Restoring dignity: Social reintegration after obstetric fistula repair in Ukerewe, Tanzania

Abstract

This study explores barriers and facilitating factors women experience re-integrating into society after treatment of an obstetric fistula in rural Tanzania. A total of 71 women were interviewed in the Mwanza region of Tanzania, including a community control group. The majority of the women who received successful surgical repairs reported that, over time, they were able to resume many of the social and economic activities they engaged in prior to the development of a fistula. Familial support facilitated both accessing repair and recovery. For 60% of the women recovering from an obstetric fistula, work was the most important factor in helping them feel ‘normal again’. However, physical limitations and other residual problems often hampered their ability to continue working. All of the treated women expressed interest in follow-up discussions with health care providers regarding their health and concerns about future pregnancies. Special attention is needed for women who are not completely healed and/or for those who experience other related medical or emotional problems after repair, especially if they lack a social network.

Keywords:

• obstetric fistula
• vesico-vaginal fistula
• Tanzania
• social reintegration
• perceived quality of life (PQoL)

Acknowledgements

The authors would like to thank the following individuals for their assistance: Ms Hellen Willy, Dr Janet McGrath, Dr Shan Mohammed, Ms Michelle Nebergall, Ms Virgina Morrison, and Dr Scott Frank. We are also grateful for the support of the Eva L. Pancoast Memorial Scholarship from Case Western Reserve University. Thank you also to Dr. Donald Patrick and the Seattle Quality of Life Group, Katherine Daneski et al., and Elizabeth Tracy for granting us permission to use modified versions of their research tools.