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Health News of Friday, 21 December 2018

Source: Edmond Gyebi

Obstetric Fistula not a curse against women, but a health condition - Ghanaians told

A maternity ward A maternity ward

Giving birth to children inarguably is supposed to be a source of great joy and fulfilment of dream for every woman especially those in legitimate marriage.

In typical African or Ghanaian set ups, many married women have lost their marriages or have been harshly chased out of their matrimonial homes by their in-laws for their inabilities to give birth to children after years in marriage.

Children are as it were, great gifts from God since it fulfills the commission of God’s covenant with mankind, to multiply or replenish the earth. Children are the backbones of marriages and future of every community or nation.

However, child bearing in Ghana and some parts of Africa is gradually becoming a monstrous journey in the lives of many women as the supposed joyous expedition is now associated with several dangers and complications which most at times frighten many women and limit their interest in having children.

Many women in Ghana have died/lost their lives while giving birth to children. Others have also developed complications during pregnancy such as bleeding from the vagina, sudden swelling of the hands or face, pain in the abdomen, severe headaches, dizziness, persistent vomiting and blurred vision among others which can even be described as “minor problems”.

Some of the women with bacterial, viral or parasitic infections before or during pregnancy mostly face complications resulting from urinary tract infection, bacterial vaginosis, cytomegalovirus, hepatitis B virus, yeast infection and toxoplasmosis, which is an infection caused by a parasite found in cat feces and raw meat.

Obstetric Fistula

However, one of the dangerous conditions derailing or stunning the pride and dignity of many Ghanaian women in silence is obstetric fistula.

About 100,000 to 150, 000 expectant women in the world suffer from fistula each year with young girls being the most affected.

Obstetric Fistula is caused by prolonged and obstructed labour, which injures the pelvic tissue that raptures the bladder resulting in uncontrollable leakage of urine or faeces.

Major contributing factors include poverty, illiteracy, low status of women and gender inequality, malnutrition, adolescent pregnancy, lack of awareness, socio-cultural practices, lack of access to family planning and emergency obstetric care.

Many people in Ghana are unaware of the devastating condition which makes it precarious for the victims.

In Ghana, at least 700 new cases of fistula are recorded every year. Majority of women who have this condition are living in isolation due to the rejection and stigmatization they face from relatives, friends and society, even though it is not infectious.

This condition prevails in all 10 regions of Ghana, but the Northern region has the highest prevalence, followed by Ashanti, Western, Central and the Upper regions. Currently, there are two main hospitals which offer dedicated Fistula care - Mercy Women’s Catholic Hospital at Mankessim-Central region and Tamale Fistula Center, Tamale Central Hospital in the Northern region.

The United Nation’s Population Fund and the Ghana Health Service assessment of obstetric Fistula 2014-2015 data indicates that 53% of patients are married and 35% at least have had primary education. Women who develop this abnormally usually suffer a chronic skin condition which is caused by the direct irritation of urine. Some patients also develop blisters and sores around their thighs caused by the constant urinary incontinence and friction.

Obstetric Fistula is one of the major contributors to infant mortalities in Ghana. It is also reported that 8 out of 10 women lose their babies from the delivery which caused the fistula.

In some parts of Ghana, women with this condition are not only stigmatized against, but also lose their marriages (rejection from husbands) and others are confined in isolated rooms till death because of the dire superstitious belief that Fistula condition is a curse born out of infidelity or adultery.

For fear of being punished for having suspected extra marital affairs and its attended rejection, most women with fistula conditions do not come out to seek help.

The Government of Ghana, through the Ministry of Health, the Ghana Health Service and Ministry of Gender, Children and Social Protection as well as other partners to increase awareness and public education on the obstetric fistula across Ghana to save women from rejection, maltreatment, stigmatisation and restore their dignities and self-esteem.

The cost of surgery of one fistula is estimated at about 400-500 dollars, and this is, however, covered by the National Health Insurance Scheme. The Government must therefore make conscious effort and commit funds to cure all affected patients in order to avoid being turned away by health facilities for no availability of funds or essential drugs.

It will be recalled that the Ministry of Health and the United Nations Population Fund some few years ago endorsed Ghanaian actor, John Dumelo as Obstetric Fistula ambassador to aid in raising funds for the treatment of this condition.

It is however, not clear as to what has happened to, or come out of the role assigned John Dumelo.

Lastly, adequate human resources or obstetrician gynecologists who have the skills to repair obstetric fistula must be raised in Ghana.

All women with fistula conditions especially those in deprived areas are encouraged to come out boldly to seek treatment without any fear or hesitation. Ghanaians must know, that victims of fistula condition have self-esteem and must show them more love and affection.