Fistula cases set to rise as more teens join motherhood

Luwero, Uganda | THE INDEPENDENT | Gynecologists have warned that cases of obstetric fistula among women are likely to increase as the country experience rampant teenage pregnancies as the COVID-19 pandemic keeps students out of school.

In the Luwero district alone, at least 16,163 teenage pregnancies were reported in the financial year 2020/21.  At least 442 of these cases involved girls below the age of 15, who were exposed to men after the closure of schools after the outbreak of COVID 19.

Luwero District Health Officer Dr Innocent Nkonwa, a gynecologist says that at such a tender age, the pelvic bones are still weak and unable to support normal delivery. Nkonwa explains that such girls need to be attended to by specialists in hospitals but these are poor to look for good delivery services.

Nkonwa adds that apart from teenagers being at risk of contracting fistula as a result of obstructed labour, they also expose newborn babies to injuries during deliveries.

Dr Moses Kayondo, a fistula surgeon and consultant gynecologist at Mbarara Regional Referral Hospital says that they have already detected an increase in cases of women suffering from Obstetric fistula as a result of teenage pregnancies. Kayondo says that although some women can be repaired, others live with the condition for life because the operations are not readily available and sometimes are unaffordable.

The medical condition comes as a result of a hole created between the birth canal and bladder and the rectum, caused by prolonged, obstructed labour. It leaves women leaking urine, faeces or both, and often leads to chronic medical problems, depression, social isolation and deepening poverty.

Teenage mothers found at Luwero hospital declined to be interviewed on the story. But by the time the gynecologists expressed fear over increasing cases, adults who are already battling the fistula disease were crying foul after failing to access treatment.

A 33-year-old woman in Wobulenzi town council said that she contracted the disease a month ago but  she is yet to trace a surgeon to operate her.

Joyce Namigadde, the Luwero District Probation officer said that although they are yet to receive a case of a teenager with fistula, at least a case has been registered where one gave birth to an abnormal child and was referred to the hospital for further management.

Brenda Nabukenya, the Luwero District Woman Member of Parliament asked the government to speed  up the reopening of schools to stop others from getting pregnant. Nabukenya adds that the Ministry of Health should also ensure that health centres are equipped to handle the girls who turn up pregnant and as well as intensify sensitization against the problem.

According to a 2016 study by the Ministry of Health, over 200,000 women are living with fistula and 1,900 new cases occur each year in Uganda.

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