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Tag: vesico vaginal fistula

  • Stephanie Linus partners SNEPCO/NNPC to treat 25 VVF patients in Sokoto

    Nollywood actress and producer, Stephanie Linus, has been showing that her movie, ‘Dry’ which espouses the issues of child bride and fistula is more than just a movie, but a tool for touching the lives of women actually living with Vesico Vaginal Fistula (VVF).

    This was as 25 women formerly living with VVF in Sokoto State have received free repair surgeries, courtesy of a collaboration of SNEPCo/NNPC and Extended Hands, the foundation started by Stephanie.

    VVF is a serious challenge  that can be experienced by women after childbirth whereby a hole develops between the vagina and the bladder, resulting in uncontrollable leaking of urine through the vagina.

    The treatment at the Maryam Abacha Woman and Children (VVF Hospital) Sultan Bello Road, Sokoto was carried out by a team of medical staff led by Dr Sa’ad Idris, a VVF surgeon and former Commissioner for Health in Zamfara State with over 20 years experience in the field. He was assisted by Dr Halima Bello a VVF surgeon, Chief Medical Director Dr Lawal Bello, Chief Matron Hamsai Abdullahi Wisso, and other doctors and nurses at the VVF center.

    Stephanie started the foundation to give VVF patients a chance of  living normal lives through free repair surgeries.

  • VVF: A reporter’s experience in Sokoto

    VVF: A reporter’s experience in Sokoto

    From Sokoto, JAMEELAH YUSUF reports on the horrors of vesico-vaginal fistula (VVF).

    It is the sprawling Maryam Abacha Women and Children’s Hospital that most women in Sokoto State living with vesico-vaginal fistula or VVF visit for remedies. The government-owned facility is located at Diori Hammani Road, Sokoto, the state capital.

    The hospital consists of two buildings, one the administrative block, the other the wards.

    A walk into the hospital on a hot Friday afternoon opened my eyes to a whole different world. It is a hospital with specialists on various gynaecological fields. The most famous for which it is known is the vesico-vaginal fistula disease.

    Wikipedia defines vesico-vaginal fistula as an abnormal fistulous tract extending between the bladder and vagina, resulting in continuous voluntary release of urine into the vaginal vault.

    The sight of young and older women with a bowl in hand, and a tiny pipe channeling liquid from beneath their wrapper into the bowls is one you cannot be oblivious to.

    The hospital has on admission, an average of 40 women of different age range that are mostly from various rural settlements in the state capital and its environs. Most of these women are awaiting surgery or have just been operated on.

    Hauwa, a 20-year-old lady revealed that she had just had her fourth operation in four years. She got married at 13, and had a baby she lost at 16. She got VVF as a result of childbirth. Since then, she kept returning to the Maryam Abacha Hospital, as the operated place opens up after a while.

    Hauwa said her father brought her to the hospital as her husband works in faraway Ibadan and only returns home after a year.  So, she is in the hospital all by herself. She would return to her father’s house once the catheter is removed.

    When asked if she plans to have a baby anytime soon, she said she hadn’t thought about that yet. Her major concern is to get her health back.

    Another patient, Kulluwa, 33, who had just been operated, after trying to deliver her seventh child at home.

    “It was difficult to get the child’s head out and when it finally came out, she was a lifeless baby,” said Kulluwa’s mother who was with her in the hospital. They noticed she was passing urine involuntarily and brought her to the hospital.

    A nurse at the hospital, Zainab Ahmad explained that they do not have a very accurate record of the age of the patients as most of them do not know their exact age.

    Mrs Zainab explained that contrary to popular belief, early marriage is not the only cause of the vescovaginal fistula disease as they have patients who are of age.  She said, “Apart from early marriage, some people have this disease as a result of prolonged labour and some other ones have pelvis that are too small to carry the weight of their babies. Another identified cause among women is numerous childbirths. Some of these women have given birth to over 12 children.”

    “The rate at which patients are brought here has reduced significantly as there is more awareness at the grassroots level.

    “Once admitted admitted, patients have the catheter fixed on them. It is taken off after four weeks, and then they have the surgery if there is the need for it. Some patients have this surgery more than four times while some others have it just once and they get cured.

    “Ideally, once the patients get their surgery done, we discharge them as soon as they are fit and schedule a checkup appointment for them after every two months for six months. After six months, if they are no longer dripping urine, we place them on a family planning package that ensures they do not give birth, after a year, we take it off and they can have their babies successfully. We however advise them strongly to come to the hospital when they are almost due. If they try to give birth at home by themselves, they would get the VVF disease once again.”

    “Most of the patients on admission are either victims of early marriages or prolonged labour. They live in small villages that are far away from the hospital. The hospital is a place of last resort for them as most of them attempt to deliver at home and only resort to the hospital when complications occur. Most times, it is already too late as they have to cover a distance of an hour or more to get there.”

