“I am alone and isolated”: a qualitative study of experiences of women living with genital fistula in Uganda

BMC Women's Health

Research Article

Jolly Beyeza-Kashesya¹  Josaphat K. Byamugisha¹  Justus Kafunjo Barageine²  Lars Almroth³  Elisabeth Faxelid³  Nazarius Mbona Tumwesigye⁴ 

[1] Department of Obstetrics and Gynaecology, School of Medicine, Makerere University, College of Health Sciences/Mulago National Referral Hospital, Kampala, Uganda;Department of Obstetrics and Gynaecology, School of Medicine, Makerere University, College of Health Sciences/Mulago National Referral Hospital, Kampala, Uganda;Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden;Department of Public Health Sciences, Global Health (IHCAR), Karolinska Institutet, Stockholm, Sweden;Department of epidemiology and biostatistics, School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda;

关键词: Focus Group Discussion;    Sexual Life;    Coping Response;    Obstetric Fistula;    Challenging Life;   

DOI  :  10.1186/s12905-015-0232-z

 received in 2015-01-28, accepted in 2015-09-03,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundGlobally, 2–3 million women are estimated to have a genital fistula, with an annual incidence of 50,000–100,000 women. Affected women remain silent within their communities, and their experiences often go unnoticed. Our objective was to explore the experiences of Ugandan women living with genital fistulas to understand how their lives were affected and how they coped with the condition.MethodsWe conducted 8 focus group discussions (FGDs) with 56 purposively selected women with a genital fistula seeking treatment at Mulago Hospital, Uganda. Data were transcribed and analysed using qualitative content analysis.ResultsWomen with a fistula were living a physically changed and challenging life, living socially deprived and isolated, living psychologically stigmatised and depressed, and living marital and sexual lives that were no longer joyful. The women’s experiences were full of life changes and coping strategies, and they used both problem- and emotion-focused coping strategies to deal with the challenges. They devised ways to reduce the smell of urine to reduce the stigma, rejection and isolation. While trying to cope, the women found themselves alone and isolated. Women either isolated themselves or were isolated by society, including by close relatives and their husbands. Their sex lives were no longer enjoyable, and generally, women felt a loss of their marital and sexual rights.ConclusionWomen with a fistula make adjustments in their lives to cope with the physical, social, psychological and sexual challenges. They use both problem- and emotion-focused coping to minimise their sense of isolation, as well as the rejection and stigma associated with fistula. These findings are essential for counselling patients, families and community members affected by a fistula. In similar contexts, health programmes should go beyond fistula closure and target communities and families to reduce the stigma and isolation faced by women with genital fistula.

【 授权许可】

CC BY   
© Barageine et al. 2015