The Nation Newspaper

Tag: VVF

  • VVF sufferers appeal for help in Kaduna

    VVF sufferers appeal for help in Kaduna

    No fewer than 20 women in Kaffin Gwari, a community in Igabi Local Government Area of Kaduna State suffering from Vesico Virginal Fistul( VVF ), on Monday, appealed for government assistance.

    The women attributed the high VVF prevalence in the community to absence of state-of-the-art health care facility for antenatal services in the locality.

    VVF is a condition that allows continuous involuntary discharge of urine.

    The Mai Unguwa (head) of the community, Malam Danjuma Ali, said the absence of quality health facility in the community, with a population of more than 150 people, subjected the women to unimaginable pains during childbirth usually with prolonged labour.

    According to Ali, the nearest health care centre is in Kawo, about 10 killometres away from the community.

    He added that women were transported by motorcycle to Rigachikun before they could get vehicle to Kawo because of the bad roads.

    “As a result, our women record incessant miscarriages while attempting to visit healthcare centres.

    “Not only that, we equally loss children under five years due to absence of healthcare services.”

    He lamented that the 100-year old predominantly Gbagyi community, still lacked basic healthcare facilities that would ensure quality life and the survival of their children.

    “There is no form of development taking place in our community; but we hope that with your visit, we will get response from the government.”

    One of the women suffering from VVF, 35-year old Jummai Joseph, said she got the condition following long labour to have her fifth child.

    She said “I had complications due to prolong labour and was taken to Kawo hospital for delivery.

    “I lost the baby which had to be removed via Caesarian Section; but my greatest shock was when the doctor told me I have VVF.

    “My life has never been the same ever since. I spent a lot of money to get treated.”

    Read also: Free VVF surgery for 30 women in Niger

    She called on husbands to be patient with their wives in such condition and urged them to be loving and caring, noting that child bearing was responsible for many VVF cases.

    She appealed to government to assist the community with state-of- the art healthcare facility to save women and children in thge locality.

    Another woman with the condition simply identified as Martha said she also got the condition after long labour.

    She added that the absence of health facility in the community made her to patronise old women with little experience, noting that the women had no knowledge of how to tackle complications during child birth.

    A resident of the community, Esther Marcus, a mother of one, also said the lack of health facility in the area was endangering lives of women and children and called on the state government to do something about it.

    “We do not have anything in this community, not even a patent store to buy medicine. We have to go to Kawo for everything. One can only imagine what we go through during medical emergency.

    “We do not even have traditional birth attendants. We have to fall back on old women with a bit of experience about child birth whenever our women want to deliver and we have lost quite a number of children in the process.”

    NAN

  • 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.

     

  • Minister leads experts on VVF repair mission

    Minister leads experts on VVF repair mission

    Vesico-Vaginal Fistula (VVF) is prevalent in Nigeria. OYEYEMI GBENGA-MUSTAPHA reports on how the Minister of Health, Prof Isaac Adewole, for three days, led a team of experts that performed surgeries on some women, and gave them back their dignity at the Wesley Guild Hospital, Ilesa, Osun State.

    For three days, 26 women  living with Vesico-Vaginal Fistula (VVF)  received treatment from a team of professionals/surgeons in genitourinary and urogynaecology. The team was led by the Minister of Health, Prof Isaac Adewole.

    The venue was the Wesley Guild Hospital, Ilesa, Osun State.

    The free obstetric fistula surgical repair was organised by the Federal Ministry of Health, in collaboration with the United States Agency for International Development (USAID), the Osun State Government and the Obafemi Awolowo University Teaching Hospital, Ile-Ife.

    Decked in a surgical kit,  Adewole busied himself with surgeries.

    This is the second time the minister would lead a team of medics, including the International Society of Fistula Surgeon National President, Prof Oladosu Ojengbende, on such surgery. The first was at the Federal Medical Centre, Jabi, Abuja last October, where surgeries were carried out on over 50 VVF patients.

    Each had an unpleasant experience  to tell. They recounted stories of their rejection, depression, isolation and mental frustration.

    One of them is Mrs. Iyabo Olaseku (not real name), a 35-year-old resident of Erinmo, Ijesa, a suburb of Ilesa, whose  VVF ailment started three years ago.

    According to her, despite her undergoing the VVF surgery, she still finds it difficult to reintegrate into the society.

