‘Shun Stigma Towards People With Ostomy’

HEALTH workers and homecare givers should stop stigmatising people living with ostomy through offering psychosocial support.

By Kudakwashe Pembere

Ostomy is a surgery where surgeons create an opening also known as stoma from an area inside the body to the outside to treat digestive or urinary systems.

This came out during a sensitisation meeting on ostomy on Monday hosted by Ileostomy Colostomy Zimbabwe Trust. A Sister in Charge at Parirenyatwa Group of Hospitals in the departments of Oncology and Pallative Care  Roseline Changondolo urged nurses to shun arrogance when managing patients with stoma.

“I would like to say to my fellow health workers that is the nurses and doctors that they should stop stigmatizing patients with stoma,” she said.

Changondolo added that through the trainings they received from ILCO Zim Trust on stoma management, she has since changed her approach when managing clients having difficulties with their urinary and or digestive systems.

Stoma bag

“So I make sure that pre-op, patients have adequate information about their diagnosis and the operation itself with the aid of diagrams, flip charts so that they have an understanding of their diagnosis. I have learnt that I have to include the family in the management of stoma because they will need the support from the family.

“Also I have learnt that stoma citing is an essential procedure. If stoma citing is done very well it means the patients will not develop complications. I have also learnt that colostomy without good citing also have negative effects to the patient because the patient may have complications requiring expensive pouching system or skin irritation,” she said adding they receive about 10 stoma patients every month.

Another stoma nurse said there was need for nurses to adequately prepare the patients mentally before and post operations.

“We had a stoma patient with offensive stool. We would use sodium to counter the foul smell. Also we had to counsel  that patient before the operation and after the operation until he had to accept living with the stoma because initially he was in denial,” she said.

The meeting was attended by international and regional organisations in Sweden, Iceland, and Zambia working with people living with ostomies.

“I think as nurses they should give the message of hope because if it is not there I will get depressed and die,” said Benjamin Lungu from Stoma Care Support Zambia. “I am nota health worker by training but my engagements with health facilities in Zambia most people with ostomy call me doctor benjamin just because of the way I interact with them.”
He added that nurses should improvise through finding alternatives in cases where stoma bags are not available at their institutions.

Europe Ostomy Association Jon Thorkelsson said fighting stigma requires a strong the nurse- doctors-family-patient support system.

It also emerged that interest among nurses to learn about stoma management was low as at some institutions only two out of 30 would express willingness to assist patients requiring stoma care.Hence there was a call for the Health ministry to include in its curricula courses of stoma care.

Challenges faced by patients with stoma include affordability and accessibility of stoma bags which at some private pharmacies fetch USD20 while at government hospitals some still find $20ZWD expensive.

A colostomy creates an opening from the colon to the outside of the body through the abdominal wall. An ileostomy creates an opening from the ileum to the outside of the body through the abdominal wall. The opening created by a colostomy or an ileostomy is called a stoma.

A colostomy or an ileostomy can be temporary or permanent. The doctor may do a temporary colostomy or ileostomy to allow the intestine to rest and heal after surgery. It will be permanent if the anal sphincter and the lower part of the rectum are removed.

A colostomy or an ileostomy may also be called a bowel diversion.

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