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VVF: Learning to manage a serious social calamity

 

 Medical experts say Vesicovaginal fistula (VVF) is a subtype of female urogenital fistula (UGF).

Matron and social health worker, Vivian Aderanti revealed that “VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault

“VVF is one of the maternal health problems confronting public health workers in Nigeria today,” she said.

It was also revealed that one of the leading causes of VVF is prolonged and obstructed labour, especially with young adults.

Other predisposing factors include young maternal age (that is: the physical immaturity of the mother’s body leading to cephalopelvic disproportion and this occurs when a baby’s head or body is too large to fit through the mother’s pelvis). It was also disclosed that traditional practices such as female circumcision also predisposes women to VVF.

However, a United Nations Population Fund (UNFPA) report indicates that more than 800,000 women in Nigeria are suffering from VVF.

The Fund emphasises that as alarming as the figure is, 20,000 women are estimated to be added to this number every year.

According to UNFPA, VVF is not only a medical disorder; it is also a serious social calamity.

 “It reflects the state of a health system failing to meet the basic needs of a growing population,” it says.

The Country Representative of UNFPA, Ms Ratidzai Ndhlovu, noted that teenage pregnancy was also a direct cause of VVF in Nigeria.

She said that most young girls engaged in sexual activities and child bearing at an early age, thereby leading to the condition.

“Looking at statistics of fistula in this country, we have a lot of young girls getting pregnant at a very tender age, which has caused Nigeria to have the highest burden of fistula.

“We also need family planning to curtail unwanted pregnancies.

“Fistula is killing so many women in the country, our wives and children are dying every day and motherhood is important to every family,’’ she said.

However, Ndhlovu advised men who are married to teenage spouses to ensure that their young wives were fully matured and educated to withstand pregnancy and complications that might arise during childbirth.

“I would like a situation where, even when the men marry 16-year-old girls, they should ensure that their young wives go on with their education.

“They should also be matured enough before engaging in sexual activities so that they can handle pregnancy and childbirth to prevent fistula from occurring,’’ she said.

Ndhlovu further said that fistula was a curable and preventable condition.

It would be recalled that UNFPA successfully rehabilitated more than 100 women living with obstetric Fistula in Sokoto and donated assorted empowerment materials worth N2.3 million to them recently.

 

The Fund noted that most women who developed VVF probably gave birth to children at home, with no skilled birth attendant present to assist..

“For this group of women every day, they must cope with the foul smell emanating from their leaking urine and faeces,’’ she said.

Ndhlovu lamented that most of the affected women often lose their babies during the childbearing process.

“Worse still, these women down with VVF are often abandoned by their husbands, stigmatised by their families and communities, and later ostracised,’’ she said.

Ndhlovu said that the beneficiaries of the UNFPA programme received a two-month training in sewing and knitting, petty trading and grinding machines’ operations, among others.

“This gesture is aimed at facilitating their reintegration process back into the society, while reducing their stigmatisation,’’ she said.

She however, said that the Fund would intensify its public awareness activities on fistula in the country.

“We are trying to make people to have a clear understanding of what fistula is and the causes of fistula so as to dispel a lot of misconception that surrounds it,’’ Ndhlovu said.

Also speaking, the Permanent Secretary, Sokoto State Ministry for Women and Children Affairs, Alhaji Suleiman Sarkin-Fulani, said that the Maryam Abacha Hospital, Sokoto, was well-equipped to care for V VF patients.

Nonetheless, he appealed to other donor agencies, partner organisations and affluent individuals to assist in treating and rehabilitating VVF patients.

In their contribution, the National Obstetric Fistula Centre in Katsina State claimed that it had so far treated over 40,000 VVF patients.

Dr Aliyu El-Ladan, the centre’s Chief Medical Director, said that the National Obstetric Fistula Centre, which was established by a German medical consultant in 1984, treated between 50 and 60 patients every month.

“We have three competent consultants that carry out operation on at least two or four VVF patients daily.

“Our centre is well-known for its standard services in the area of medical operations for the VVF patients,” he said.

Besides, El-Ladan said that the centre had a standard rehabilitation unit, where patients were trained on how to become self-reliant after their therapy.

“After treatment, the patients undergo different skills acquisition training to become self-reliant.

“We train them in knitting, soap and pomade making, baking and beads making to enable them to earn a living after discharge,’’ he added.

In all, health experts underscore the need for the government to initiate pragmatic measures to address all the factors leading to the rising cases of VVF in the country.

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