Tanzania: Poor Services ‘to Blame for Fistula’

Poor rural health facilities have in recent years resulted in many cases of childbirth complications that causes ‘obstetric fistula’.

An ‘obstetric fistula’ is a hole formed between a vagina and bladder of a woman who has undergone difficult childbirth.

It is mainly caused by prolonged and obstructed labour, usually resulting from the failure of a baby to pass its head through the birth canal of a carrying mother, which presses the soft tissue of the vagina and bladder between the fetal skull and pelvic bone.

The resultant pressure, according to health experts, cuts off blood supply tissues, causing them to disintegrate and leaving a hole that passes urine or feces continuously into the vagina.

In the last six years, over 5,000 women were treated of obstetric fistula in the country, especially in rural areas. The disease, health experts say, is an indicator of poor health services.

According to the World Health Organisation (WHO) at least 50,000 of every 100,000 expectant mothers in developing countries develop obstetric fistula.

In Tanzania’s most rural areas, many people believe the disease is a result of sexual promiscuity.

Last year alone, specialists from the African Medical Research Foundation (Amref) and Weil Bugando Medical Centre (WBMC) in Mwanza, treated over 500 women of the disease, commonly known as ‘recto-vagina fistula’.

Currently there is a national programme to eradicate the disease, but health experts have warned that as long as health conditions do not improve in especially rural areas, the disease will be difficult to fight.

According to senior national programme officer Ms Subila Mwambingu, Kenyan doctors have also been assisting in the programme that has so far seen 111 repairs done countrywide.

Some of the areas where experts have treated women of the disease are CCBRT in Dar es Salaam, Rubya and Sokoine hospitals in Kagera and Lindi regions, respectively.

Others health centres where repairs are being done are Muhimbili, Mbozi, Berega, Geita, Kibondo, Nyangao in Mtwara region, Mbesa, Muheza, Kahama, Ifakara, Mbeya referral hospital, Nkinga, Ilembula, Heri and Musoma municipality.

However, Ms Mwambingu said the lack of equipment for the repairs was slowing the programme.

She said some of the instruments needed are operating tables and lamps, and fistula operating sets.

Source: The Citizen – 23 April 2008