Grace is 28-years old, the fourth born of nine children in her family. She got married after completing primary school, because all of her friends were getting married and having children. She had begun menstruating and believed there was no time to wait.

She married a young man named Willy in exchange for three cows. Together, they grew coffee on a small piece of land, generating enough money for their household needs. They also farmed maize, beans and groundnuts to eat.

When Grace was pregnant with her first child, she went into labor in the morning. Her water broke and she had severe pain. She could not go to the hospital because it was far from home and no transport was available. Her husband trusted his mother and the traditional birth attendant (TBA) to care for Grace, since the TBA had helped many other women to deliver. The TBA checked Grace’s cervix and told her to wait before pushing as her cervix was still closed.

The next morning, the TBA came to check on Grace again, and found that Grace had been trying to push the baby out all night, as her mother-in-law had told her to do this. The TBA stayed with Grace until the evening when she saw the head of the baby. She pulled the baby out, but it had already died. They then waited for the placenta to come out. When it did not discharge, the TBA pulled it out.

The next day, Grace’s stomach was swollen. She was taken to a mission hospital for treatment, but after being discharged, Grace found herself leaking urine. She also had ‘foot drop’ caused by the severe nerve compression in her legs during labor, so she could not walk. She did not understand what had happened. Her husband Willy told her that the TBA might not have been skilled and may have injured Grace when she was pulling the baby out.

Grace and her husband did not tell people about the leaking urine except for a few close relatives. Grace had difficulty working because she needed time to wash everyday. She used pieces of cloth to wash, like those used for baby’s diapers. When people saw the cloth, they asked her where the baby was, saddening Grace since her baby had died. Having fistula made Grace feel different from all her friends, and her husband asked if he could remarry. She agreed so she could have help, and Willy married Lucy.

Grace conceived again while she still had the fistula. On the day she went into labor, she was thatching a roof with Lucy, and delivered the baby in just two hours. Grace and Willy were very happy to have a new baby boy. They called the baby Furaha, meaning ‘happy’.

However, Grace continued leaking urine until one of Willy’s friend’s informed him that fistula could be repaired at the district hospital. Willy went to the hospital and asked about the cost of the operation, after which he sold some coffee to raise the necessary money. Fortunately, the repair was successful and Grace has healed.

Grace and Willy believe good communication and fairness helps keep their family happy. When they sell crops, they pool all their money and jointly develop a budget and prioritize how they should spend the money. Any remainder is divided equally among all family members. Willy has learned from Grace’s suffering with fistula. He sent his second wife to the hospital early in her pregnancy so that she would deliver without complications.