Skip to main content
Top
Published in: BMC Women's Health 1/2019

Open Access 01-12-2019 | Research article

The loss of dignity: social experience and coping of women with obstetric fistula, in Northwest Ethiopia

Authors: Debrework Tesgera Bashah, Abebaw Gebeyehu Worku, Mezgebu Yitayal, Telake Azale

Published in: BMC Women's Health | Issue 1/2019

Login to get access

Abstract

Background

Obstetric fistula is a debilitating condition resulted from poorly (un) managed prolonged obstructed labor. It has significant psychosocial and economic consequences on those affected and their families. Data regarding experiences and coping mechanisms of Ethiopian women with fistula is scarce.

Methods

Qualitative design was employed with in depth interview technique by using open ended interview guide. Eleven fistula patients waiting for surgical repair at the fistula treatment center of Gondar Specialized Referral Hospital were selected with typical case selection. Thedata were audio-taped, transcribed and translated from Amharic to English. Open code version 4.03was used to organize data and identify themes for analysis.

Results

The age of participants of the study ranged between 19 to 43 years. Ten of them were from rural areas. Regarding their educational status eight cannot read and write. Similar number were either separated or divorced. Six of them lived with obstetric fistula without treatment from one to five years. Five women related their condition to their fate. The women faced challenges in role performance, marital and social relationships and economic capability. Frequent bathing, use of stripes of old clothes as a pad, self-isolation and hiding from being observed, wearing extra clothes as cover, increasing water intake and reducing hot drinks and fluids other than water were the ways they have devised to cope with the incontinence.

Conclusion

The study participants reported that they experienced deep sense of loss, diminished self-worth and multiple social challenges. They coped with the incontinence in various ways among which some were non effective and might have continuing negative impact on woman’s quality of life even after corrective surgery. Developing bridging intervention for early identification and referral could reduce period of women’s suffering.
Appendix
Available only for authorised users
Footnotes
1
Pseudo name is used for confidentiality.
 
