Risk and Resilience: Obstetric Fistula in Tanzania - EngenderHealth

TBAs referred the women to a health care facility,
but this was often after several hours of labor.
Opinion of Care
The nurse at a
facility told me, “If
you don’t pay
TSh 15,000 (US $15),
you will never get a
blood transfusion.
If you have to die,
better die”.
(Patient at Bugando, age 24)
The women with fistula had varying opinions
regarding the care they received during labor and
delivery. These depended largely on the type of
facility at which they delivered. Nearly all of the
women with fistula were satisfied with the care
they received at their final place of delivery. Some
of the reasons were because the providers saved
the woman’s life and/or the baby’s life, or because
they were able to identify the problem the woman
was experiencing. Another woman reported that
the nurses’ aides and nurses took good care of her
during the weeks she was in the hospital, checking
on her on a regular basis. Another woman from
Singida indicated that she was comfortable with
the services from the doctors who administered
the surgery to her, as they managed to save her life
and the life of her baby. One woman told
interviewers about a positive experience at a
peripheral facility: “Health services at the health
center are good. They even discovered I had a
problem and told me to go a bigger hospital.”
(Woman from Songea, age 18)
you don’t pay TSh 15,000 (US$15), you will never
get a blood transfusion. If you have to die, better
die.” (Patient at Bugando, age 24) Another woman
shared that “the nurses were there and provided
the needed care. Some of the attendants spoke
kindly, but some used abusive language.” (Patient
at Bugando, age 28)
“The nurses were there and provided the needed
care. Some of the attendants spoke kindly, but
some used abusive language.” (Patient at
Bugando, age 28)
One woman reported that inadequate care and the
high charges at the private hospitals contributed to
the loss of her baby. She explained bitterly that she
called the nurses during labor, but they did not care.
When she called the nurses, they would say, “You
keep calling. Do you call us so that we can carry you
on our backs Don’t disturb us, and you go.”
(Patient at Bugando, age 24) A woman said that
she did not get good service because a wound
developed after a few days. She explained that “the
nurses showed arrogance to my mother, claiming
that she was not cleaning the wound properly, and
that this was the reason which caused the wound to
smell badly and develop into pus early.” (Woman
from Songea, age 18)
Fewer than half of the women were not satisfied
with the care they received for various reasons.
Some women were dissatisfied because they were
not treated well. One woman who went to a
hospital during her pregnancy was told she would
need a blood transfusion. The nurse told her “If
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