Restoring dignity: Social reintegration after obstetric fistula repair in Ukerewe, Tanzania

Abstract

This study explores barriers and facilitating factors women experience re-integrating into society after treatment of an obstetric fistula in rural Tanzania. A total of 71 women were interviewed in the Mwanza region of Tanzania, including a community control group. The majority of the women who received successful surgical repairs reported that, over time, they were able to resume many of the social and economic activities they engaged in prior to the development of a fistula. Familial support facilitated both accessing repair and recovery. For 60% of the women recovering from an obstetric fistula, work was the most important factor in helping them feel 'normal again'. However, physical limitations and other residual problems often hampered their ability to continue working. All of the treated women expressed interest in follow-up discussions with health care providers regarding their health and concerns about future pregnancies. Special attention is needed for women who are not completely healed and/or for those who experience other related medical or emotional problems after repair, especially if they lack a social network.

An Exploratory Study of Reintegration of Women Following Obstetric Fistula Surgery in West Pokot, Kenya

“…Several scholars have demonstrated the importance of family and community support to the reintegration of fistula patients (Diallo, 2009;Mohammad, 2007;Pope et al, 2011). Similarly, in this study, moral support and acceptance from family and the larger community were emphasized.…”

“…Thus, it is seen as the first step toward reintegration. For instance, the women with residual symptoms in the Tanzania study perceived themselves as not yet healed and reported a low perception of their quality of life (Pope et al, 2011). The current study did not directly measure quality of life although it points to better social reintegration among women with successful repair in the post-corrective surgery period.…”

“…Similarly, Pope et al (2011) demonstrated that women who have residual symptoms of weakness, pain, and urinal incontinence after surgery find difficulty in reintegration in Tanzania. Surgical repair, therefore, has an important role in the life of a woman living with obstetric fistula for two main reasons.…”

“…Follow-up studies to evaluate the postsurgical period conducted in the African region include Turan et al (2007) in Eritrea;Nielsen et al (2009) in Ethiopia;and Pope, Bangser, and Requejo (2011) in Tanzania. The follow-up studies have provided insights into the needs of fistula survivors in the period following corrective surgery.…”

Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in West Pokot, Kenya

“…For instance, Mohammad 26 describes a re-integration programme for fistula survivors in Nigeria, where the need for economic empowerment was given priority, to good effect. Nonetheless, in some studies, for example Pope, Bangser and Requejo, 27 women have been shown to be able to resume normal economic activities, with their families as the core supporting unit.…”