Literature
1.
go back to reference Özge T, Vandana T, Evelyn L, Cynthia KS, Saifuddin A. Measuring the incidence and prevalence of obstetric fistula: approaches, needs and recommendations. Bull World Health Organ. 2015;93:60–2.CrossRef Özge T, Vandana T, Evelyn L, Cynthia KS, Saifuddin A. Measuring the incidence and prevalence of obstetric fistula: approaches, needs and recommendations. Bull World Health Organ. 2015;93:60–2.CrossRef
2.
go back to reference Ryan F. The typical story of obstetric fistula : the need to enhance awareness, action & funds. 2014(17). Ryan F. The typical story of obstetric fistula : the need to enhance awareness, action & funds. 2014(17).
3.
go back to reference Almaw TF, Keysers L, and, Chhachhi A. From trauma to rehabilitation and reintegration: experiences of women facing the challenges of obstetric fistula in Addis Ababa, Ethiopia. November,2010. Almaw TF, Keysers L, and, Chhachhi A. From trauma to rehabilitation and reintegration: experiences of women facing the challenges of obstetric fistula in Addis Ababa, Ethiopia. November,2010.
4.
go back to reference Zhengx A, Frank W, Ander J. Obstatric fistula in low income countries. Int J Gyneacol Obstat. 2008;104:85–9.CrossRef Zhengx A, Frank W, Ander J. Obstatric fistula in low income countries. Int J Gyneacol Obstat. 2008;104:85–9.CrossRef
5.
go back to reference Ahmed S, Genadry R, Stanton C, Lalonde A. Dead women walking: neglected millions with obstetric fistula. Int J Gynecol Obstet. 2007;99(Suppl 1):S1–3.CrossRef Ahmed S, Genadry R, Stanton C, Lalonde A. Dead women walking: neglected millions with obstetric fistula. Int J Gynecol Obstet. 2007;99(Suppl 1):S1–3.CrossRef
6.
go back to reference Kalembo F, Zgambo M. Obstetric fistula: a hidden public health problem in sub-Saharan Africa. Arts Soc Sci J. 2012;41:1–8. Kalembo F, Zgambo M. Obstetric fistula: a hidden public health problem in sub-Saharan Africa. Arts Soc Sci J. 2012;41:1–8.
7.
go back to reference Abrams P, Ridder Dd, deVries C, Sohier Elneil, Esegbona G, Mourad S, et al. Obstetric fistula in the developing world. ICUD (international consultation on urological diseases). 2010:1-7. Abrams P, Ridder Dd, deVries C, Sohier Elneil, Esegbona G, Mourad S, et al. Obstetric fistula in the developing world. ICUD (international consultation on urological diseases). 2010:1-7.
8.
go back to reference Tarekegn SM, Lieberman LS, and, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian demographic and health survey. BMC Pregnancy Childbirth. 2014;14(161):1–13. Tarekegn SM, Lieberman LS, and, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian demographic and health survey. BMC Pregnancy Childbirth. 2014;14(161):1–13.
9.
go back to reference Women’s Dignity Project and EngenderHealth T. Reducing the Risk of Obstetric Fistula: Skilled Birth Attendance and Emergency Obstetric Care. 2006:1-13. Women’s Dignity Project and EngenderHealth T. Reducing the Risk of Obstetric Fistula: Skilled Birth Attendance and Emergency Obstetric Care. 2006:1-13.
10.
go back to reference Lilian T, and, Thecla W. Living with constant leaking of urine and odour: thematic analysis of socio-cultural experiences of women affected by obstetric fistula in rural Tanzania. BMC Womens Health. 2015;15(107):1–9. Lilian T, and, Thecla W. Living with constant leaking of urine and odour: thematic analysis of socio-cultural experiences of women affected by obstetric fistula in rural Tanzania. BMC Womens Health. 2015;15(107):1–9.
11.
go back to reference Kabir M, Iliyasu Z, Abubakar I, Umar U. medico-social problems of patients with vesico-vaginal fistula in Mutala Mohammed specialist Hospital, Kano. Ann Afr Med. 2004;2(2):54–7. Kabir M, Iliyasu Z, Abubakar I, Umar U. medico-social problems of patients with vesico-vaginal fistula in Mutala Mohammed specialist Hospital, Kano. Ann Afr Med. 2004;2(2):54–7.
12.
13.
go back to reference Mutambra J, Maunganidze L, Muchichewa P. Towards promotion of maternal health: the psychological impact of obstetric fistula on wumen in Zimbabwe. Int J Asian Soc Sci Towards Promotion Mat Health. 2013;3(1):229–39. Mutambra J, Maunganidze L, Muchichewa P. Towards promotion of maternal health: the psychological impact of obstetric fistula on wumen in Zimbabwe. Int J Asian Soc Sci Towards Promotion Mat Health. 2013;3(1):229–39.
14.
