By Abiemwense Moru, News Agency of Nigeria (NAN)
Obstetric fistula is linked to one of the leading causes of maternal mortality—difficult labour during or lack of sufficient obstetric care, according to the World Health Organisation (WHO).
Obstetric fistula is a painful consequence of protracted, obstructed labour that causes urine, faeces, or both to flow from the vaginal opening.
The persistent and embarrassing odour of leaked urine, faeces, or both causes health and psychological problems, including social isolation.
This can lead to financial difficulties, community stigmatisation, and a lower overall quality of life.
Women who suffer from obstetric fistula experience constant embarrassment, and social discrimination.
According to reproductive health experts, if left untreated, this illness can lead to chronic medical conditions like skin infections, kidney problems, and even death.
According to the United Nations Population Fund (UNFPA), 500,000 women and girls worldwide suffer from fistula, with obstructed labour accounting for around 8 per cent of maternal deaths.
According to the agency, 90 per cent of pregnancies in which the mother gets a fistula end in stillbirth. Fortunately, not only is the condition treatable, it is also preventable.
According to WHO, surgical repair of an obstetric fistula has a 90 per cent success rate in simple cases and a 60 per cent success rate in complex situations.
Sexual and reproductive health care, access to contraception, access to skilled birth attendants, and high-quality emergency obstetric care can help to prevent this injury and can be treated with reconstructive surgery.
In Nigeria many women who suffer from obstetric fistula do not have access to healthcare, as access to comprehensive VVF services remained inadequate.
With an annual incidence of 12, 000 cases and a backlog of 150000 cases, obstetric fistula is a major public health problem in Nigeria.
Addressing the challenge posed by obstetric fistula should be the responsibility of the local governments, through Primary Health Centres.
However, this is not the case as the PHC’s remain the weakest link in the nation’s healthcare delivery system.
“The Ward Minimum Health Package for Nigeria (NPHCDA, 2006) proposed strengthening a primary care facility at the level of each ward to provide basic emergency obstetric care services’’, according to National Strategic Framework for the Elimination of Obstetric Fistula in Nigeria (2019-2023).
The enormity of the task therefore requires robust partnership with the private sector and civil society organisation.
Like many other parts of the country, VVF is a major maternal health challenge in the Federal Capital Territory (FCT).
Recently, ActionAid Nigeria (AAN) in collaboration with Gwarinpa General Hospital established a centre for the treatment of fistula cases.
The Federal Ministries of Women Affairs, Health and Social Welfare commended the inauguration of ActionAid’s first Vesico -Vaginal Fistula (VVF), Centre.
Mrs Uju Kennedy-Ohanenye, Minister of Women Affairs said the initiative would help women and the country to address VVF.
“I am assuring all Nigerians that the ministry of women affairs, the ministry of health and ECOWAS have a huge plan this year to make sure that all fistula patients get treated this year.
“We are equally asking the doctors that are into these surgeries to volunteer to help Nigerians. It is time they start to enjoy the fruits of their country’s labour’’, she said.
Also, Prof. Muhammad Pate, Coordinating Minister of Health and Social Welfare, said the VVF centre was a landmark toward providing critical care and support for women and girls.
“This is a task that the government alone cannot handle hence, there have been solicitations of support from various stakeholders for a lot more to be done,” said Pate.
He was represented at the event by Mr Lawrence Anyanwu, Director and Head of Reproductive Health Division.
“The inauguration of the 20-bed wards at Gwarinpa Medical Centre signifies not only the completion of a construction project but a tangible commitment to breaking the cycle of early marriage and VVF in the Federal Capital Territory.
“The Ending Child Marriage Project, collaboration between ActionAid Nigeria and Gwarinpa Hospital with funding support from ActionAid Italy represents a beacon of hope in this battle,’’said Mr Andrew Mamedu, Country Director, ActionAid Nigeria.
He said the motivation in providing the facility was to provide essential healthcare services.
He said it was meant to address the root causes of VVF by empowering women and girls to express their rights, informed choices, and shape their own destinies.
Moriamo Shaibu, Medical Director of Gwarinpa General Hospital, said over 80 per cent of the cases of patients who developed fistula in Abuja previously did not know where to access care.
Shaibu said they were usually referred to Jos, Bauchi, Katsina and other centres.
In Sokoto State, the USAID-sponsored Momentum Safe Surgery in Family Planning and Obstetrics (MSSFPO) has also complemented government’s efforts to bring succour to victims of VVF.
So far, it has successfully repaired 57 Vesico Virgina Fistula (VVF) cases initially deemed irreparable.
MSSFPO Country Representative, Dr Kabiru Atta, disclosed the figure during the stakeholders’ meeting on the project sustainability and scaling up event on Thursday in Sokoto.
Atta said the project implemented by Engender Health, has achieved 85 per cent success on surgical obsectric care, enhancing healthcare workers skills and Female Gentile Mutilation (FGM).
He said that other areas comprised VVF prevention, treatment and care for fistula patients through clinical capacity buildings.
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He explained that the project which, started in 2022, also work with partners to strengthen health system and expand access to contraceptive choices to all clients in Nigeria.
As the fight against VVF gathers momentum in Nigeria, observers say it is important governments at all level, civil society organisations and development partners continue to collaborate.
This is one task that should not be left in the hands one entity. Not should be spared in bridging the treatment, care and support gaps for VVF victims.
