Fistula isn’t just a women’s affair

Monday June 11 2018

Dr Syriacus Buguzi.

Dr Syriacus Buguzi. 

By Dr Syriacus Buguzi

Recently,World Fistula Day was marked with awareness campaigns and, as it has always been the case, the women, girls and women’s organisations were raising voices high for those affected.

When the day passed, I began reflecting on what had transpired during the campaigns and it dawned on me that fistula, here in Tanzania, has “almost become a women’s affair.” Well, a man too, could get a fistula somewhere in his body.

This has reminded me of a scenario, years ago, when a man sustained a gunshot wound on his stomach, which caused him to develop a fistula. This wasn’t in Tanzania, though.

You see, a fistula, as per English dictionary, is an abnormal or surgically made passage between a hollow or tubular organ and the body surface, or between two hollow or tubular organs.

In women, there have been many cases of fistula, associated with birth complications. That’s why campaigns seem to target women with obstetric fistula—a medical condition in which a hole develops in the birth canal as a result of childbirth.

The fistula, in women, could occur between the vagina and rectum, ureter, or urinary bladder. When this happens, a woman passes out urine or faeces without control. This has caused depression, infertility and social isolation among many women in Tanzania.

Case of a man

The man, I talked about, sustained a gunshot wound that created a window into his stomach. This later enabled scientists to understand digestion. His case also transformed how physiologists studied the body.

History has it that before that, doctors typically decided what was wrong with a patient or how a bodily function worked — often based on 1,600-year old medical ideas.

The wound was gruesome. And, the man, named St. Martin wasn’t expected to live beyond a night. In one of the LiveSceince pieces, one scientist, Rogers, is quoted as saying, “He had lung hanging out of his wound.”

But, what really happened is that St. Martin became fed up with surgery and was left with a fistula.

It was a hole in his stomach through the abdominal wall, which left it open to view. This means that strong stomach acid essentially disinfected the wound from the inside out, making it safe to not sew it up. So, handyman was hired to clean the wound daily.

I recalled this story as a way of letting you known how certain fistulas could occur—in extraordinary circumstances, yet, here in Tanzania, there are many men who have suffered problems in their urinary system that have led to fistulas.

It may occur as a communication between the rectum and prostate or urethra usually after radiation treatment or surgery for prostate cancer but there is usually a way of dealing with it.

Some may have had this problem because of trauma or accidents. But, do they seek care? That’s why I normally end my column by saying: Seek informed health choices to stay safe.