A Situational Analysis of Vesico-Vaginal Fistula at the Aberdeen Women's Centre-Freetown

Vesicovaginal fistula is a hole that develops between a woman’s vagina and her urinary bladder, usually as a result of prolonged obstructed labour, resulting in continuous or intermittent urine leakage down their legs. The purpose of the study was to have a general overview of the burden of Vesico-vaginal fistula in 50 patients case- notes with urinary and/or stool leakage at the Aberdeen Women’s Centre, Freetown city within the period under review. The specific objectives of this study were to investigate; the prevalence/burden of VVF, the risk factors contributing to it, the age distribution, the mode of delivery and the physical and psychosocial impacts of this condition on affected women. The results reveal an overall prevalence/burden of VVF to be 90% with prolonged obstructed labour with difficult vaginal delivery being the main associated cause (80%). Another reported associated cause was shown to be cesarean section (6%). It also shown that patients with ages 15-19 accounted for the highest number of fistula patients (28%) followed by ages 20-24 (20%). Ages 10-14 accounted for only 4%. In all, the age range 15-34 accounted for 82% as these are part of the sexually active reproductive age. Furthermore, the study reveals that a total of 30 patients (60%) were recorded for both stigmatization and depression which was highly responsible for the mental ill health of the patients. The high incidence of VVF is shown to be associated with low socio-economic status of women compounded with cultural and religious beliefs and practices as depicted in the conceptual framework for the risk management systems of fistulas. To reduce both the incidence and social impact of the consequences of VVF, it is recommended that women’s status be improved through education, employment and teaching of income-generating skills to augment their resources in addition to creating community awareness at all levels as this involves reaching different target groups that make up the community such as leaders at national, regional and local levels including politicians, health professionals, traditional leaders, ‘Soweys’, Mammy Queens, TBAs, CHWs, Councilors, husbands, teachers etc.