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.’’