Abstract
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.
