Human Rights Watch is urging the Kenyan government to provide support for the tens of thousands of women suffering from obstetric fistula.

At a press conference in Nairobi Thursday, New York-based Human Rights Watch released the report "I Am Not Living, But I Am Not Dead", which details the struggles of Kenyan women living with fistula, a childbirth injury which can cause incontinence in victims.

Fistula occurs when vaginal tissue is torn during difficult childbirths.  According to the report, women in Kenya are at increased risk of injury because of societal misconceptions about reproduction.  The report claims many women become victims because they are too young to sustain a pregnancy when they deliver, and poverty makes safer options, such as a caesarean section, impossible.  

In addition to the physical effects, the author of the report, Agnes Odhiambo, said that fistula inflicts significant psychological damage on its victims.

"Fistula is a devastating childbirth injury.  It leaves women with no control urine or stool.  Fistula destroys women's lives.  Women are ostracized because they smell," she said.  "They are often abused, beaten, abandoned, divorced by their husbands or isolated in their homes.  It has a huge psychological impact on women and girls.  Some get depressed and suicidal.  In addition, it places a huge financial burden on already poor families," said Odhiambo.

According to the report, the Kenyan government has failed to provide adequate support for women suffering from fistula.

The majority of women affected by fistula in Kenya are poor.  Because they cannot afford treatment, they are forced to live with the emotional and physical consequences of the injury.

The report applauds the government for providing free maternity care to impoverished communities, but criticizes the service for not providing assistance to poor women who develop complications in childbirth.  Women injured during delivery are forced to seek help at local hospitals, where high costs exclude many from receiving proper care.

The report also found that sex education in Kenya's schools does not suitably educate women about safe sex and reproductive issues.  The Kenyan educational system mandates sex education in public schools, but Human Rights Watch said many teachers simply ignore the requirement.

Human Rights Watch called on Kenya's government to take action to prevent reproductive injuries, including offering free access to surgery for victims of fistula, proper sex education for young students and an awareness campaign to educate women and reduce the stigma endured by women living with fistula.

Related report by Cathy Majtenyi