by Claire Scott
Week two in Zambia has been a busy one! This week I was kindly hosted by the Plan Zambia team based in Kabwe, Central Province. Together we have started inquiries to identify potential interviewees for my study (being incontinence sufferers, or those that care for incontinence sufferers), and although I didn’t think that this would be an easy task, it is proving to be more complicated than I could imagine!
We have already found that the term incontinence is not widely understood, and although the condition is recognised once the symptoms are explained awareness is usually limited to an association with obstetric fistulas. Incontinence as an issue for men is unknown. There is also a lack of reported cases of incontinence, which is surprising given that the literature suggests around a third of parous (have given birth) women will suffer from the condition at some point. This may be due to misdiagnosis or perhaps a reluctance to disclose, albeit this is at odds with a culture that claims to not shy away from discussing even the most private and rare health issues. Or perhaps incontinence is just not an issue for those that have it … my efforts to unravel the mystery of a lack of incontinence in Zambia are ongoing and I will keep you updated!
I was also fortunate to attend the official launch of Chamuka Chiefdom By-Laws on ending child marriage, teenage pregnancies, child defilement and child labour in Chisamba district, Central Province. Plan Zambia advocates to influence traditional leaders to make changes to traditional practices that perpetrate the violation of children’s rights, and Chief Chamuka has emerged as a champion and strong supporter of child protection activities. The positive consequences of the By-Laws will be far reaching, and may include reducing the incidence rate of fistulas (and subsequent incontinence) by increasing the age of first exposure to the risk of pregnancy.
The event was attended by Zambian First Lady Esther Lungu and Ghanaian First Lady Rebecca Akufo Addo, five traditional leaders from neighbouring districts, and representatives from the United Nations and European Union. It was a great opportunity to see the impressive results that Plan Zambia is achieving, and to also watch some traditional Zambian entertainment!
 A fistula is an abnormal opening between the bladder and vagina, and/or between the rectum and vagina. It is usually the result of an obstructed (prolonged) delivery, which is more likely to occur in young girls due to pelvic immaturity.
 Walker, G.J.A. and Gunasekera, P. (2011) ‘Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors’, International Urogynecological Journal, 22, pp. 127-135.