TOP
  • Home
  • Health
  • Surgical camps helping reduce fistula cases in West Nile

Surgical camps helping reduce fistula cases in West Nile

By Agnes Kyotalengerire

Added 5th July 2017 10:21 AM

Moriku, a mother of four and a resident of Maaji Camp in Adjumani district, developed fistula three months ago during childbirth.

Fistulasurgicalcamps1 703x422

Dr. Emmanuel Odar (in yellow clinical coat) carrying out surgery during the recent surgical camp at Adjumani hospital. Photos by Agnes Kyotalengerire

Moriku, a mother of four and a resident of Maaji Camp in Adjumani district, developed fistula three months ago during childbirth.

HEALTH

Not even the inconvenience of a catheter fixed to her bladder bothers her.  She sits in bed breastfeeding her three-month-old daughter. When the doctor moves to her bed, she smiles, saying she is feeling much better. 

“I was confined to the house and feared to move out. I will now be able to work and look for school fees for my children,” narrates an overjoyed Grace Moriku, a 30- year-old refugee, before her mother quickly cuts in. “I cannot believe that my daughter has overcome the shame of leaking urine!” says Layet Cizaria, 75.

 gnes okomiku  enrolled nurse attending to race oriku 30 who also got fistula repair during the surgical camp Agnes Mokomiku , enrolled nurse attending to Grace Moriku, 30, who also got fistula repair during the surgical camp

 
Moriku, a mother of four and a resident of Maaji Camp in Adjumani district, developed fistula three months ago during childbirth.

She delivered by caesarean section and a catheter was fixed to help empty the bladder since she was confined to bed.

Upon removing the catheter two weeks later, she realised she was continuously leaking urine. When she returned to hospital two weeks ago, the doctor admitted her, put her on medication and advised her to wait and get treatment during the surgical camp.

 gnes okomiku  enrolled nurse attending to aida ungenia 35 who also got fistula repair during the surgical camp Agnes Mokomiku , enrolled nurse attending to Faida Eungenia, 35, who also got fistula repair during the surgical camp

 
Moriku is one among the several fistula victims who had surgery during a fistula surgical camp at Adjumani hospital in West Nile region last week.

The four-day fistula surgical camp organized by Ministry of Health in partnership with Amref-Health Africa offered free surgical services.

Michael Ojja, Adjumani hospital administrator said they organised a fistula surgical camp because they do not have a fistula surgeon yet they receive some cases of fistula patients from both the community and the refugee camps.

Aside, Ojja said the surgical camp was aimed at training health workers at the hospital. He said the camp also benefited the residents because they cannot afford to pay for fistula surgery services so they have to wait for free treatment.

One fistula repair costs between US$400 (about sh1.4 million) and the procedure lasts between 1-5 hours depending on the complexity of the case, explains Dr. Peter Mukasa a fistula specialist working with UNFPA.

Dr. Emmanuel Odar, fistula surgeon and senior consultant gynaecologist at Arua referral hospital who also conducted the surgeries said out of 100 people he screened, he was able to repair five fistulas which indicates that the number of women with fistula in West Nile region is reducing. 

 r mmanuel dar talking to race oriku during a ward round Dr. Emmanuel Odar talking to Grace Moriku during a ward round.

 
This is confirmed in the UDHS 2011 report on the situation of fistula in Uganda, with fistula prevalence in West Nile region standing at 2.0% as opposed to western region at 4.0%

Odar attributed the low fistula numbers in the region to the continuous fistula surgical camps which have helped to reduce the back log of cases.

He also says the routine fistula surgery done at Arua referral hospital supported by UNFPA and Amref-Health Africa where women are operated upon as they present has also helped the fistula cases to drop.

The surgical camp meant to offer only fistula surgery attracted women with other gynaecological problems like fibroids, uterine prolapse, cervical cancer and ovarian masses. Over 40 women in the reproductive age were diagnosed with pelvic inflammatory infections (PIDs).

Dr.Odar attributed the pelvic infections to a lot of sexually transmitted infection cases in the community that go untreated.

“Such untreated infections become chronic and block the fallopian tubes which are major cause infertility,” he warns.

Facts about vesicovaginal fistula

Vesicovaginal fistula is a tear that occurs during childbirth between the vagina and the bladder causing the urine to continuously leak, says Dr. Odar.

 r manuel dar operating a patient during the surgical camp Dr. Emanuel Odar operating a patient during the surgical camp

 
He further explains that when a woman gets obstructed (prolonged) labour, the tissue in between the birth canal and the urinary tract undergoes decay within 5-7 days creating a hole which results into urinary fistula, although there are also cases of faecal fistula especially if the pressure is backwards.

Odar says unfortunately most cases of fistula due to obstructed labour result into babies dying.

“When you see a mother with fistula carrying a baby, then the fistula was due to surgery especially if the surgeon was junior and accidentally stitched the bladder together with the uterus.

Prevalence

Globally, UNFPA reports that there are approximately 3.5 million cases of fistula with up to 100, 000 new cases annually with majority being in Sub-Saharan Africa and Asia.

In Uganda, UNFPA reports that 1,900 new cases of fistula are still occurring every year. The health ministry estimates that only 2,000 repairs are done every year because of limited number of fistula surgeons with only 24 across the country coupled with inadequate funding to support the repairs across the country. 

More From The Author

Related articles