title: Still living with fistula: an exploratory study of the experience of women with obstetric fistula following corrective surgery in West Pokot, Kenya.
abstract: Obstetric fistula is a complication of pregnancy that affects women following prolonged obstructed labour. Although there have been achievements in the surgical treatment of obstetric fistula, the long-term emotional, psychological, social and economic experiences of women after surgical repair have received less attention. This paper documents the challenges faced by women following corrective surgery and discusses their needs within the broader context of women's health. We interviewed a small sample of women in West Pokot, Kenya, during a two-month period in 2010, including eight in-depth interviews with fistula survivors and two focus group discussions, one each with fistula survivors and community members. The women reported continuing problems following corrective surgery, including separation and divorce, infertility, stigma, isolation, shame, reduced sense of worth, psychological trauma, misperceptions of others, and unemployment. Programmes focusing on the needs of the women should address their social, economic and psychological needs, and include their husbands, families and the community at large as key actors. Nonetheless, a weak health system, poor infrastructure, lack of focus, few resources and weak political emphasis on women's reproductive health do not currently offer enough support for an already disempowered group.
authors.affiliation: School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Khisa
authors.forename: Isaac K
authors.initials: IK
authors.lastname: Nyamongo
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007630:Kenya; D008393:Marriage; D007744:Obstetric Labor Complications / Q000523:psychology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011247:Pregnancy; D036301:Qualitative Research; D019651:Plastic Surgery Procedures / Q000523:psychology; D012934:Social Isolation; D014548:Urinary Fistula / Q000209:etiology / Q000523:psychology* / Q000601:surgery*; D055815:Young Adult