Khisa Anne M, Nyamongo Isaac K
School of Nursing Sciences, University of Nairobi, Nairobi, Kenya.
Reprod Health Matters. 2012 Dec;20(40):59-66. doi: 10.1016/S0968-8080(12)40661-9.
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.
产科瘘是一种妊娠并发症，影响经历长时间梗阻性分娩后的女性。尽管产科瘘的外科治疗已取得成果，但手术修复后女性长期的情感、心理、社会和经济经历却较少受到关注。本文记录了接受矫正手术后女性所面临的挑战，并在更广泛的女性健康背景下探讨了她们的需求。2010年，我们在肯尼亚西波科特对一小部分女性进行了为期两个月的访谈，包括对八名瘘管幸存者的深入访谈以及两次焦点小组讨论，其中一次是与瘘管幸存者进行的，另一次是与社区成员进行的。这些女性报告称，矫正手术后仍存在持续问题，包括分居和离婚、不孕、耻辱感、孤立、羞耻、自我价值感降低、心理创伤、他人的误解以及失业。关注女性需求的项目应满足她们的社会、经济和心理需求，并将其丈夫、家庭和整个社区纳入关键行动者范围。尽管如此，薄弱的卫生系统、糟糕的基础设施、缺乏重点、资源稀缺以及对女性生殖健康的政治关注度不够，目前无法为这个已然弱势的群体提供足够的支持。