    Mrs. Olaseku said: “It was very devastating and dehumanising. I have lost everything called self-worth and esteem. It was frustrating, leaking and oozing out bad odour as an adult. I kept to myself. I hardly go out again. So blending into the society is going to take a while.”

    The story of Hajia Sadia Kolawole (not real name), a mother of two children, moved listeners to tears . She recalled being transferred from a Lagos hospital to Ilesa.

    “I have been abandoned by my family, relatives. Even my husband is nowhere to be found in the last two years. I used to be a trader but now, I have been economically devalued as I cannot stand in public places for too long because of the bad odour emanating from my body,” she said.

    Adewole said the over 300,000 women living with VVF in Nigeria is of serious concern to the ministry and to the USAID, hence the reasons he is advocating regular trainings for volunteers in the specialised medical field to join the Federal Government in tackling VVF.

    To cater for the axis, the hospital was declared a VVF repair centre.

    “I am announcing that the Ilesa Wesley Guild Hospital has become a centre for VVF operations in Nigeria. I am reiterating that the simple way to prevent obstetric fistula is to be delivered safely by skilled medical personnel. This is to reduce the cases of VVF because most of them are usually the case of obstetric fistula. These are helpless women caught in the web of VVF,” Adewole said.

    On why he participated, the minister explained. “This is our small way of showing leadership and concern to the plight of the suffering masses, and our display of affection must be a thorough practical approach of putting smiles on their faces, removing shame and reproach, restoring dignity to womanhood and more importantly lifting the undue financial burden the disease has placed on them.”

    Ojengbende and the Minister’s Special Adviser, Dr. Imran O. Morhason-Bello, described the minister’s participation as a rare display of patriotism, considering his tight schedule.

    “He sees this mission to the Wesley Guild Hospital is another life-saving intervention. And he is here with more capable hands to perform another round of VVF repairs on suffering women,’’ the aide said.

    “Prof. Isaac Folorunso Adewole is taking giant stride in evolving and revolutionising the entire medical sector in the last 24 months. He started the free cervical and breast screening for women last year. He initiated the Northeast Emergency Nutritional and Medical Response, and has  promised to ensure smooth implementation of more surgeries of the VVF in the 2018 budget,” Morhason-Bello, added.

    Declaring the event open, the Country Project Manager of USAID Fistula Care Plus, Chief Iyeme Ifem, decried the silence and long years of medical  denial — VVF treatment was restricted to the North.

    He said the massive turnout for the treatment in the Southwest had shown that many sufferers were hidden and untreated, adding that none of the 26 patients were Hausa-speaking people.

    He urged VVF paients to seek medical help by reporting to the nearest teaching hospital or VVF centre in their locality.

    He described VVF as an abnormal trait extending between the bladder and the vaginal, that allows the involuntary discharge of urine into the vagina vault.

    “In most cases, research has revealed, 90 percent are caused from prolonged obstructed labour during the first or second child bearing, often associated with marked pressure necrosis, edema, tissue sloughing and cicatrisation.

    ‘’Studies have shown that cultural beliefs of marriage and conception at a very young age, often before full pelvic growth has been achieved, is the most prevalent factor, coupled with unsupervised antenatal care by quack medical professionals during child birth and prolong labour,” Ifem said.

    He continued: “An obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour, leaving a woman incontinent of urine or faeces or both. More than 75 percent of women with obstetric fistula have endured labour that lasted three days or more. In the western part of Nigeria, cases of obstetric fistula are from havoc of traditional birth attendance and from mismanagement of CS in some conventional hospital.

    “Twenty-three of the patients have been rejected and abandoned in the society, as they are either divorced or separated as only two are still under a man’s roof. They have become financial burdens to the community, which they belong as they are not employable due to the stigmatisation and serial loss of dignity over time. It has also affected their emotional and psychological well-being.’’

  • FG to build more VVF hospitals

    The Minister of Health, Prof. Isaac Adewole, said Federal Government is planning to build three more Vesicovaginal Fistula (VVF) hospitals in the country to make treatment accessible to the poor and vulnerable.

    Adewole told the News Agency of Nigeria (NAN) in Lagos on Sunday that poverty and lack of accessible healthcare were major causes of VVF in the country.

    He said VVF mostly affected the poor, younger women and those abandoned by their husbands.

    “There are thousands of Nigerian women with VVF, and it is only poor people that will have it. The rich won’t have it because it is an indication of lack of care during delivery.

