Birth COMPLICATIONS in AFRICA | Dr. Medina Ndoye | VESICOVAGINAL FISTULA
Childbirth is a beautiful experience, but for many women in Africa, it has become synonymous with abuse, suffering, and economic hardship. Despite the advancement in healthcare delivery systems globally, women in sub-Saharan Africa continue to face the risk of birth complications such as Vesicovaginal Fistula (VVF). This condition results in the woman losing control of her urine or feces, and the effect on her life can be devastating. In this article, we explore the problem of Vesicovaginal Fistula and the measures put in place to combat it.
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What is Vesicovaginal Fistula?
Vesicovaginal Fistula (VVF) is a severe medical condition that results in the weakening or tearing of tissues between the vagina and bladder. This creates an abnormal hole that allows urine to leak uncontrollably into the vagina. Some of the symptoms include the smell of urine, continuous dampness in the underwear, urinary tract infection, and social isolation. The condition arises when there is prolonged obstructed labor typically in settings where women have no access to medical facilities or skilled birth attendants. This means that women in sub-Saharan Africa are the most affected. The numbers are expected to rise due to the impact of Covid-19 and the increased poverty levels in these regions.
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Causes of Vesicovaginal Fistula
Several factors can cause Vesicovaginal Fistula; they include;
Limited access to maternity care: Women who live in sub-Saharan Africa have limited access to maternity care owing to distance, lack of skilled medical personnel, and infrastructural deficit. This causes women to deliver their babies at home, leading to complications and eventual Vesicovaginal Fistula Female Genital Mutilation (FGM): This is a cultural practice that involves the cutting of the female genitalia. It is prevalent in sub-Saharan Africa and some areas of the Middle East. The practice is a violation of human rights and often leads to VVF.
Although the causes of VVF are not always known, it is important to seek medical attention if you experience symptoms such as pain, discomfort, or frequent urination. With early diagnosis and treatment, VVF can often be successfully treated.
Early child marriage: Child marriage denies the girl-child the right to an education and exposes her to childbirth too early. This leads to complications due to the immaturity of the reproductive system and, subsequently, VVF.
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Impact of Vesicovaginal Fistula
Vesicovaginal Fistula severely impacts the life of a woman in several ways as highlighted below;
– Social isolation and shame: Women living with Vesicovaginal Fistula experience unbearable shame and social isolation. They find it challenging to interact with others due to the consistent smell of urine, leading to further isolation and depression.
– Economic hardship: VVF patients often lack the resources to cater to their medical bills and daily upkeep. This, coupled with the ostracization, means that they may never be able to find sustainable sources of income.
– Death of newborns: Delivering at home without a skilled birth attendant significantly increases the chances of neonatal mortality as there is no proper equipment and care during the delivery.
– Limited opportunities for women: Due to the shame associated with VVF, most women who suffer from it drop out of school and cannot participate in productive activities, leading to further impoverishment.
Solutions
The Vesicovaginal Fistula problem requires a collective effort to address. Several stakeholders are engaging in measures to combat the problem. They include:
– Maternal health advocacy: There is an increased need for advocacy to help policy-makers to see the importance of maternal health and its effect on the economy. This will make an impact on reducing the cases of VVF in Africa.
– Access to healthcare: More needs to be done to provide health care to women living in rural communities. This will help reduce the number of women who deliver their babies at home without proper medical care.
– Ending child marriage and FGM: Cultural practices that expose women to VVF must be abolished to stop the cycle of poverty and preventable deaths.
– Creating safe spaces and community support for women living with VVF: Establishing support systems such as rehabilitation centers and community-based programs for women living with VVF will help reduce the stigma associated with it. These efforts will enable them to participate in society and live productive lives.
Conclusion
The problem of Vesicovaginal Fistula is a severe public health concern that affects several women in Africa. The impact of this condition extends beyond the individual affected but creates a ripple effect of impoverishment and social isolation. However, the changes in government policies, provision of health care, and community involvement offer a glimmer of hope for the women affected. With adequate support and advocacy, Vesicovaginal Fistula may soon be a thing of the past, and women in Africa can walk tall with dignity and respect.
