UGANDA: Dealing with the challenge of fistula and isolation it brings

December 10th 2008

Annet Kusiima’s condition has made her timid but persistent in finding ways to deal with fistula. Kusiima has hope that she will be fine but right now the problem is almost unbearable, writes Rachel Kabejja.

Not many people can stand the stench of urine. Perhaps mothers can because of the unconditional love for their children or the doctors while executing their jobs but for a lay person, the smell is unbearable. People with such cases tend to lose friends and generally, society perceives them in a negative way.

While visiting Mulago Hospital VVF ward (for fistula patients) and meeting many women suffering from fistula, I couldn’t easily decide whose story to take on and whose to leave because of their willingness to talk.

It was hard as I sat, listened and imagined myself in such a situation; the fact that I wouldn’t be able to work, meet up with friends or serve at my church because of the continuous flow of urine, the whole thought was frightening.

Annet Kusiima, 20, the second born of seven children says she got pregnant while in senior four and when the labour pains started in early March last year, they called in a village mid wife to help her deliver, in vain. Following that, she was transferred to Mubende Hospital the following morning but the baby had already died.

Kusiima says after the incident, two days passed minus passing urine and all of a sudden, the third day saw her begin the journey of unending flow of urine from her bladder. She can’t clearly explain what happened; all she remembers was feeling the urine passing out uncontrollably and when she lay down, it would flow up to her head. “The doctors at Mubende Hospital then gave me three months before I could be transferred to Mulago Hospital and they discharged me. I stopped drinking and begun skipping meals in an attempt to stop the flow of urine but in vain. Even when I didn’t drink anything, the urine would continue coming. My mother always encouraged me to eat and drink but it was hard,” Kusiima says.

While at home, Kusiima recounts hearing an announcement on radio inviting people with similar cases for treatment at Kiboga Hospital but when she got there, the doctor was winding up her course and told to her go back after another three months.

When Kusiima returned, the doctor told her that the situation was in its advanced stages and could only be handled at Mulago Hospital and on October 30, she was operated upon.

Fistula has not only left Kusiima with a wound on the bladder but also made her lame and given her another problem of blood flow which she says comes in bits. “I thought they were my periods in the beginning but now I know they are not,” Kusiima says. She says, “The blood is quite smelly and comes out in bigger clots, sometimes smaller ones leaving me confused. Maybe it comes from the wounds.”

Kusiima adds that the pain begun like that of a burn causing immense discomfort in her whole body while she was still pregnant and when the pain left, a nerve in her ankle disappeared and the doctors said they couldn’t do anything about it.

Maureen Katushabe, 24 married and a mother who has lost four children and has one baby, got fistula when the doctors at Buhinga Hospital tampered with her bladder. “During labour, my bladder got full and when the doctors inserted a tube in me to pass urine, the process failed to work moreover the baby was due and in the process of the operation to save the baby, the bladder was affected. The baby also died in the process,” Katushabe says.

Katushabe couldn’t get immediate help from Buhinga and Mbarara Hospitals because the wound left by the operation hadn’t healed and now she still lives with fistula and is awaiting treatment at Mulago Hospital.

According to the hospital attendants, most cases of fistula occur among rural women who will use local midwives during labour to deliver and when the expectant mothers fail to get help, they will resort to the professional midwives. It’s coming close to a year now since Katushabe got fistula and she is still waiting for a miracle.

Source: Daily Monitor 10 December 2008