    “About 85.7 per cent of the poor have no health coverage and no one to look after them.

    “The rich ones are taken care of properly. No rich one will have VVF, even when they have it or there is a mistake, they will quickly repair it because they have the money, ” he said.

    Adewole said federal government, through its Rapid Results Initiative launched in October, would be performing 10,150 free VVF surgeries in partnership with International Society of Obstetric Fistula Surgeons.

     

  • ‘Most VVF patients are victims of FGM’

    At least 85 per cent of Vesico Vaginal Fistula patients in the country are victims of Female Genital Mutilation and cutting FGM/C, according to a recent research.

    Medical Director of the National Obstetrics Fistula Centre of Excellence Abakaliki (NOFIC), Prof Sunday Adeoye stated this at a two-day training of Community Champions on FGM Abandonment in Ebonyi State.

    The event was organised by the National Orientation Agency (NOA) in conjunction with the United Nations Children’s Fund (UNICEF) and the United Nations Population Fund (UNFPA).

    Describing the practice as unacceptable, Prof Adeoye canvassed a bottom-top approach to curtail the practice.

    He said, “Among over 412 patients we studied, over 85 per cent of them have suffered some form of mutillation or another which is not acceptable.”

    While noting that FGM/C is a contributory factor to VVF in the county, Prof Adeoye commended the efforts of the wife of the Ebonyi State governor, Mrs Rachel Umahi to stamp out the practice.

    He noted that there is need for the people at the grassroots to join the fight against the practice in order for it to be successful.

    Unicef Chief of Enugu Field Office, Charles Nzuki in a goodwill message regretted that many women lose their lives during childbirth because of FGM.

    He said, ”We must abandon FGM because it is one of the major reasons women die during childbirth and suffer from Vesico Vaginal Fistula (VVF) painful menstruation, painful sexual intercourse, exposed to life threatening infections such as HIV and Tetanus amongst other negative consequences”.

    “Ending FGN is life-saving. There is need to prevent millions of girls and women from undergoing painful, harmful an irreversible damage to their genitalia. Let us encourage parents and caregivers to leave genital organs of girls and women as naturally created”.

    The state Director of NOA, Dr. Emma Abba said Ebonyi state has the highest prevalence rate of female genital mutilation and cutting (FGM/C) in the south east region of the country.

    He said 15 million girls between 15 and 19 years are at risk of being subjected to the inhuman treatment by 2030 if nothing is done to stop the practice.

    He listed local government areas in the state where the practice is common to include Izzi, Afikpo, Abakaliki, Ezza North and Ebonyi local government

    He noted that the agency will soon approach the state House of Assembly to pass a bill prohibiting female genital mutilation.

    He said, “In the southeastern region, Ebonyi State has the highest prevalence rate above the regional average at 62%”.

    “About 120 million to 40 million women have been subjected to FGM and 3 million girls are at risk each year, according to World health organisation (WHO).”

    “FGM relates to all procedures that involve partial or total removal pof external female genitalia or other injury to the female genital organs for non-medical reasons”.

    “This practice is an abuse of human rights and causes serious health complications, including fatal bleeding”.

    General Manager of Radio Nigeria-Unity FM Abakaliki, Gregory Odiakosa said it is still surprising that it is still being practised despite all the campaig.

    He expressed shock that Ebonyi is number two in ranking of prevalence rate in the country.

    Describing the training as a very nice move he said the expectation is that participants will go back and work assiduously to end the practice.

    Mr Odiakosa who described FGM as a wicked and evil practice blamed tradition for its continued practice.

    He noted that the practice has very negative consequences for the women and the girl-child, urging stakeholders to ensure that the practice stopped in the state.

     

  • NGO, ExxonMobil calls for legislation to curb VVF

    The Executive Director of an Uyo-based non-governmental organisation (NGO),  Community Partners for Development (CPD), Dr Nsekpong Udoh, working with the support of ExxonMobil,  has called for legislation to forestall incidence of Visco-Vaginal Fistula (VVF) disease.

    Udoh made the call in Uyo while speaking at the awareness seminar for representatives of women groups in Akwa Ibom recently.

    Dr. Nsekpong said that apart from creating awareness on the disease, government should ensure that child marriages were discouraged through enactment of law to punish offenders.

    She lamented that a lot of people living with VVF have been stigmatized and some divorced due to their health condition.