    One very impressive thing you would notice about the VVF patients of the Mariam Abacha hospital is the spirit of sisterhood they share. These patients are mostly from villages far apart, united by the same predicament.

    In the evenings, they are mostly found in the hospitals courtyard with the bowl that collects the urine from their catheter lying close to them while they weave hand fans from straws or do other things.

    The atmosphere isn’t as gloomy as one would imagine as these women seem to have accepted their fate and are doing a good job at staying happy and living in the moment.

    One would think that with the amount of aid Nigeria receives from numerous international organisations especially for health, funding would not be a problem.

    I met a number of patients who haven’t been operated and have only had one dosage of their required drugs in over four weeks of their admission. When asked why they haven’t been given more drugs, I was made to understand that there are no more drugs.

    The hospital is impressively maintained but the welfare of the patients could make use of more attention. The bureaucracy in the administration of most sectors in Nigeria, including the health sector, is the major reason why funds given as aids do not get to the intended recipients as it was given by the organisation. Hospitals like the Maryam abacha clinic have special needs that should be attended to as a matter of priority by the state Government.

     

    • Yusuf is a 500-level law student of the Uthman Danfodio University Sokoto, and contributor to our Campus Life

     

  • Tender care for VVF patients in Kaduna

    Tender care for VVF patients in Kaduna

    Vesico Vaginal Fistula (VVF), a childbirth disorder, hurts physically and emotionally but Kaduna State has found sustainable ways to soothe the pain. ABDULGAFAR ALABELEWE reports

    The experts say Vesico Vaginal Fistula or VVF afflicts over 12,000 women every year in Nigeria, leaving them unable to control urine. The condition is defined as a hole that develops between the vagina and the bladder, resulting in uncontrollable urine leakage. The causes: mostly obstructed labour, early marriage and poverty.

    Most of those 12,000 new cases are in northern Nigeria, according to USAID.

    The Project Manager, USAID Fistula Care Plus Project, Dr. Habibu Sadauki said at an event in Zaria that over 5,000 cases have been repaired.

    The USAID Project Manager disclosed that in Kano State alone, 10 to 15 new cases are recorded every week in various hospitals in the state, as he maintained that fistula can be repaired and prevented if parents educate their female children to patronise hospitals for proper delivery.

    VVF patients are often rejected by their husbands and avoided by the rest of the society. The patients themselves withdraw from the world that does not want them.

    That is where the Kaduna State government is making a difference. VVF patients at Hajia Gambo Sawaba General Hospital Zaria, the state’s VVF centre, are getting double treatment. After the surgery to stop urine leakage, the state government in collaboration with United Nations Population Fund (UNFPA) trains and empowers them with vocational skills and gives them starter packs to enable them easily deal with the post-VVF stigma.

    The 100 rehabilitated women were recently provided with tools and machines to start off businesses to become self-reliant after undergoing series of training during their stay in the hospital.

    Wife of the state governor, Hajia A’isha el-Rufai, while speaking at the graduation ceremony of rehabilitated and empowered patients held at Gambo Sawaba General Hospital described the continued recurrence of obstetric fistula as “a human rights tragedy”, reflecting the marginalisation of those affected.

    “Their isolation means they often go unnoticed by policymakers, and as a result, little action is taken to address or prevent their condition,” she said.

    The governor’s wife said that the patients would be reintegrated into their families and the society through their newly acquired skills and tools for economic empowerment. “The gesture is a testimony to the consistent commitment of the state government toward ensuring improved health outcomes for its citizenry.”

    “Obstetric fistula is one of the most serious and tragic injuries that can occur during child birth. It is a hole between the birth canal and the bladder or rectum caused by prolonged, obstructed labour without timely access to emergency obstetric care, notably a cesarean section. It leaves women leaking urine, faeces or both and over time, it leads to chronic medical problems,” she said.

    Kaduna State Commissioner for Health and Human Services, Dr. Paul Manya Dogo said, “VVF a serious condition that sadly crippled the future of young prospective women in Nigeria, with Northern States bearing the greatest burden.

    According to him, “many girls between the ages 11 years and 15 years, who become mothers mostly because they were married-out early suffer some forms of deprivation. Such girls denied access to emergency obstetric care, are often victims of VVF.”

    “Estimates in Nigeria reveal that between 400, 000 and 800,000 women are currently living with the scourge of VVF with about 20,000 new cases being recorded annually,”

    The Commissioner stressed the need for community and village leaders, clerics, health workers and the media to create more awareness on the causes and how to prevent VVF.

     

  • Eradicating vesico vaginal fistula

    Eradicating vesico vaginal fistula

    ALTHOUGH child marriage is against the law in many countries, including Nigeria, as international treaties forbid the practice, it is estimated that about 51 million girls are forced into early marriages yearly worldwide, even with its attendant challenges for women.

