This project has been supported by Standard Chartered Bank – Kenya Limited with technical support from KMWA members and the Kenyatta National Hospital.
Obstetric fistula is one of the most serious and disabling complications of child birth which has virtually been eliminated in developed counties but is still prevalent in the developing world. Fistulas occur as a result of the 3 classic delays in getting the appropriate Emergency Obstetric Care (EmOC): delay in deciding to seek medical attention, delay in reaching a health care facility, and delay in receiving Emergency Obstetric Care at the facility.
VVF occurs when the blood supply to the tissues of the vagina and the bladder is restricted during prolonged obstructed labor, the tissues die between these organs, forming holes through which urine can pass uncontrollably. RVF occurs in a similar way to VVF however, holes form between the tissues of the vagina and rectum, leading to uncontrollable leakage of faeces. The main factors that precipitate this are cross-cutting and include:-
- Insufficient access to emergency obstetric care;
- Preference to deliver at home with Traditional Birth attendants (often unskilled attendance). Poor access and referral systems due to long distances are some of the reasons why women deliver at home under unprofessional care. Obstructed labor is a common outcome of home deliveries;
- Poorly managed Caesarean Sections at health centers;
- Malnutrition and possibly repeated infections.