    “For long term solution, sensitization and legislation is needed because if there is a correct legislation about early marriages, teenage pregnancy would stop.

    “When a child is pregnant, they make sure such child goes through proper care and legislation in place,” she said.

    She decried that much had not been done by government in creating awareness on the disease as it was being done in HIV and other illnesses.

    She tasked the women groups to take the sensitization campaign to the rural areas, market places and even the church to check the control of the disease.

    Udoh noted that a lot of women in the rural areas were still suffering from VVF ignorantly without going to the hospital for treatment.

    The director said that her NGO had taken the sensitisation to all the three senatorial districts in Akwa Ibom to create awareness and prevent incidence of VVF in the state.

    She appealed to the state government to expand the VVF centre in Mbribit Itam near Uyo, adding that the centre had been overstretched being the only centre in the state.

    The State Director of Reproductive Health, Mrs Comfort Akpan, said that the public health directorate was committed to reducing the number of girls and women suffering from this VVF.

    Akpan, who was represented by Mrs Grace Okon, Family Planning Officer, State Ministry of Health, said that sensitization and awareness creation was the key to reducing the disease.

    She lamented statistics had shown that Nigeria had a higher burden of VVF than other countries of the world.

    She advised Traditional Birth Attendants (TBAs) to refer first pregnancy to the hospital for proper ante natal care to prevent the occurrence of the VVF.

    The representative of the Public and Government Affairs Department, ExxonMobil, Mr Eyo Bassey, commended the initiative of the NGO for organising the awareness seminar.

    Bassey said that as a good corporate citizen, ExxonMobil, would always support initiatives that would bring succour to the masses especially children and women on our society.

     

  • Akwa Ibom governor’s wife donates relief materials to VVF patients

    The wife of Akwa Ibom State Governor, Mrs. Martha Udom Emmanuel, has visited the Pope John Paul 11 Family Life Centre, also known as the VVF Hospital, Mbribit Itam; she donated relief materials, such as mattresses, pillows as well as food items ranging from bags of rice, beans, garri and toiletries to patients in the hospital.

    The governor’s wife, who was represented by her Special Assistant on Women Affairs , Rev. Mrs. Mercy Cephas, thanked the members of staff of the hospital for their commitment to service, noting that though God was the source of help for man, with human beings as the channel.

    She promised that government would do everything possible to ameliorate the plight of patients. While interacting with patients in the wards, she also put smiles on their faces by giving each patient in the hospital cash for their upkeep

    The matron of the home, Rev. Sister, Sylvia Ndubuaku, thanked the governor’s wife for the visit, stating that it was a confirmation of her love and compassion for the vulnerable in the society. She added that the government has supported the hospital in many ways, such as the provision of nurses and other members of staff.

    She highlighted some of the needs of the hospital to include rehabilitation of inmates, firm hospital beds, surgical instrument as well as television set for the patients, while soliciting for governments’ support in this regard.

    Also speaking, a patient in the hospital, Mrs. Mercy Exodus, thanked the governor’s wife for her humane disposition towards the needy and vulnerable in the state, praying that God would sustain and guide her and the governor in the discharge of their duties. She also thanked Mrs Emmanuel for giving them with gifts.

     

  • VVF: Coalition against a scourge

    VVF: Coalition against a scourge

    For Maimuna, multiple tragedies came early in life. She was not quite 14 when she was forced to marry a man she had never met. Soon after, she got pregnant but the baby died at delivery. Then, she went down with vesico-vaginal fistula or VVF and was taken to hospital.

    Her father compelled her to marry a 29-year-old man a few days to her 14th birthday. She never had any foreknowledge of the marriage; she was only informed after the ceremonies regarding her marriage had been concluded.

    Maimuna was quoted as saying that marriage was never on her mind, and that she was surprised when her friends informed her at the stream that people had gathered in their house for her marriage ceremony.

    “I thought they were joking, she said. “A few moments later, some older women came to tell me that I should go to my aunt’s house for a meeting. That was when I was told that my marriage had just been concluded and that I was now a wife. I asked my friends who the husband was and I was told.”

    Maimuna is among the over two million people globally living with VVF, and for no fault of theirs.

    The National Strategic Framework, which is committed to the eradication of the disease, says that there are between 12,000 and 20,000 new cases of VVF every year in Nigeria.

