Living with vesico-vaginal fistula: experiences of women awaiting repairs in Ebonyi State, Nigeria

Abstract

Vesico-vaginal fistula (VVF) is one of maternal health problems confronting public health workers in Nigeria today. Information on how women suffering from this condition cope is important in that it can inform the design and delivery of programmes and interventions to address the challenges that face victims of VVF. The objective of this study was to highlight how women living with VVF cope with the health problem in Ebonyi state, Nigeria. In-depth interviews were conducted with ten women awaiting repairs at the National Fistula Centre at Abakaliki in Nigeria. Six of the women have lived with the health problem for more than ten years. Findings show that nearly all the women attributed their health problem to supernatural causes. The women stated that they go through a lot of physical and emotional problems. Some of the ways they have devised of physically coping with the problem include bathing regularly and use of strips of old wrappers as pads. Many of them cope emotionally and financially by attending religious gatherings and having some form of income yielding business. The study recommends the need for repairs to go hand in hand with vocational training so that they will have some income yielding business after repairs.

Consequences of obstetric fistula in sub Sahara African countries, from patients’ perspective: a systematic review of qualitative studies

“…All included studies were conducted in Sub-Saharan Africa: two in Ethiopia [21, 22], five in Tanzania [11, 13, 23–25], one in Uganda and Tanzania [11], one in Eritrea [16], two in Uganda [26, 27] two in Nigeria [19, 28], one in Kenya [29],one in Ghana [30], and one in Malawi [31]. All research took place in treatment or rehabilitation facilities, except reports from Kenya and Malawi which were conducted in the community.…”

“…Physical consequence was the core theme shared across most studies, described as loss of body control and the challenges faced to keep cleanness [13, 16, 19, 24, 28, 29, 32]. Physical challenges include the emotional and medical problems of fistula which resulted from incontinence, such as genital sores, smells, wounds, pain, discomfort, exhaustion, and foot drop [21].…”

“…Most studies included marital and social relationships issues as the main theme [11, 13, 19, 22, 23, 26, 29]. It is a common event that fistula-affected women face divorce as they fail to satisfy their husband’s sexual needs and/or fail to bear children.…”

“…This challenges were emerged as the result of different interrelated problems such as lack of support and family care, physical or economical incapability to access care, and lack of information or knowledge about fistula care and treatment [28]. It might also result from the reactions and comments of people with a poor understanding of the condition [19, 29]. Perceived causes of fistula and social stigma has caused psychological morbidity to women [19, 23, 27].…”

“…Women living with fistula may be blamed by the community members for their condition, viewing it as punishment for sin or a venereal disease or curse [17]. The women are unable to participate in religious activities and social gatherings, and are considered unhygienic [18, 19]. …”