ENDOMETRIASIS: THE OVERLOOKED ASPECT OF SEXUAL REPRODUCTIVE HEALTH OF REFUGEE GIRLS AND WOMEN
*SRH- Sexual Reproductive Health
Endometriosis is the silent, unknown, and neglected condition that hides in the bodies of many women and girls in Africa. It is the forgotten condition in Africa that is rarely addressed in medical seminars or local research. Despite reports (WHO, 2021) indicating endometriosis affects around 10% (190million) of women and girls globally, it still remains one of the most grossly under-reported and under-researched conditions in Africa.
How comes endometriosis is under-looked among women and girls in Kenya? Endometriosis is a uterine condition where the tissue lining the uterus develops outside its natural area or forms in other places (Mayo Clinic, 2018). When the uterine tissue occurs in areas it’s not supposed to exist, it creates a chronic inflammatory reaction that leads to symptoms such as:
• Extremely Painful periods
• Menstrual disorders like abnormal or heavy periods
• Pelvic Pain (most common symptom)
• Lower back pain
The majority of symptoms are misdiagnosed for they resemble other gynecological complications. This is because inadequate research and information on this condition disable clinicians from discerning the root cause of pain in the patient.
Research (John J. K. Annan, 2019) published on endometriosis shows that lack of information on endometriosis in the general public and medical practitioners is among the leading cause of under-treatment and under-reporting of this condition in Africa. Other obstacles preventing this condition from being properly known include:
• Lack of awareness in the public and medical practitioners
• Inadequate diagnosis & therapeutic facilities
• Underdeveloped endometriosis research programs
• Insufficient training in diagnosis and treatment of endometriosis in hospitals and clinics
• Costly charges of treatments
• Stigmatization of women and girls suffering from this condition by their community
Since endometriosis affects women and girls between 18-40, it means any woman of these ages can develop the condition. However, determining the exact occurrence in this age group has been difficult in recent years due to wanting research and low interest in this topic by African governments or health institutions.
The situation is dire among the refugee female population because of limited access to sexual reproductive health services in the camps (Jane Freedman, 2020). The difficulty arises when refugee women and girls lack the necessary documentation to access medical services, face language barriers; experience xenophobia and racism, discrimination due to their sexual orientation (LBTQ), and or limited treatment facilities; pose great hindrance in creating awareness on endometriosis among adolescent girls and women.
Furthermore, research on asylum-seeking and refugee women's sexual reproductive health is under-done and rarely includes uterine conditions. What is covered under sexual reproductive health (SRH) include maternal and newborn care, family planning, access to contraceptives, reproductive cancers, sexual or intimate partner violence, treatment and prevention of HIV or sexually transmitted infections, and other health needs that fit into these categories (Leah H. Keller, 2019). Unfortunately, matters concerning uterine conditions such as endometriosis are rarely added into SRH discussion due to lack of awareness and insufficient data on the condition.
Nevertheless, the situation is not hopeless. Presently, Kenyan women are courageously coming out and talking about their personal experiences with endometriosis (EMMANUEL WANJALA, LYNDSAY NYAWIRA, 2019). Also, local non-profit organizations focusing on female reproductive health are putting more effort into spreading awareness of this condition to the citizens and refugees. Similarly, non-profits that are not health-based but run SRH programs could consider adding uterine conditions such as endometriosis in their modules to spread the awareness.
With the reducing stigmatization around this condition, endometriosis will no longer remain unknown or a secret among affected refugee women and girls. Instead, by bringing endometriosis to light more work can be done to make treatment available and SRH education covering uterine conditions accessible to women and girls living in refugee camps and urban areas.
EMMANUEL WANJALA, LYNDSAY NYAWIRA. (2019, March 2018). ENDO WARRIORS SPEAK OUT BIG READ: Endometriosis, The monster silently tormenting women. Retrieved from The Star: https://www.the-star.co.ke/news/big-read/2019-03-28-endometriosis-the-monster-silently-tormenting-women/
Jane Freedman, T. L. (2020, May 19).
Sexual and reproductive health of asylum seeking and refugee women in South Africa: understanding the determinants of vulnerability. Sexual and Reproductive Health Matters, 28(1). doi:10.1080/26410397.2020.1758440
John J. K. Annan, R. E.-R.-A. (2019, January). Endometriosis: An “Unexplored”, “Neglected” or “Forgotten” Condition in Africa? Open Journal of Obstetrics and Gynecology, 9(1), 29-41. doi:10.4236/ojog.2019.91004
Leah H. Keller, A. S. (2019, February 28). More to Be Done: Individuals’ Needs for Sexual and Reproductive Health Coverage and Care. Guttmacher Policy Review, 22, 8-15. Retrieved from https://www.guttmacher.org/gpr/2019/02/more-be-done-individuals-needs-sexual-and-reproductive-health-coverage-and-care#
Mayo Clinic. (2018, July 24). Endometriosis. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
WHO. (2021, March 31). Endometriosis. Retrieved from World Health Organization: https://www.who.int/news-room/fact-sheets/detail/endometriosis