    The Country Representative of the United Nations Population Fund in Nigeria, Ms. Ratidzi Ndhlovu said Nigeria accounts for over one third of the global burden of fistula, adding that “these numbers are not acceptable, not when fistula is all but eliminated from the developed world”.

    This is corroborated by medical experts from the Ahmadu Bello University, Zaria who argued that “from available information, Nigeria has the highest number of VVF in the world”.

    VVF was reported by Derry in 1935 after an examination of the mummified remains of Egyptian Queen Henhenit (11th Dynasty, 2050 BC). Since then, the disease has remained a challenge for gynaecologists.

    Fortunately, the diagnosis and surgical management of vesico-vaginal fistulas are associated with high cure rates if performed by qualified surgeons.

    A recent study in Nigeria revealed that about 9% of girls suffering from fistulas married before menarche. Obstetric fistula is a hole in the birth canal caused by prolonged, obstructed labour due to lack of timely and adequate medical care, leaving the woman with devastating injury (a fistula) that renders her incontinent. This condition harms women physically, socially and economically, and often leads to isolation from families and communities, thereby deepening their poverty and worsening their sufferings.

    Sufferers of the ailment are easy to distinguish them from other people. They usually carrying little buckets with a little string in between their legs. Such buckets usually contain liquids. In Kaduna State, they are usually found at the Gambo Sawaba General Hospital where there is a VVF Centre equipped by Nigerian Breweries Plc with support from Heineken African Foundation. The Nation was informed that Rotary International and the Federal Ministry of Health have also played a great role in ensuring that victims of this ailment receive adequate care.

    In July 2010, the Managing Director of Nigerian Breweries Plc, Nicolaas Vervelde said at the commissioning of the centre that about 95 per cent of VVF cases were found in Africa. Vervelde said over two million women suffer from the disease globally, with about 95 per cent in Africa, adding that more and more women are developing VVF as a result of complications during childbirth especially among young women and those not attended to by qualified midwives.

    He also disclosed that the company was working out a training plan for two in-house surgeons to ensure the sustainability of the VVF operations in the hospital as well as support the training of traditional birth attendants to enable them better attend to women with limited access to the hospital. The company went through with its promise and sent two medical doctors to the Netherlands for training and were supposed to work with the state government for at least two years on their return.

    The United Nation has declared May 23 every year as the International day to end Obstetric Fistula. The Nigerian government has taken special interest in the ailment and designated three VVF centres as National Obstetric Fistula Centres form prevention, treatment, training and research. Speaking at the commemoration of the International day to end obstetric fistula in Kaduna, Minister of Health, Prof. Onyebuchi  Chukwu said that “the prevention and treatment of obstetric fistula is a priority for the federal government as part of its commitment to improve the maternal reproductive health indices. Evidence abound that prevention is the key and as such, government working through the Midwives Service Scheme and SURE-P MCH programme have ensured the availability of functional PHC to guarantee skilled birth attendants and supply of essential maternal health commodities for the provision of quality antenatal care, clean safe delivery and postnatal care for women and children”.

    The Minister said further that “Presently, for the treatment of VVF, there are 15 VVF centres out of which the federal government has designated three as National Obstetric fistula centres for prevention, treatment, training and research. Furthermore, government is repositioning commitment to give succour, hope and life back to VVF victims under the Transformation Agenda.”

    On her part, the UNFPA Representative in Nigeria, Ms. Ratidzai Ndhlovu said “Nigeria is contributing over one-third of the global burden of fistula. These numbers are not acceptable, not when fistula is all but eliminated from the developed world”.

    She noted that “the consequences of fistula are devastating – it leaves those affected ashamed, ostracised and in many cases alone, which further deepens their poverty and magnifies their suffering. For UNFPA, where we work to ensure no woman dies while giving life, it is also our commitment that no woman should be injured while giving life. To address the neglected health and human rights violation of obstetric fistula, UNFPA, together with partners around the world, launched the global campaign to end fistula. With support from UNFPA, 47,000 women and girls have undergone fistula repair surgery. Partner organisations have provided treatment to many more women and girls living with fistula.”

