Fighting obstetric fistula in Nigerian women

This was disclosed when northern women converged in Kaduna on May 19, 2014 to commemorate the inaugural international day to end obstetric fistula in Nigeria organised by the office of the first lady of Kaduna State in collaboration with United Nations Population Fund (UNFPA). At the event, which brought together wives of the northern states […]

This was disclosed when northern women converged in Kaduna on May 19, 2014 to commemorate the inaugural international day to end obstetric fistula in Nigeria organised by the office of the first lady of Kaduna State in collaboration with United Nations Population Fund (UNFPA).
At the event, which brought together wives of the northern states governors, health experts, government officials, mothers and victims of obstetric fistula among others; the representative of United Nations Population Fund (UNFPA) in Nigeria, Ms. Ratidzai Ndhlovu stated that obstetric fistula represents the face of the global community’s failure to protect the sexual and reproduction health and rights of women and girls as well as failure to achieve equitable access to comprehensive sexual and reproductive health services.
Obstetric fistula or vaginal fistula according to web definition is a medical condition in which a fistula (hole) develops between either the rectum and vagina or between the bladder and vagina after severe or failed childbirth, when adequate medical care is not available. It is considered a disease of poverty because of its tendency to occur in women in poor countries who do not have health resources comparable to developed nations.
According to Ndhlovu, fistula thrives among the poorest of the poor and among women and girls who are often uneducated and have limited access to health services including maternal and family planning. The consequences of fistula she stated are devastating as they leave those affected ashamed, ostracised and in many cases alone, which further deepens their poverty and magnifies their suffering.
Speaking further, she disclosed that with support from UNFPA, 47,000 women and girls have undergone fistula repair surgery; adding that partner organisations have provided treatment to many more women and girls living with fistula. She also mentioned that stigmatization has forced many women with this condition to remain hidden.
She said far more support and momentum are needed to enable the campaign to expand its reach to all corners of the world where women suffering from fistula remain isolated and often unaware that treatment is possible and available; she urged all stakeholders to move beyond an emotional response to a point of actions that will over time eliminate obstetric fistula in Nigeria.
She therefore called on both federal and state government, non-governmental organisations, United Nations and development organisations to action in four areas including prevention, treatment and care, social re-integration and resource mobilisation.
Some victims of obstetric fistula the Home Front spoke to at the event said it is really devastating.They also decried stigmatisation by friends, family members and the society at large as a result of the sickness.
They therefore advised women to religiously attend ante-natal care when they are pregnant and go to health facilities for delivery so that complications that may arise before, during and after delivery can be handled professionally.
The wife of Kaduna State Governor, Hajiya Fatima Ramalan Yero urged VVF centres across the country to continue to perform routine repairs at a large scale to help rehabilitate the affected women and girls. “We want a situation whereby a year from now, we would have collectively repaired over 5,000 women and restored their dignity,” she said.  
Earlier, during a breakfast meeting with the wives of the 19 northern states governors, Hajiya Yero urged them to reach a consensus and draw up a regional strategic plan with concrete actions on how to mobilize resources to prevent obstetric fistula, treat the thousands of survivors and rehabilitate and integrate them into the society.
In the same vein, experts and development partners  called for prompt actions to end obstetric fistula through provision of quality maternal health care and accountability mechanisms.
A  release issued by Development Communication (DEVCOM) described obstetric fistula as 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 called fistula that renders her incontinent.
This condition the statement said harms women physically, socially and economically, and often leads to isolation from families and communities, thereby deepening their poverty and worsening their sufferings.
Also, a Gynaecologist and technical adviser at Development Communications (DevComs) Network, Dr. Olalekan Olaniyan attributed the causes of obstetric fistula to early marriage, illiteracy, ignorance and poverty.
To him, poor health-seeking behaviour, delays in using health facilities, delays in reaching health facilities, poor health infrastructure for caesarean delivery when needed make the risk of obstetric fistula greater.
He therefore called on government to improve health systems and social infrastructures in order to provide prompt caesarean session for women going through prolonged and obstructed labour. He also advocated for alleviation of poverty, illiteracy and end of harmful traditional practices.
According to World Health Organisation (WHO), about  2million young women live with untreated obstetric fistula in Asia and sub-Saharan Africa.
However, obstetric fistula according to WHO is preventable and can be avoided by delaying the age of first pregnancy; ending harmful traditional practices; and timely access to obstetric care; noting that preventing and managing obstetric fistula contribute to the Millennium Development Goal 5 of improving maternal health.
Furthermore, the United Nation’s Secretary-General, Ban Ki-moon in his statement to mark the International Day to end obstetric fistula stressed the need to raise awareness on the condition saying it is not well understood even in societies where it is prevalent.
Meanwhile, the Executive Director of UNFPA, Dr. Babatunde Oshotimehin in his statement said that about 20,000 girls below age 18 give birth in developing countries daily and nine in 10 of these births occur within marriage or union.
Nigeria according to him is one of such countries where child marriage and harmful traditional practices are common. While percentage of births delivered in health facility is 35.8% according to Nigeria Demographic and Health Survey (NDHS) preliminary report, 2013; over 64% of births take place at home and other places due to several factors including; inability to afford health services, distance to health facility and attitude of health workers among others.
The UNFPA however recommended universal access to reproductive health services, including maternal health care and fistula treatment; adding that gender-based social and economic in-equities must be eliminated, early child bearing discouraged, education and human rights promoted and community participation fostered to bring an end to vaginal fistula.