For ages, fibroids tumour have posed a serious impediment to the wellbeing of African women, torturing many to no end and denying many the joy of beholding their fruit of the womb. To make matters worse, a lot of myths, fear and terror have been built around it, giving it a rather gargantuan image. Gboyega Alaka attempts an unraveling of the disease.
Oghenetegha is 45 years old, married, with a 13-year-old lonely daughter. ‘Tegha (as she is called for short) had Onome in the very first year of her marriage with her husband, John, but has not been able to have another child since then. She revealed that she and her husband tried several times for another child without success, with a couple other successes ending in miscarriages. At a point, she sought doctors’ opinion and was soon told that she had fibroids growing inside her. That, she said, in a way explained why her stomach was growing and why she sometimes felt some movement in her stomach.
The doctors advised for prompt surgery to clear out the unwanted occupant, but Tegha would not hear of it. Operation? Go under the knife and get herself killed? No! According to Tegha, she had heard enough news of women dying in an attempt to clear out the fibroid growing in their tummy, that she’d rather look for other alternatives. So, no, she thanked the doctors, and rebuffed all attempts by her husband to convince her. Instead, Tegha embraced other touted alternatives of local herbs, Indian herbs and concoctions, to no avail.
Late last year, she met a doctor relative of hers who told her to come over to the Lagos State University Teaching Hospital in Ikeja. She later found out that the reason for the invitation was for her to see how women come in for the operation and come out thanking God for a successful process. The relative doctor, her cousin, explained to her that the mortality rate for such operations is now very low and that women rarely die anymore. August 2014 was therefore a month of joy for her, as she successfully had the unwanted occupant of her innards removed. Mercifully, her womb was also left intact, and as you read this report, Tegha is about six months pregnant.
If Tegha has a beautiful story to tell at the end of the day, maybe not quite so for Munirat yet. Mercifully, she has two issues already, a boy and a girl, who are now both in the university. But that’s the much she can recall in terms of marital bliss. For 17 years, she hasn’t had sex – not with her husband, though not divorced; and not with any other man at that. Munirat’s husband, Adewale, travelled to Europe in search of a better life right after they had their second child in 1998. At the time, it was good news to the family and hopes were high for a soon better life. But after two years rolled into ten and now approaching two decades, without any chance of Munirat joining her husband in Europe, all the hope eventually petered out. Adewale hasn’t been able to get a work/residency permit or citizenship, and so can neither step out of the UK nor travel home to see his family. Any attempt would mean forfeiting all he has achieved in that country; as he would not be able to get past the immigration guys again.
About a decade after her husband left, Munirat began developing a protruding abdomen and having some growing sensation in her tummy. Eventually doctors diagnosed that she had fibroid. They recommended some drugs, to no avail. In her desperation, she also tried herbs and other local stuffs; but without any remarkable success.
As you read this, the fibroid has so grown to a stage where she sometimes bleeds really badly and is sometimes forced to branch in any nearby house to clean-up and re-pad. She recalled a certain occasion when she had to branch into her in-laws house around Iyana-Ipaja after the bleeding became unbearable and uncontrollable. “I just noticed that passers-by were taking a second look at me in a curious manner. Apparently, they thought I was menstruating and was one of those careless women who couldn’t keep a tab on their time. But I still didn’t understand until a certain lady moved close to me and whispered in my ears that I had blood stains all over my backside!” You can imagine how embarrassed I was. That is my fibroid story. And could you believe this is all because of my husband? Doctors told me it has been able to grow so uncontrollably because I haven’t been having sex, and that regular sex could have suppressed it.
“To make matters worse, my husband, for whom I am carrying this cross has gone to take another wife and is in fact, raising another family in the UK now. He apparently got tired of trying to get me a passage over, and being a man, he eventually succumbed to the emotional urge to get himself a woman. In truth, I may not be able to totally blame him, but nevertheless, it is painful.”
Asked why she hasn’t gone for a surgery to evacuate the unwanted tumour, Muninat screamed “No! You don’t want me to witness my children’s wedding and nurse my grandchildren? My best friend died while trying to remove her fibroid through an operation. You want me to suffer the same fate?”
Munirat would therefore rather bear the pain and ignominy, than take any ‘life-threatening risk.’
As for Patience, 55, who lost her husband about four years ago, the greatest gift her late husband bequeathed on her was paying for her fibroid surgery. She was married to her husband for about 25 years without a child; looking back, she regretted that she didn’t undertake the operation earlier, to take out the tumour, as her husband took ill and died months after he had assisted her in evacuating the tumour. Had she been able to summon courage early enough, she imagined that she could have had more time with her husband and maybe carried a pregnancy successfully to have a child. So for now, she remains childless and not sure of her chances anymore. But she looks onto God with hope.
Scary statistics
Until recently, the mortality rate for fibroids operation in Nigeria was scary. More of the time, the stories were always of fatality: of patients bleeding to death, not coming back to life after the operation; or in the more benign yet grave alternative, the woman’s womb had to be taken out. Whatever the outcome, it was more like a cul-de-sac option.
But should treating come with so much terror and horror?
