Faculty of Health Sciences

The onset of the Coronavirus disease 2019 (COVID-19) pandemic has affected the mental health and well-being of women in vulnerable settings. Currently, there is limited evidence that explores the wellness of elderly women under the associated restrictions. This study explores the lived experiences of elderly women in a vulnerable community in Durban, South Africa. A face-to-face, in-depth qualitative approach was implemented to interview 12 women aged 50 years and over. Thematic analysis was used to analyse the data. The findings suggest that social interactions, the effect of a high death rate, and financial strain predominantly affect stress and anxiety levels. Despite the women being in receipt of pensions and/or other grants, their supplementary income was reduced. This, together with the additional expenses incurred during the lockdown, resulted in anxiety over finances. The lack of social interaction, with limits on visiting family and other loved ones when they were ill, along with the limit on the number of people attending the funerals of loved ones were also stressful. This study also reports on the resulting coping mechanisms, which included using hobbies such as baking and sewing as a means of self-care. Religious beliefs also relieved stress while home remedies were used as preventative measures during the lockdown restrictions due to COVID-19.

Penile cancer is a rare malignancy with prevalence higher in areas of high Human Papilloma Virus (HPV) such as Africa, Asia and South America. In middle- and low income countries where circumcision is not routinely practiced, the rate of penile cancer could be ten times higher. A penectomy refers to a procedure which all or parts of the penis are surgically removed. Total penectomy involves the removal of the entire penis. During this procedure, a new opening is created in the perineum through which urine can pass. In some cases, the testicles, scrotum and lymph nodes may be removed. A partial penectomy involves the removal of part of the penis and typically leaves the shaft intact. Surgical treatment is inevitably mutilating. Despite its therapeutic effectiveness, total penectomy leads to mutilations that affect the ability of patients to void urine while upright. It also affects the patient’s corporal image, genital sensibility, and self-esteem. Purpose: The purpose of the study was to explore the lived experiences of post penectomy patients receiving care in a Public Hospital in KwaZulu-Natal. Methodology This was a qualitative study based on Edmund Husserl’s descriptive phenomenology which is described as the science of the essence of consciousness or inquiry into the consciousness of the patient. Purposeful sampling was used for the study. Data was collected using face-to-face in-depth interviews with patients who had penectomy surgery and were receiving follow-up health care in the selected public hospital. These patients were a year or more post-surgery therefore had sufficient experience to provide rich data. Participants were met and told about the study when they came to the hospital’s outpatient department for their follow up visits, and interviews were conducted where they are most comfortable such as at their homes. Results The data was analysed by means of content analysis and raw data was coded and sorted into sub-categories and categories. Sub-categories were: feeling severe pain, beliefs about causation of illness, feelings of loss of life, sense of self care, coping mechanisms, support system, loss of self-esteem, fear of people knowing about the surgery performed, bodily discomfort from disfigurement, being able to have sexual satisfaction, and use of sexual gadgets. The underlying meaning of categories were formulated into themes which were: thought processes before penectomy surgery, psychological effects of penectomy surgery, difficulty in urination, and sexual function post penectomy surgery. All participants had penile cancer. Pain was the main reason for these participants to make a decision to have the penectomy surgery; participants had severe sores around their penile area and these sores were not healing. Other reasons during their thought processes before making a decision for the penectomy surgery was the penile cancer itself, with participants being worried that if they delay or they do not agree to the surgery the cancer would spread to other organs of the body Conclusion Even though penectomy surgery is a debilitating procedure and inevitably mutilating despite its therapeutic effectiveness, the pain and the illness that the participants were going through led them to take the decision to have the surgery. Outcomes were the relief of pain and healing from penile cancer. No recurrence of cancer was verbalised by the participants after the surgery.

Faculty of Health Sciences

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