention steps. It also presents the opportunity for women who may not have known there were others with this condition to understand that there is a treatment or for someone in the community to refer a woman living with fistula.

We spent much of the afternoon discussing what the Regional Representatives will do when they find a woman who may have a fistula. The participants offered their ideas on how to provide psychosocial support and involve the woman’s husband and family. To conclude our day, we all took a trip to Gynocare. We toured the facilities and met some of the staff.

We also got the opportunity to speak with some women recovering from fistula repair surgery. Hugs and greets were exchanged, as many of the Regional Representatives knew the patients. It was a joyous conclusion to another day of training.

Introducing One by One's Newest Recruits

Today marked the first day of the first training of One by One’s Regional Representatives for Western Kenya. Thirty-one participants, 27 women and 4 men, have traveled from 20 counties to Eldoret to become trained to do outreach in their communities, refer women with fistulas to Gynocare for free surgical repair, and help provide psychosocial support for these women when they return home.

We began the day with a dynamic introduction by Sarah Omega, fistula survivor and Outreach Manager for One by One, and discussed the goals for the training. Then, each of the participants introduced themselves to their new team of field representatives. We took care of some paperwork, which included a pre-training survey whereby we’ll gain a better understanding of the participants, their knowledge of fistula, and their expectations for the training. After a quick tea and mandazi break, the participants took turns leading a few songs to get everyone energized for the next session. Sarah facilitated a session covering the causes and sequela, treatment, and prevention of obstetric fistula. We also discussed the myths about obstetric fistula that many community members hold, which included the idea that fistulas were caused by unfaithfulness, devils, genetic inheritance, witchcraft, a curse, AIDS, poverty, and not sitting properly (with legs crossed) after giving birth. The Regional Representatives know they will need to work hard to dispel these myths and the stigma around obstetric fistula in their communities.


Then, we went over the importance of community-based outreach and the role each of the Regional Representatives play in creating awareness of obstetric fistula, identifying women in the community with fistulas, spending quality time with these women and building trust, arranging transport for women to travel to Gynocare for treatment, and supporting women when the return home to their community. After a hearty lunch, we gave the 21 participants who were fistula survivors the opportunity to share their story with the group. After each retelling, the other participants offered their words of support and encouragement. Finally, we spent time brainstorming strategies to educate communities about obstetric fistula. Some of the ideas proposed by the participants included: home visits, community meetings (barazas) led by the chief, seminars in churches and schools, youth group meetings, and tournaments.

We concluded an exciting first day of training with a group photo. Check out One by One’s newest volunteers. We’re so excited to have them out in the communities and, soon to be, hard at work to end fistula.