577 Twent four year old Kgomotso Dingaan show a colostomy bag that she now uses after giving birth at Rahima Moosa Mother and Child Hospital and later developing rectovaginal fistula. 120214. Picture: Bongiwe Mchunu

Johannesburg - A woman whose vagina was badly torn during childbirth and was allegedly not stitched properly, resulting in her having a rectovaginal fistula, has spoken out about her “hospital hell”.

Kgomotso Dingaan, 24, suffered a fourth-degree tear when she gave birth two months ago at the Rahima Moosa Mother and Child Hospital in Coronationville in Joburg.

A rectovaginal fistula is an abnormal connection between rectum and vagina. If the opening between the rectum and vagina is wide it will allow flatulence and faeces to escape into the vagina, leading to faecal incontinence.

Dingaan now wears a colostomy bag and blames her woes on the Department of Health, but spokesman Simon Zwane has, however, denied that medical staff caused Dingaan’s rectovaginal fistula.

Dingaan, a somatology graduate, said she had had a difficult labour.

The child’s heartbeat was faint, so a nurse, she said, climbed on her bed.

“She put her hands on my stomach then pressed very hard and the baby came out,” she said.

Dingaan said it was while she was being stitched that the nurse realised she had been badly torn and called a doctor. She was taken to theatre and stitched there.

However, Dingaan believes she was not stitched properly because a few days later faeces started coming out of her vagina. Scared, she returned to the hospital.

“The doctor said I had a 10cm tear, but only 8cm had been stitched.

“I was at the hospital for 10 days and while there it was so bad I had to wear a nappy.”

Dingaan was taken to the Helen Joseph Hospital where she was fitted with a colostomy bag. That, however, was just the beginning of her hospital hell, she said. Three days after the colostomy bag was fitted, Dingaan found that the wound was septic. She returned to the hospital where a doctor tried to remove the stitches, but the pain was unbearable and Dingaan asked her to stop.

“She gave me antibiotics and told me to return the following week but, when I did, she had forgotten about our appointment, was dismissive and did not do anything.”

Zwane said the department sought an opinion from an obstetric and gynaecology specialist who confirmed that a tear during delivery was a potential delivery risk and not associated with negligence.

He said the need and reasons for the temporary colostomy as a temporary intervention to facilitate wound healing was explained to Dingaan. He also denied that a nurse had climbed on the bed to push the baby out.

Professor Eckhart Buchmann, a specialist at the Department of Obstetrics and Gynaecology at Wits, said a fourth-degree tear is one that goes from the vagina to the rectum and happens in one in 500 births and can be easily repaired in the theatre.

However, a rectovaginal fistula, which he described as “horrible”, was not very common and was normally caused by faulty stitching and suturing, infection or poor tissue.

“We can’t control some of these cases, but if we do better surgical work we will prevent some of them from happening.

“Unfortunately, when it comes to surgery, there are not a lot of skills in the country,” Buchmann said.

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The Star