Woman breaks silence after suffering with childbirth injury for 15 years

Hilaria Shikongo from Karibib has kept a painful secret for 15 years.

The 32-year-old has never been able to speak about a condition she developed after an injury during childbirth in 2011, when she gave birth to her daughter.

At the time, she was just 16 years old.
“I experienced faeces coming from both sides – from the vagina and the anus,” she says.

As a result of the injury, she developed obstetric fistula, a childbirth condition that creates a hole between the birth canal and the bladder or rectum.

Today, she is speaking publicly about it for the first time, hoping other women will know they are not alone.

It started when she went into labour at Usakos and suffered for days.

By the fourth day, her father, worried that she had been in labour too long, drove from Karibib to take her to Swakopmund State Hospital.

An ambulance followed behind.
“I was very tired.

I could hear people, but I could not move,” she says.

At the hospital entrance, nurses realised both baby and mother were in danger.

There was no time to move her to a ward.

“They said they only had minutes to save us. Right there at the door they opened my legs and cut me.

I even kicked when they cut me,” she says.

Her baby was delivered at the entrance.

Shikongo was then taken to the maternity ward, where a nurse stitched the tear. But the stitches were not dissolvable.

Days later, she returned to have them removed because they were causing painful pulling when she walked. Soon after returning home to Karibib, another problem emerged.

Shikongo says she struggled to pass stool. After taking medication to help with her bowel movements, she realised something was wrong.

“I experienced faeces coming from both sides,” she says.
At first, she thought it was normal after childbirth.

But after a few days, she told her mother, who immediately took her back to the hospital.

A local nurse, known as sister Vicky, recognised the condition and referred her for surgery at Katutura State Hospital in Windhoek.

Doctors repaired the fistula. But the wound opened again.

“It was smaller than before, but it opened again. I never went back,” she says. “It was too much for me to go through again.”

LIVING AROUND THE CONDITION

Since then, Shikongo has adapted her life to the condition by avoiding foods that upset her stomach. On days she fears leakage, she wears a sanitary pad.

“When I have a runny stomach, it comes out. If I know I’m not okay that day, I just put a pad on,” she says. “I have learned to live with it. It’s just there,” she says.

For years, Shikongo told no one – not friends, not family and not partners.

“I only told my sister last December, and even that was as a joke,” she says.

“Relationship-wise it’s very difficult to tell somebody something like that.

You are afraid of being judged.”
Her current partner knows and supports her decision to seek treatment.

“My partner wants me to fix it. I also want to try,” she says.

She has not told her daughter (15).

“I didn’t want her to feel guilty. It was not her fault. But now she is grown. I will tell her,” she says.

Her sister, Metrichia Shikongo (25), says she was shocked when she first heard about the condition.

“At first, I did not understand that she was serious,” Metrichia says. “When I realised she had been living with this for 15 years, I was very shocked.”

Metrichia says she feels proud of her older sister for speaking up.

“She never showed weakness. She carried herself like everything was normal,” she says. “As her sister, I am proud of her strength. She inspires me.”

Shikongo went on to give birth to three more children after her first delivery. For Metrichia, that speaks of courage.

“The fact that she gave birth to three more children after what happened inspires me as another woman,” she says.

A PREVENTABLE INJURY

Specialist obstetrician and gynaecologist Dr Simon Emvula says obstetric fistula remains a preventable childbirth injury affecting vulnerable women.

“It occurs when a hole develops between the birth canal and the bladder or rectum, leading to continuous leakage of urine or stool,” he explains.

While most often linked to prolonged, obstructed labour, he says fistula can also follow severe perineal tears, traumatic deliveries or delayed and inadequate repair of childbirth injuries.

“No woman should suffer lifelong incontinence because she gave birth,” Emvula says.

“The consequences are devastating – medical complications, loss of dignity, social isolation and psychological trauma – yet, this condition is almost entirely preventable with timely, quality obstetric care.”

He says prevention requires stronger maternal health systems, including skilled birth attendants in rural areas, 24-hour emergency obstetric services such as caesarean sections, proper training to prevent and repair severe tears, and effective referral and transport systems.

He adds that women with fistula need specialised surgical repair and reintegration support, services he says are available at Namibia’s referral state hospitals.

“Safe motherhood is not a privilege. It is a constitutional and human right,” he says.

The experience has shaped Shikongo’s future. Last month, she started with her nursing studies.

“The reason I chose nursing is because of this,” she says. “Any young girl can go through it.”

She believes more awareness is needed so women recognise symptoms early and seek help.

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