Vesico-vaginal Fistula (VVF)
The obstetric vesico-vaginal fistula (VVF) is as
old as mankind, yet is now almost unheard of in western
industrialised countries.
It consists of a communication between the
bladder and the vagina, causing a perpetual leak of urine. It is
a result of poor obstetric care during labour and childbirth. If
the baby is too big for the mother to deliver normally, the baby’s
head presses against the pelvic bones and eventually cuts off
the blood supply to the bladder and a hole develops. Usually the
baby dies and often the mother too.
If the mother is lucky enough to survive, she is
totally incontinent, dribbling urine down her legs and soaking
her clothes. This often leads to rejection by husband, family
and community.
Repair of the fistula does not require
sophisticated surgery, but when successful, it can revolutionise
a woman’s life. From being an outcast, she is now once more an
accepted member of society.
Because of improvements in diet, later age at
first pregnancy, better communication and transport, and
availability of medical care, obstetric fistulae are very rare
outside developing countries. Nevertheless, although accurate
numbers can only be guessed, it is estimated there are a minimum
of a million patients with VVF waiting for surgery worldwide.
Further information:
Maternal problems in Kambia District
Childbirth in Kambia
Traditional birth
attendants
Training of Maternal and Child Health Aides
Visit to Kambia by midwives from Cheltenham
http://news.bbc.co.uk/2/hi/africa/3817009.stm
http://www.unicef.org/pon96/womfail.htm
http://www.huntermissions.com/VVFLinks.html
http://news.bbc.co.uk/1/hi/world/africa/3817009.stm
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Ladies whom Richard Kerr-Wilson
operated on in November 2004.
Julia Fortes (medical student) also worked with
these ladies when doing her VVF research in
May 2004.
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Here, they are singing and clapping a song of
thanks just a day or so after their operation |
Further information:
Childbirth in Kambia
Traditional birth
attendants |
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