go back to reference Ahmad KM, Sharifi K, and, Bahram AA. Prevalence of obstetric fistula among women of reproductive age in six provinces of Afghanistan,. Social and health development program (SHDP) 2011. Ahmad KM, Sharifi K, and, Bahram AA. Prevalence of obstetric fistula among women of reproductive age in six provinces of Afghanistan,. Social and health development program (SHDP) 2011.
16.
go back to reference Browning A, Patel T. FIGO initiative for the prevention and treatment of vaginal fistula. Int J Gynaecol Obstet. 2004;86(2):317–22.CrossRef Browning A, Patel T. FIGO initiative for the prevention and treatment of vaginal fistula. Int J Gynaecol Obstet. 2004;86(2):317–22.CrossRef
17.
go back to reference Rachel P, Maggie B. Jennifer HR. restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania. Glob Public Health. 2011;6(8):859–87.CrossRef Rachel P, Maggie B. Jennifer HR. restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania. Glob Public Health. 2011;6(8):859–87.CrossRef
18.
go back to reference Gulati BK, Unisa S, Pandey A, Sahu D, Ganguly S. Correlates of occurrence of obstetric fistula among women in selected states of India: an analysis of DLHS1-3 data. OBGYN. 2011;3(2):121–8. Gulati BK, Unisa S, Pandey A, Sahu D, Ganguly S. Correlates of occurrence of obstetric fistula among women in selected states of India: an analysis of DLHS1-3 data. OBGYN. 2011;3(2):121–8.
19.
go back to reference Gulati B, Unisa S, Pandey A, Sahu D, Ganguly S. Correlates of occurrence of obstetric fistula among women in selected states of India: an analysis of DLHS1-3 data. OBGYN. 2011;3(2):121–8. Gulati B, Unisa S, Pandey A, Sahu D, Ganguly S. Correlates of occurrence of obstetric fistula among women in selected states of India: an analysis of DLHS1-3 data. OBGYN. 2011;3(2):121–8.
20.
go back to reference Bangser M, Manisha M, Janet S, Chris D, Catherine K, et al. Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. Int Urogynecol J. 2011;22:91–8.CrossRef Bangser M, Manisha M, Janet S, Chris D, Catherine K, et al. Childbirth experiences of women with obstetric fistula in Tanzania and Uganda and their implications for fistula program development. Int Urogynecol J. 2011;22:91–8.CrossRef
21.
go back to reference Tebeua P-M, Bernis L, Boisrondd L, Duke A, and, al. e. Knowledge, attitude and perception about obstetric fistula by Cameroonian women. A clinical survey conducted in Maroua, capital of the far north province of Cameroon. Prog Urol. 2008;18:379–389. Tebeua P-M, Bernis L, Boisrondd L, Duke A, and, al. e. Knowledge, attitude and perception about obstetric fistula by Cameroonian women. A clinical survey conducted in Maroua, capital of the far north province of Cameroon. Prog Urol. 2008;18:379–389.
22.
go back to reference Yifru B, and, Asres B. Reasons for persistently high maternal and perinatal mortalities in Ethiopia. 2008. Yifru B, and, Asres B. Reasons for persistently high maternal and perinatal mortalities in Ethiopia. 2008.
23.
go back to reference Mselle LT, Karen MM, Bjørg E-O, Abu M, Thecla WK. “I am nothing”: experiences of loss among women suffering from severe birth injuries in Tanzania. BMC Womens Health 2011;11(49):1–12. Mselle LT, Karen MM, Bjørg E-O, Abu M, Thecla WK. “I am nothing”: experiences of loss among women suffering from severe birth injuries in Tanzania. BMC Womens Health 2011;11(49):1–12.
24.
go back to reference Browning A, Menber B. Women with obstetric fistula in Ethiopia: a 6-month follow up after surgical treatment. Br J Obstet Gynaecol. 2008;115(12):1564–9.CrossRef Browning A, Menber B. Women with obstetric fistula in Ethiopia: a 6-month follow up after surgical treatment. Br J Obstet Gynaecol. 2008;115(12):1564–9.CrossRef
25.
go back to reference Donnelly K, Oliveras E, Yewondwossen T, Belachew M, Mengistu A. The quality of life of Ethiopian women after fistula repair: implications on rehabilitation and social reintegration policy and programming. Int J Res, Interv Care. 2015;2(17):150–64. Donnelly K, Oliveras E, Yewondwossen T, Belachew M, Mengistu A. The quality of life of Ethiopian women after fistula repair: implications on rehabilitation and social reintegration policy and programming. Int J Res, Interv Care. 2015;2(17):150–64.
26.
