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Kenya: How Covid-19 Lockdown Contributed to Fistula as Most Pregnant Women Kept Off Hospitals

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4 years ago

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Kisii — The lifting of the longstanding Covid-19 curfew has come as a relief to pregnant women and new mothers.

The nationwide curfew that had been in place since March 2020 to curb the spread of coronavirus meant that pregnant women in labour had to endure long hours of pain due to restricted night travel, putting them at risk of getting fistula, an injury to the birth canal that causes urine and faeces leakage.

Dr John Omboga of Nairobi Women’s Hospital says there was an increase in the number of women coming in with fistula when curfews and lockdowns were imposed.

He says most poor women had no access to private cars and were unable to reach health facilities in time, especially if labour started at night, while others stayed home longer fearing that prolonged stay in maternity wards would increase their risk of contracting coronavirus.

“Many patients I have attended to showed up late when they have already developed vesicovaginal fistula, recto-vaginal fistula (RUF) or perennial tears fistula complications,” says Dr Omboga.

In the thick of the pandemic, Dr Omboga says he used to see at least two or three patients a day with fistula complications, which he says, is higher compared to situations before pandemic kicked in.

Most of the women that Dr Omboga sees gave birth at home, assisted by untrained midwives, others gave birth with the assistance of family members, while others visited ill-equipped rural clinics.

The women also visited hospitals in with severe cases of fistula after delaying seeking medical attention due to lack of money. The pandemic led to loss of jobs for many households meaning that out-of-pocket medical bill payments were competing with other basic needs such as buying food and other necessities.

Dr Omboga is urging the government to set aside resources to create awareness on how prolonged or obstructed Labour causes fistula, why pregnant women should give birth in hospitals, and seek help immediately they experience an inability to control urine and faeces chronic pain, and infections.

The Kisii County Director of Health Services Sarah Omache urged women with fistula to visit Kisii Teaching and Referral Hospital (KTRH) for treatment.

Omache said the Level 6 hospital has partnered with the Flying Doctors and the Freedom from Fistula Foundation to provide free surgeries to women suffering from fistula.

Speaking at KTRH last week, she asked the public to sensitize the community on the importance of women being screened so that they would be able to discover the problems early since its preventable and curable.

Martha Nyanchama is among the young women who have been living with fistula for more than one year.

Nyanchama says she had a stillbirth and quack doctors attending to her “used wires to pull out the babym,” a procedure that caused complications.

“I have been struggling with this condition for almost one year now but I got surgery which I hope will restore my dignity. No woman should shy away from the treatment of obstetric fistula,” said the 27-year-old, “When I was in so much pain, my mother came to help me clean my soiled clothes and fetch water for me from the river. But when the other women saw my mother washing my clothes and fetching water, they also started to mock her and called her names.”

Despite the stigma, she says, her husband was by her side. In most rural homes, husbands abandon their wives with fistula. Nyanchama’s husband said men should support women suffering from the condition, instead of ostracizing them.

And despite free treatment of obstetric fistula, many women in Kenya delay seeking treatment.

The condition, health officials say, can largely be avoided by going to a hospital for delivery, the cessation of harmful traditional birthing practices, and timely access to obstetric care.