    While calling for action from both the government, civil society, Community and Faith based organisations as well as the media to end the ailment, she said “government should strengthen health systems to ensure the prevention of high quality maternal health care that is accessible to all women, ensure free or highly subsidised delivery care and caesarean sections and a fully functional data management system for the collection of data including notification of fistula cases the promotion of and support of girls’ enrolment and retention in school. Government should also integrate fistula treatment into free antenatal care and delivery plan, taking services closer to vulnerable women, equipping all treatment centres with appropriately and continuously offer free treatment as well as strengthen government owned skill acquisition centres and link with fistula treatment centres to empower survivors.

    Wife of the Kaduna State governor, Hajia Fatima Mukthar Yero argued that obstetric fistula is a preventable and in most cases, treatable childbirth injury that leaves women incontinent, ashamed and often isolated from their communities.

    “It occurs when a woman or girl suffers prolonged, obstructed labour without timely access to an emergency caesarean section,” she said.

    Mrs Yero wants the world to reach a consensus and draw up a regional strategic plan with concrete actions on how we can mobilise resources to prevent obstetric fistula, treat the hundreds of thousands of survivors and rehabilitate and reintegrate them into society.

    The successful treatment of fistula cases depend largely on the availability of trained, specialised and highly committed experts and surgeons, nurses and other support staff. In 2011 about 54 doctors and 66 nurses were trained through the collaboration of the UNFPA on the management of Obstetric fistula in the country, while the government took steps to address the lack of budgetary allocation to the treatment of VVF cases. It budgeted N300 million in 2010 and N160 million in 2012 for this purpose. However, investigations revealed that there is no budget line for VVF treatment at the state level.

    A gynaecologist and Technical Adviser at Development Communications (DevComs) Network, Dr. Olalekan Olaniyan, says early marriage, illiteracy, ignorance and poverty exposes women to obstetric fistula. He argued that poor health-seeking behaviour, delays in using health facility, delays in reaching health facility, poor health infrastructure (for Caesarean delivery when needed) make the risk of Obstetric fistula even greater. However, the World Health Organisation (WHO) believes that obstetric fistula is preventable and can be avoided by delaying the age of first pregnancy; ending harmful traditional practices; and timely access to obstetric care.

    Dr. Olaniyan wants government to improve health systems and social infrastructure, in order to provide prompt caesarean session for women going through prolonged and obstructed labour. He also advocates the alleviation of poverty, illiteracy and end of harmful traditional practices.

  • What is Nigeria’s scorecard in VVF care? 

    Vesicovaginal fistula (VVF) is still a serious health issue in young women in Nigeria. The Federal Government has tried to eliminate it, but many women are still living with it and do not know where to seek help, writes WALE ADEPOJU.

    The Federal Government has been battling to eliminate Vesicovaginal Fistula (VVF), an abnormal fistulous tract extending between the bladder, which allows continuous involuntary discharge of urine into the vaginal vault.

    Last year, the government drew up a five-year plan to eliminate it, promising to take its care to a new level. But many women, especially in the remote villages, are still battling with the condition.

    A senior Federal Ministry of Health official, who craved anonymity, said the country was on the right track in eliminating the condition.

    There are three national fistula centres in Abakaliki, Ebonyi State; Babaruga, Katsina State and Nngi, Bauchi State; and about 16 VVF units in secondary facilities nation-wide.

    The government has prepared a policy document for five years to ensure that a machinery is in place to tackle the condition headlong.

    This, the source said, is a physical intervention programme designed to give short term succour.

    The official also said the President had promised to restore hope, life and joy to those with fistula problems.

    He ensured that some of the women yet to be treated have a chance to access treatment. One-third of them had their cases treated through the fund provided by the Federal Ministry of Finance to the Ministry of Health. It is called “Seed Money”, in October, last year.

    “This was under the Glowing Girls and Women in Nigeria (GLOWIN) programme. In Katsina alone, about 200 women with VVF were treated. In all, over 2000 women living with VVF were repaired,” the official said.

    The source further said the government carried out an  assessment across the country, funded by United States Agency for International Development (USAID) in partnership with United Nations Population Fund (UNFPA), Federal Ministry of Health, and Federal Ministry of Women Affairs.

    It was discovered that between 160,000 and 200,000 women are living with fistula.

    Also, yearly, about 12,000 women become victims.

    About 5,000 women are repaired (treated) yearly. There are also about 7,000 women with Fistula that cannot be treated yearly and they keep adding to the backlog of cases of fistula every year.

    A consultant urologist at the Lagos University Teaching Hospital (LUTH), Dr Habib Tijani, said the condition has a profound effect on the patient’s emotional well-being.

