Taufique Imran :
Among all the morbid condition that can affect a woman in times of labor, having an obstetric fistula is considered the most debilitating and devastating. Because it not only involves physical consequences but also comes with non-physical consequences as well which include psychosocial, economic and reproductive health challenges of an obstetric fistula patient.
Fistula affects both a patient physical and social life coherently. Thus it considers a “social calamity” by many where women with obstetric fistula are often ostracized by their husbands, families and communities. The most common and the greatest fear among these women affected by obstetric fistula is relationship changes after developing an obstetric fistula. The majority of these women’s marital histories included polygamous relationship and most of these women become second wife after their fistula developed. Thus, creating challenges in intercourse, specifically urine or faecal leakage, often stressed their relationships. And for those whose marriage still remained, women often doubted their relationship would continue to survive the challenges of having fistula.
These are mostly the challenges faced by patients prior to fistula repair. But as we think of now after the fistula repair there will be a happy ending to these miserable stories but little do we know the concerns and struggles only increases throughout time.
Women shared their concerns and struggles since having a fistula repair, though many of these are different from the past. However, the relationship challenges to an extent still persists to many women.
Most of these women remain single because it is difficult to find a supportive husband to marry, which is very important given their previous relationship experience. In some cases, not having a husband becomes one of the greatest concerns after surgical repair. And to some others the most concerning is the financial challenge that continues after fistula repair. These challenges affect their ability to return to their respective Fistula Care Centre for follow up appointments and surgeries.
From a recent survey of Duke University on emotional and psychological consequences of obstetric fistula, it came to known that the numbers of risk factors and concerns like these may increase the likelihood of developing psychological disorders as depression and Post Traumatic Stress Disorder or PTSD in those affected patients. “And in terms of Bangladesh, fistula patients have a higher rate of mental health dysfunction” said by Sarah M. Wilson in her report on the Psychological Sequelae of Obstetric Fistula which indicates the growth of severe depression and endorsing suicidal ideation in women affected by obstetric fistula. These few studies indicate the empirical evidence for psychiatric comorbidity in women with obstetric fistula.
To prevent this situation definitive steps must be taken and might include some following strategies:
Community awareness can play a very important role on eliminating such morbidity where the community should be aware of mental health issues created by obstetric fistula throughout sketch and comedies in community rallies, radio ads and flyers.
Community reintegration can also be a viable step to end this misery. Throughout community reintegration we can offer them fistula survivors to re-enter the society by skill training (tailoring, nursing etc.) and also by offering financial loans to support groups.
So it is time we ensure the end of this misery by implementing such initiatives because
(“Mothers give the gift of life; it’s time to return the favor” (UNFPA))
Among all the morbid condition that can affect a woman in times of labor, having an obstetric fistula is considered the most debilitating and devastating. Because it not only involves physical consequences but also comes with non-physical consequences as well which include psychosocial, economic and reproductive health challenges of an obstetric fistula patient.
Fistula affects both a patient physical and social life coherently. Thus it considers a “social calamity” by many where women with obstetric fistula are often ostracized by their husbands, families and communities. The most common and the greatest fear among these women affected by obstetric fistula is relationship changes after developing an obstetric fistula. The majority of these women’s marital histories included polygamous relationship and most of these women become second wife after their fistula developed. Thus, creating challenges in intercourse, specifically urine or faecal leakage, often stressed their relationships. And for those whose marriage still remained, women often doubted their relationship would continue to survive the challenges of having fistula.
These are mostly the challenges faced by patients prior to fistula repair. But as we think of now after the fistula repair there will be a happy ending to these miserable stories but little do we know the concerns and struggles only increases throughout time.
Women shared their concerns and struggles since having a fistula repair, though many of these are different from the past. However, the relationship challenges to an extent still persists to many women.
Most of these women remain single because it is difficult to find a supportive husband to marry, which is very important given their previous relationship experience. In some cases, not having a husband becomes one of the greatest concerns after surgical repair. And to some others the most concerning is the financial challenge that continues after fistula repair. These challenges affect their ability to return to their respective Fistula Care Centre for follow up appointments and surgeries.
From a recent survey of Duke University on emotional and psychological consequences of obstetric fistula, it came to known that the numbers of risk factors and concerns like these may increase the likelihood of developing psychological disorders as depression and Post Traumatic Stress Disorder or PTSD in those affected patients. “And in terms of Bangladesh, fistula patients have a higher rate of mental health dysfunction” said by Sarah M. Wilson in her report on the Psychological Sequelae of Obstetric Fistula which indicates the growth of severe depression and endorsing suicidal ideation in women affected by obstetric fistula. These few studies indicate the empirical evidence for psychiatric comorbidity in women with obstetric fistula.
To prevent this situation definitive steps must be taken and might include some following strategies:
Community awareness can play a very important role on eliminating such morbidity where the community should be aware of mental health issues created by obstetric fistula throughout sketch and comedies in community rallies, radio ads and flyers.
Community reintegration can also be a viable step to end this misery. Throughout community reintegration we can offer them fistula survivors to re-enter the society by skill training (tailoring, nursing etc.) and also by offering financial loans to support groups.
So it is time we ensure the end of this misery by implementing such initiatives because
(“Mothers give the gift of life; it’s time to return the favor” (UNFPA))
