Let's discuss Fistula Disease and its effect on international and behavioral health.
Can you imagine living with a disease where your only option is having a surgical procedure? Can you imagine living in a country with limited resources to obtain appropriate treatment? Obstetric fistula disease affects 50,000 to 100,000 women worldwide and an estimated 200,000 people in the United States.
What is Fistula Disease?
A fistula improperly joins two biological parts, like a blood vessel or organ, with another structure known as a fistula. This abnormal connection can lead to various complications depending on the location and the organs involved.
The most common cause of fistulas is trauma, which can occur due to injuries that disrupt normal tissue. Surgical procedures can inadvertently create fistulas when unexpected healing leads to unintended connections between tissues.
Chronic inflammation and infections can also contribute to the development of fistulas, as persistent irritation and immune responses can cause tissue breakdown and the formation of abnormal passages.
Fistulas can present significant challenges to affected individuals, causing discomfort, infection, and other complications that require medical intervention to manage effectively. They may also develop because of an infection or inflammation.
This disease can also result from complicated labor, which creates a hole in the birth canal. Fistula disease is the leading cause of infant mortality. There are many adversities faced when it comes to this disease, such as incontinence, humiliation, societal discrimination, and health challenges.[2]
Types of Fistula Disease?
- Anal Fistula
- Vesicovaginal
- Rectovaginal
- Enterocutaneous
The most common of the four types is anal fistula, which can affect 1 in 500 people; it is when the skin around the anus and the anal canal develop an irregular connection that looks like a tunnel, causing an infection, wound, or inflammation in the rectal region, which is the cause of this tunnel.
- A vesicovaginal fistula is the gap that develops between the vagina and the bladder, which causes urine to leak from the bladder into the vagina, causing discomfort and urinary tract infections.
- A rectovaginal fistula is a medical disorder in which a gap appears between the vagina and the rectum resulting in leakage of feces into the vagina from the rectum, causing irritation and other problems.
- An enterocutaneous fistula forms between the skin and the intestine on the abdominal wall. This fistula leaks out the body's gut contents, such as food, digestive juices, and feces.[1]
Fistula Health Disparities in Other Countries?
In Asia and Africa, statistics show that 2 million women are living with this disease without treatment. In countries that have modern-day technology and resources available to treat fistula disease, a cesarean is typically done. Unfortunately, these procedures and emergency obstetric facilities are not always available in countries with limited resources.
If left untreated, more abscesses can form, which can cause continued infections. Systemic infections resulting from an untreated fistula can spread to other parts of the body, causing Sepsis immediately requiring medical attention. Many different problems can occur, such as fecal leakage, annual strictures, and consistent pain around the anus.[3]
In South Asia and sub-Saharan Africa, where pregnant women lack adequate access to high-quality emergency obstetric treatment, obstetric fistulas continue to be a problem. It can be challenging to determine the prevalence of fistulas; 6,000 cases occur every year, and one million women can be affected.
The continuing increase in obstetric fistula forces us to consider how cultural and medical organizations fail to safeguard women and girls, serving as a constant reminder of global health disparities. People with fistulas face significant physical and social difficulties. They often experience the embarrassment of having a urine smell, and they lack the resources needed to regulate their incontinence.
Many people have multiple physical and medical conditions that interfere with their daily lives. Affected women avoid social events and fistula public meetings due to the agony and stigma around them.[4]
