Vaginal fistula is a severe medical condition in which a fistula (hole) develops between either between the rectum and the vagina or between the bladder and the vagina after a severe or failed childbirth when adequate medical care is not available.
Vaginal fistula occurs when a girl or woman has an obstructed childbirth labour and does not get a Caesarean Section when she needs it. The obstruction may occur because the mother’s pelvis is too small, the baby is badly positioned or its head is too big.
The prolonged obstructed labour threatens the life of both the baby and the mother. During this prolonged labour, the soft tissues of the pelvis are compressed between the baby’s head and the mother’s pelvis bones. The lack of blood flow causes the tissue to die creating a fistula or hole between the mother’s vagina and rectum or between the mother’s vagina and bladder or both resulting in leakage.
If the fistula (hole) is between the vagina and the bladder, the woman gets urine leakage and if it is between the vagina and the rectum, the woman gets feces leakage.
Early marriages and early childbirth, domestic violence, sexual abuse, rape , female genital mutilation (FGM), malnutrition which is linked to under-development of the female body are all risk factors which may lead to vaginal fistula. Uganda has one of the highest rate of vaginal fistula in the world partly because of the very high rate of teenage pregnancy.
Most women living with vaginal fistula suffer from depression, abandonment by their partners, families and communities and live in isolation because of the constant leaking of urine and feces and the resulting smell.
Vaginal fistula can be treated through reconstructive surgery. Unfortunately, many hospitals in Uganda suffer from shortage of staff and medical equipment necessary to perform reconstructive vaginal fistula repair.