    Quite often, in most African countries, parents of child brides are driven by factors such as pressure to conform to age old traditions like preservation of chastity and economic considerations to give out their young daughters in marriage. It is not uncommon also in poor developing countries, for poverty-stricken parents to settle debts by offering their underage girls as payments.

    In Nigeria, the marriageable age varies from one region to the other. For instance, in the north-west and north-east regions, 14 years is considered as the average age for marriage, while in the north-central region, marriage could be contracted between 2nd and 3rd menstruations, whereas in the southern part it varies from 16 to 18 years. Child marriage invariably leads to early sexual contact and, subsequently, pregnancy at a time when the young girl is not adequately physically developed to permit the passage of a baby with relative ease.

    These child brides often suffer from physical and psychological trauma. But the most demoralising effect of early marriage is Vesico- vaginal fistula, VVF, otherwise known as obstetric fistula, a medical condition where there is an opening between the uterus and the bladder because the pelvic bones do not have sufficient time to develop before the process of conception.

    A fistula is a passage or hole that has formed between two organs in the body. Therefore, apart from the common form of opening (vesico vagina fistula), there can also be a hole between the vagina and the rectum called recto- vagina fistula, between the colon (large intestine) and the vagina known as colo-vaginal fistula, while an opening between the vagina and the small intestine is termed entero-vaginal fistula. A vaginal fistula starts with tissue damage and days to years of tissue breakdown, a fistula develops.

    Vesico vaginal fistula is a devastating injury in which an abnormal opening forms between a woman’s bladder and vagina, resulting in a continuous leakage of urine or in medical parlance, what is termed urine incontinence. It is a common complication of childbirth, often experienced in poor developing countries as a result of prolonged  labour, usually among teenage mothers. It is estimated that at least 3 million women in poor countries have unrepaired vesico vaginal fistulas and that 30, 000-130,000 new cases develop each year in Africa.

    Vesico vaginal fistula starts with tissue damage, resulting from days of pushing a baby that does not fit through the birth canal often in very young mothers below the ages of 18, an aftermath of neglect during labour and childbirth mainly in developing countries where emergency obstetric care is lacking. Fistula also can be as a result of deep tear in the perineum or an infected episiotomy after childbirth. Women with the problem of stunted growth as a result of poor nutrition can be at risk and the barbaric culture of female genital mutilation called ‘gishiri’ cut amongst the Hausa people of the north employed during pregnancy and labour also results in vesico vaginal fistula.

    This traditional practice, often performed by untrained traditional birth attendants to treat varieties of gynaecological conditions, where a cut is made in the anterior wall of the vagina with an unsterilised sharp instrument results in vesico-vaginal fistula, if the cut is made too deep. Consequently, this gynaecological condition is mostly common in the northern part of the country, where maternal morbidity as a result of the condition is high with an estimated 70% of the 150, 000 cases recorded in the country being recorded in the region.

    The immediate physical consequences are urinary incontinence or faecal incontinence in case of recto-vaginal fistula, dermatitis due to the infection of the skin area. If nerves to the lower limbs are damaged, victim may suffer from paralysis of the lower half of the body. But by far the most traumatic effect of this ailment is the social consequences. Oftentimes, the victim gives birth to a stillborn baby, thus leaving the woman childless. And if the fistulae is unrepaired, the woman remains incontinent and childless, while also suffering abandonment by her spouse on whom she may be economically dependent.

    The victims of vesico-vaginal fistula become social outcasts due to constant stench oozing from their bodies, leaving them physically, emotionally and socially traumatised. And if the victims are uneducated, with no vocational trainings, no gainful employment or visible means of livelihood, they walk a long road of rejection and pain.

    One of the best ways to eradicate fistula is through caesarian section. This intervention was employed in the Western countries at the end of the 19th century as a means of tackling the menace. Birth attendants should be trained and re-trained in emergency obstetric care to be able to decide on a swift surgical intervention if obstructed labour occurs. Access to emergency obstetric care should be expanded and not necessarily limited to the urban areas. All medical staff in the Primary Health Centres should be trained in emergency obstetric care.

    Developing countries and their donor agencies should raise priority attention on women’s reproductive health, by allocating tangible amounts of money to address issues of infants and maternal mortality. Also, public awareness of the ailment should be carried out to sensitise the public on the dangers attached to it. Poverty, empowerment of women, family planning and the policy on the official age for marriage by young girls should be addressed.

    Fistula repair centres should be established as the success and recovery rate from an operation to correct fistula is very high – almost 90%. Counselling is also essential to treat non-physical wounds. This is necessary for a complete recovery. Prolonged physical therapy is also important to treat nerve damages. However, in the longer term, there is a need for an holistic approach to address both the direct and indirect causes of fistula and other maternal morbidities, including female genital mutilation and child marriages.

    Bakare is of the Features Unit, Ministry of Information and Strategy, Alausa, Ikeja