    “VVF not only affect women physically, but emotionally. This is why we do all we can to repair and provide final solution to their problems,” he said.

    According to the World Health Organisation (WHO), VVF is often caused by childbirth (in which case, it is known as an obstetric fistula), when a prolonged labour presses the unborn child tightly against the pelvis, cutting off blood flow to the vesicovaginal wall. The affected tissue may necrotise (die), leaving a hole.

    Vaginal fistulas can also result from violent rape. This injury common in some war zones, where rape is used as a weapon against innocent females. As a result, some health centers in countries such as the Democratic Republic of Congo (DRC) have begun to specialise in surgical repair of vaginal fistulas.

    It can also be associated with hysterectomy, cancer operations, radiation therapy and cone biopsy.

    “Vesicovaginal fistulae are typically repaired either transvaginally or laparoscopically, although patients who have had multiple transvaginal procedures sometimes attempt a final repair through a large abdominal incision, or laparotomy.

    “The laparoscopic (minimally invasive) approach to VVF repair has become more prevalent due to its greater visualisation, higher success rate, and lower rate of complications,” he said.

    Possible complications of surgical treatment are recurrent formation of the fistula, injury to ureter, bowel, or intestines and vaginal shortening.

  • VVF patient, 44, needs N1.5m for repair

    VVF patient, 44, needs N1.5m for repair

    Life has become unbearable for 44 years old Mrs Folake Ojikutu, a native of Ijede, a town in Ikorodu, on the outskirts of Lagos, since she came down with vesicoveginal fistula (VVF) in 2000.

    She wears pampers daily to avoid messing herself up with urine.

    She said the doctors also ran a pipe into her vagina to collect urine because of incontenence.

    Recounting how it began, Mrs Ojikutu said  when she wanted to deliver at Jobat Hospital, at Idumota, Lagos, her baby was forced out of her womb by those taking delivery.

    She said this was the genesis of her problem.

    Ever since, she has had to contend with ceaseless flow of urine.

    This condition, she said, made her to undergo three surgeries at the Sagamu General Hospital, Ogun State, to restore her dignity.

    “But, the repairs, which were carried out in 2001, 2002 and 2003 did not stop the problem,” she said.

    Mrs Ojikutu said it was during that period that her husband passed away.

    “When my husband died in 2003, I couldn’t do anything because I didn’t have money for another surgery. So, what I usually do was to use tissue paper to cover my private part to stop the urine from trickling out of my pant. It is really embarrassing,” she said.

    She said she was introduced to the gynaecology ward of the Lagos University Teaching Hospital (LUTH), Idi Araba, when she attended the hospital PEPFAR Clinic. It was at the ward that I was referred to the Urology Department where I had two successive surgeries on March 3 and 5, to repair my private part. Yet, the urine didn’t stop as I get wet easily. This time around, I needed pad to stay dry all day.

    After, the surgeries, I was told I would need to have another surgery. I thought it would be free since I had both surgeries at the same department and the problem persisted.

    The last surgery cost N400,000 since it was a minor one. But now, the consultant said I should look for N1.5 million which also includes money for blood.

    Mrs Ojikutu, who grinds pepper at Oto Market in Oyingbo, Ebute Metta area of Lagos, said raising such money was a problem and as such would need the help of well-meaning individuals, corporate organisations and government.

    “I asked the hospital for assistance but I was turned down. So I need help to have the surgery,” she said.

    She is appealing to them to come to her rescue so that she can live a normal life again.

    Any help can be rendered through her First Bank Account: Ojikutu Gayat Afolake: 3056837387.

    Mrs Ojikutu, who presently live at 4B, Kalejaiye Street, Fadeyi in Shomolu, said she could no longer bear the burden, adding: “I am always depressed because of the problem. I’m always very careful. So, I decided to cry out for help because I can’t shoulder it alone. Where do I get money from as someone who grinds pepper to survive.”

    Consultant urologist, LUTH, Dr Habib Tijani said her case was a big type of VVF.

    He said some are small while others are big.

    He said she had an obstructed labour which affected her private part.

    “It is true she has had surgeries at Sagamu General Hospital trice and twice here at LUTH but we are going to do something to stop the urine,” he said.

    Tijani, who is the Head of Department of Surgery, LUTH, said the repair is going to be a bit more major because the aim is to give her final solution.