Fistula found in Rural KZN, eastern cape

2011-09-01 00:00

DR T. D. Naidoo, head of the uro-gynae section at Pietermaritzburg’s Grey’s Hospital, has volunteered his service and expertise to help women diagnosed with fistula in North African countries.

He has operated at the Addis Ababa Hospital in Ethiopia where the condition is a common occurrence. He told The Witness that the condition is quite rare in South Africa, but it does occur in small pockets of KwaZulu-Natal and the Eastern Cape where poverty and poor education are factors.

He said a study done by a researcher at King Edward Hospital found that locally the condition is usually found in young women pregnant with their first child who are not given any prenatal care by nurses or clinics. The problem is they are too scared to go to the hospital or they don’t know that they should be seeing a health care professional during their pregnancy.

He explained: “In some cases the women live in a remote village and it costs too much for them to visit a clinic. They are usually cared for by the older women in the family or the traditional healer. It is a problem when the woman has a small stature and her hips are too small in relation to the size of the baby.

“A midwife or doctor will be able to see this and suggest that the woman gives birth at a hospital or has a caesarean section. But in a rural area, the young woman will suffer in labour for up to four days before giving birth to a stillborn child.

“The young woman can cause damage to her body by continuous pushing during an extended labour. The fistula [hole] usually develops when the unborn child is squeezed so tightly in the birth canal. The blood flow is cut off to the surrounding tissues, which necrotise and eventually rot away. An obstetric fistula develops between either the rectum and vagina or between the bladder and vagina.”

Body fluids from the uterus will leak into the anal cavity or vice versa and she ends up with a terrible hygiene problem.

Many women suffer from incontinence of the bladder or bowel and infections. He said the psychological trauma of women who suffer from this condition is under-estimated. “It is all very sad, when it can be prevented by prenatal care, education and contraception.”

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