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By Precious Moyo

Bulawayo is set to have its first public obstetric fistula clinic   established at UBH to serve the southern parts of the country by year end, thanks to funding from the United Nations Development Fund (UNDP). 

“The clinic will cater for women suffering from urinary incontinence a condition common among women and usually caused by pelvic surgery, pregnancy, childbirth and menopause,” said United Bulawayo Hospitals (UBH) operations director Mr Richard Sithole.

Many women in Zimbabwe are haunted by urinary incontinence, which is referred to as involuntary urination due to uncontrolled leakage of urine. 

 According to health experts, it can be due to neurologic injury, birth defects, stroke, multiple sclerosis, and physical problems associated with aging.

Nomalanga Ncube, in a ternate dress, sits uncomfortably  as she narrates how urinary incontinence affects her life.

“To me it had become a normal inconvenience because l knew that after few minutes l would feel pressed and find myself messing my panties. My husband always complain about this when we are having sex because l would wet the bed,” she said shyly.

Ncube had accepted it as normal that her urine leaks whenever she laughed, coughed or when she was just seated.

“During my second pregnancy l went to United Bulawayo Hospital (UBH) for a check up and the doctor told me that l was suffering from urinary incontinence,” she said.

She is not the only one with this case, Jenniffer Moyo said urinary incontinence caused her to quarantine herself form public gatherings in fear of suddenly messing up.

“There are times l would tell people that l am not feeling well as l feared to attend meetings. Even church leaders did not understand me and l felt so bad,” she said.

Incontinence occurs because of problems with muscles and nerves that help to hold or release urine. The body stores urine-water and wastes removed by the kidneys — in the bladder, a balloon-like organ. The bladder connects to the urethra, the tube through which urine leaves the body.

 According to experts, women experience urinary incontinence twice as often as men. Pregnancy and childbirth, menopause, and the structure of the female urinary tract account for this difference.

 Control over the urinary sphincter is either lost or weakened.

Urinary incontinence is a common problem that affects many people.According to the American Urological Association, urinary incontinence is more common among women than men.

The association says  an estimated 30 percent of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men.

However, in Zimbabwe there is only one public obstetric fistula clinic found in Chinhoyi in Mashonaland West Province which caters for women with urinary incontinence because it is treated as a normal condition.

Mr Sithole said the health sector acknowledges that there is a loophole in service delivery for women reiterating that the only obstetric fistula clinic is found in Chinhoyi.

“At least the northern region has one clinic but for the southern region we do not have one, that’s why we are putting efforts to have one this side,” he said.

Sithole said UBH received US$86 000 from the UNDP to construct the clinic and the infrastructure is almost complete.

The clinic will have two theatres, one for operations and the other for other maternal services, he added.

“This surgery is critical for women because it’s a condition that many women suffer from but they have nowhere to be treated. Private hospitals that offer such health services are expensive for an ordinary patient so this has come as a rescue for members of the public,” he said.

Mr Sithole said the hospital needs drugs and equipment for the clinic. “Our doctors are already equipped and are waiting for a large space to work on. For now they are attending to a few critical cases,” he said.

“The majority of women with this condition do not know that it is something that can be treated. When they come for some other treatment like pregnancy check, through comprehensive screening, medical practitioners discover that the women have such conditions and they are referred for treatment.”

Mr Sithole said psychologically the detrimental effects of incontinence can be reduction in self-esteem, depression, social withdrawal and sexual dysfunction.

“Urinary incontinence is not generally a great threat to life, it is more often an everyday annoyance and because of this can lead to emotional distress. However if incontinence is left untreated, complications can occur including, candida infection (commonly referred to as thrush), skin infections and blood poisoning,” he said.

A gender activist, Ms Fiona Nyoni said the opening of the clinic will come as a relief to women.

“Urinary continence is an embarrassing condition if l might say. You lose your self esteem and respect because of these leakages. However this is a condition different from cancer whereby the family can rush to raise funds to treat you. Instead they won’t understand that you have a health problem. Therefore it is a good thing for us to have one in the Southern region and at a public hospital where people can access treatment at a reasonable charge,” she said.

A nurse who preferred anonymity said from her experiences with females with urinary incontinence, spouses do not take the condition seriously.

“Untreated urinary incontinence can lead to skin diseases like rashes, skin infections and sores can develop from constantly wet skin. It also causes urinary tract infections and this increases your risk of repeated urinary tract infections. However spouses do not take this seriously such that they rarely give you money to consult a private doctor. It is a good thing to have one at a public hospital,” said the nurse.