Online journal, Web MD in a piece titled: Fibroid Tumors: What Every Woman Must Know states that; “There probably isn’t a woman alive who doesn’t feel a wave of terror, when her doctor mentions the word tumour. But when it’s a fibroid tumour, experts say there is little to fear. There is virtually no threat of malignancy – and there are a number of excellent treatment options…”
The above statement is credited to Steve Goldstein, MD, professor of obstetrics and gynaecology of the New York University (NYU) Medical Centre, who is by all means an authority in the field; but from the stories of the African (Nigerian) women told above and the grave fears exhibited, it might appear that his statement is based solely on the American society and its excellent medical facility and personnel.
That piece also describes fibroid tumours as being “composed of renegade muscle cells that come together to form a fibrous “knot” of “mass” within the uterus.”
It also categorised fibroids, based on their locations; hence the Submucosal fibroids, located just under the uterine lining; Intramural fibroids, which lies between the muscles of the uterine wall; and the Subserol fibroids, which extends from the uterine wall into the pelvic cavity.
It also explains that “fibroids most commonly occur between ages 30 and 40, with black women at greatest risk.” And that, “at least one genetic link has been identified, indicating that fibroids may also run in families (be hereditary).
For some women fibroids cause no symptoms, but when they do, doctors say problems often ‘involve heavy menstrual periods and prolonged bleeding;’ and sometimes ‘abdominal pain or swelling and increased urination.’
Dr A. A.Adewunmi, Senior lecturer/Hon. Consultant, Obstetrician and Gynaecologist at the Lagos State University Teaching Hospital, Ikeja, Lagos corroborates the part about women of black race. He said: “Not all women are susceptible to fibroid, but majority of the women are susceptible to fibroid- particularly women of the black race. For instance, it is more prominent in black women than white women; and when we talk of prominence, we’re talking about between 7 to 8 out of every 10 women.”
He also explained that a lot of women have fibroids and hardly know until it has become troublesome or began to show symptoms of science. He also corroborates the part about the tumour not being malignant, putting the probability of it being malignant at 1 to100,000.
Dr Adewunmi however said the cause of fibroids, like cancer is not known, and that also accounts for the reason why it has no known cure yet – except hysterectomy, which is the removal of the womb.
He said fibroids tumour is occasioned more by lack of use of the uterus. “The womb is supposed to be carrying a baby, and if the womb or uterus is not carrying a baby for a long period of time, something else will grow there because – as he put it: “nature abhors vacuum.”
He explained that this is unfortunately more like an indictment of the good girls who choose to live the chaste life. “That’s why it is usually said that ‘bad girls have babies, while the good girls have fibroids’ – the good girls are keeping their body because they’re not yet married, so that place is left empty…” And by the time they get married maybe around 30 or 35, they may discover that they already have fibroids.
7 out of 10 women would rather try alternative medicine first
As a quick survey, this reporter spoke to ten women randomly within Lagos metropolis on whether they would immediately consent to undergoing surgery to take out troublesome fibroid tumours. Most of them amazingly said they would rather go for local herbs, sounding rather confident that there are herbs that can take care of it, hence they cannot go and take any life-threatening risk in the name of surgery. In all, seven out of the ten women spoken to denounced the surgical process. One even swore that she knows a trado-medical practitioner who does it without stress.
‘We’ll make her deliver deliver the fibroids like a baby’- Herb dealer
Alhaja Shakirat Okegbenro, a senior dealer in herbs and other local therapy stuff in Ikotun market, Lagos, says traditional medicine is capable of taking care of fibroid tumours. Contrary to persistent debunking by orthodox medical practitioners’, she said they would put the patient on local herbs medication, known in Yoruba as ‘agbo’, and after sometime, “she would deliver the fibroids as if she is delivering a baby.”
She dismissed in strong terms the claim that the only definitive treatment for fibroids is surgery. There are herbs that we administer in addition to other stuffs that we burn and ask them to take with hot drink.
Asked how long a patient would use the local herbs before she is eventually delivered of the fibroid tumour, Alhaja Okegbenro said, “that varies depending on the individual’s body system and resistance or adaptability to the herbs. But surely, she would be delivered of it.
She however would not reveal the type of herbs they use, whether in part or whole, arguing that “that is our own trade secret.”
Interestingly, traditional herb dealers seem to agree with orthodox medicine that fibroids are present in most, if not all women. She said any woman, who does not have fibroids may not be able to have a child of her own.
It’s all lies
But Dr. Adewunmi vehemently debunks this claim, saying most of the time they are causing more harm than good.
“That’s where we get most of our terrible cases. They would claim anything.” He explained that as a result of the things they give the women to insert in their vagina and the corrosive effects and scar it leaves behind; most marriages have had to break up because the couple can no longer enjoy the pleasure of sex, because penetration has become near impossible. “I operate fibroids on a weekly basis here and if I tell you what I see…. A lot of cases are so hopeless, because the women have gone round and round. Some have even lost their marriages because they can no longer have sex; hence the pleasure of marriage is no longer there. I mean, when you insert a corrosive into her vagina that would burn it off, chances are that the penis may not even be able to go into the woman up to half way, and so the man abandons the woman. I have seen several cases like that, not ten, not twenty!”
Thanks to the activities of these so-called ‘medical practitioners,’ he said it is hard to really assess the mortality rate of fibroid operation in this present day, because the women would have patronised them and made a very terrible case of a bad situation.
Almost in a fit of anger, Dr. Adewunmi said, “Somebody cannot have a tumour and then you turn around and say she should just rub something and it would disappear. Most times, what they see and claim to be fibroids coming out of the women’s private part are clotted blood. I’ve been practising medicine for over thirty years, so I should be able to tell you certain things categorically!”