go back to reference Söderbäck M, Wilhelmsson E, Häggström-Nordin E. Absence and reliance:Liberian women's experience of vaginal fistula. Afr J Midwifery Womens Health. 2012;6(1):28–34.CrossRef Söderbäck M, Wilhelmsson E, Häggström-Nordin E. Absence and reliance:Liberian women's experience of vaginal fistula. Afr J Midwifery Womens Health. 2012;6(1):28–34.CrossRef
27.
go back to reference Khisa AM. Nyamongo IK. Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in west Pokot, Kenya. Reprod Health Matters. 2012;20(40):59–66.CrossRef Khisa AM. Nyamongo IK. Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in west Pokot, Kenya. Reprod Health Matters. 2012;20(40):59–66.CrossRef
28.
go back to reference Inhorn M. Defining women's health: a dozen messages from more than 150 ethnographies. Med Anthropol Q. 2006;20(3):345–78.CrossRef Inhorn M. Defining women's health: a dozen messages from more than 150 ethnographies. Med Anthropol Q. 2006;20(3):345–78.CrossRef
29.
go back to reference Okoye UO, Emma-Echiegu N. And, Tanyi PL. living with vesico-vaginal fistula: experiences of women awaiting repairs in Ebonyi state, Nigeria. Tanzania J Health Res. 2014;16(4). Okoye UO, Emma-Echiegu N. And, Tanyi PL. living with vesico-vaginal fistula: experiences of women awaiting repairs in Ebonyi state, Nigeria. Tanzania J Health Res. 2014;16(4).
30.
go back to reference Ijaiya MA, Rahman AG, Aboyeji AP, Olatinwo AW, Esuga SA, Ogah OK, et al. Vesico-vaginal fistula: a review of Nigerian experience. West Afr J Med. 2010;29:294–8. Ijaiya MA, Rahman AG, Aboyeji AP, Olatinwo AW, Esuga SA, Ogah OK, et al. Vesico-vaginal fistula: a review of Nigerian experience. West Afr J Med. 2010;29:294–8.
31.
go back to reference Mohamed EY, Boctor MF, Ahmed HA, Seedahmed H, Abdelgadir MA. Et al. contributing factors of vesico-vaginal fistula (VVF) among fistula patients in Dr. Abbo's National Fistula & Urogynecology Centre - Khartoum. Sudanese J Public Health. 2009;4:259–64. Mohamed EY, Boctor MF, Ahmed HA, Seedahmed H, Abdelgadir MA. Et al. contributing factors of vesico-vaginal fistula (VVF) among fistula patients in Dr. Abbo's National Fistula & Urogynecology Centre - Khartoum. Sudanese J Public Health. 2009;4:259–64.
32.
go back to reference Mwini-Nyaledzigbor PP, Agana A, Beryl F. Lived experiences of Ghanaian women with obstetric fistula. Health Care Women Int. 2013;34(6):440–60.CrossRef Mwini-Nyaledzigbor PP, Agana A, Beryl F. Lived experiences of Ghanaian women with obstetric fistula. Health Care Women Int. 2013;34(6):440–60.CrossRef
33.
go back to reference Baba SB. Birth and sorrow: the psycho-social and medical consequences of obstetric fistula. Int J Medical Sociol Anthropol. 2014;2(2):055–65. Baba SB. Birth and sorrow: the psycho-social and medical consequences of obstetric fistula. Int J Medical Sociol Anthropol. 2014;2(2):055–65.
34.
go back to reference Yeakey M, Chipeta E, Rijken Y, Taulo F, Tsui A. Experiences with fistula repair surgery among women and families in Malawi. Glob Public Health. 2011;6(2):153–67.CrossRef Yeakey M, Chipeta E, Rijken Y, Taulo F, Tsui A. Experiences with fistula repair surgery among women and families in Malawi. Glob Public Health. 2011;6(2):153–67.CrossRef
35.
go back to reference Bonnie JR. Shattered lives: understanding obstetric fistula in Uganda: Oregon State University; 2012. Bonnie JR. Shattered lives: understanding obstetric fistula in Uganda: Oregon State University; 2012.
36.
go back to reference Pope R, Bangser M. JH. R. Restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania. Global Public Health. 2011;6(8):859–73.CrossRef Pope R, Bangser M. JH. R. Restoring dignity: social reintegration after obstetric fistula repair in Ukerewe, Tanzania. Global Public Health. 2011;6(8):859–73.CrossRef
37.
go back to reference Gharoro E, Agholor K. Aspects of psychosocial problems of patients with vesico-vaginal fistula. Obstet Gynaecol. 2009;29:644–7.CrossRef Gharoro E, Agholor K. Aspects of psychosocial problems of patients with vesico-vaginal fistula. Obstet Gynaecol. 2009;29:644–7.CrossRef
Metadata
Title
The loss of dignity: social experience and coping of women with obstetric fistula, in Northwest Ethiopia
Authors
Debrework Tesgera Bashah
Abebaw Gebeyehu Worku
Mezgebu Yitayal
Telake Azale
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2019
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-019-0781-7

Other articles of this Issue 1/2019

BMC Women's Health 1/2019 Go to the issue