For fistula victims in Kenya, there is hope. This past September, gynecologists from all over the country were trained at the Kenyatta hospital to treat fistula patients.

Many women suffer in silence in isolation and silence for a condition that is easy to prevent. Thanks to this training, patients like Julia Karimi can now see a light at the end of tunnel. She and many women in the country can now breath a sigh of relief knowing that they won't be treated as outcasts because their injury can be remedied.

Obstetric fistula is a hole in the birth canal caused by prolonged labor without prompt medical intervention, usually a Caesarean section. The woman is left with chronic incontinence and, in most cases, a stillborn baby.

The smell of leaking urine or feces, or both, is constant and humiliating, often driving loved ones away. Left untreated, fistula can lead to chronic medical problems, including ulcerations, kidney disease, and nerve damage in the legs.

A simple surgery can normally repair the injury, with success rates as high as 90 percent for experienced surgeons. The average cost of fistula treatment and post-operative care is just $300. Sadly, most women with the condition do not have access to skilled personnel.

That is why the training for gynecologists at the largest referral hospital in East Africa is a welcome idea as it open doors to women from the region to access repairs for fistulas.

Obstetric fistula is one of the major complications that result from obstructed labor. When labor is prolonged, before medical attention is can be obtained, several serious complications can occur, says Dr. Solomon Orero, an obstetric gynecologist who works at the referral hospital and refugee camps.

"A woman may die, lose her child or face complications like fistula," he says, adding that this is due to the many delays women have to go through before they reach a health care facility with skilled attendance.

Many women in Africa face a lot of barriers to accessing health care including lack of money, difficulty in reaching a health facility and cultural barriers. Over half of married women ages 15 to 49 on the continent consider money to be a big problem in getting health care. This may reflect not only in poverty but also gender differences in control over household resources.

Geographic access to health care, which involves distance to the health facility and lack of transportation, poses a big problem for women in Sub-Saharan Africa. In Zimbabwe and Namibia, married women cite geographic access more often than other obstacles to accessing health care.

A million women in the world are faced with obstetric fistula, with 50,000 to 100,000 more cases each year, says the UN Population Fund. According to Australian doctors Reginald and Catherine Hamlin, these statistics compelled them to start a fistula hospital in Addis Ababa, Ethiopia.

Fistula patients are often shunned severely due to their odor. At Kenyatta National Hospital ward 42D was put aside for the duration of the fistula patients stay at the medical facility. While it took the Hamlins more than a decade to establish a fistula hospital, I am glad to see that it will be cost effective in this region to train more doctors to perform the necessary surgery to help the victims of fistula.

As the Kenyan doctors wind up the training in Nairobi, one Julia Karimi will be going home today. She came into ward 42D smelling but now she can go home with her self-esteem back.

But treating individual instances of fistula is not an end in itself. More needs to be done to deal with all the factors that contribute to maternal mortality and morbidity as whole. Like all other issues where women are concerned, where there is a will there is always a way.

The persistence of fistula is a signal that health systems are failing to meet the needs of women.