Engender Health/USAID Repairs 400 Fistula Patients In Cross River

About four-hundred women and girls in Cross River State have received orrective surgeries and treatments for obstetric fistula under the USAID-funded Fistula Care Plus project which is being implemented in Nigeria by Engender Health.

An obstetric fistula popularly known as VVF 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.

Iyeme Efem, Engender Health Nigeria Country Project Manager told legislators in Calabar yesterday that women who experience this preventable condition suffer constant urinary incontinence which often leads to social isolation, skin infections, kidney and bladder disorders and even death if left untreated.

The Engender Health Nigeria team had paid an advocacy visit to the Cross River State House of Assembly in Calabar to seek the lawmakers support for Fistula prevention and treatment activities in the state through policy and budgetary interventions.

“We have able been carry out about 400 successful repairs since 2011 till date and the clients come from all the 18 local government areas of the state. “

Efem noted that the 30-bed capacity fistula clinic in Ogoja is very small as the number of patients who visit the centre during every singular pull effort overstretches the facility with some patients not having a bed space.

“The fact that fistula occurs is a clear indication that we have a very poor health system. Fistula occurring in any country is an indictment of the health system of that country,” Efem said.

He noted that site on which United States’ most expensive hotel, Waldorf Astoria in New York was built was the last fistula centre in the U.S in 1895. But thanks to the widespread availability of
emergency obstetric care and interventions such as C-sections, fistula is now rare in developed nations but remains a problem of poverty.

“Maybe one day, we will have the Fistula Centre in Ogoja as the most expensive research centre in the world,” he said.

According to the World Health Organisation (WHO), there are over two million people living with fistula globally and between 50, 000 to 100, 000 women develop the condition every year.

Efem said that in Nigeria “About 100,000 to 150,000 have fistula presently with 12, 000 new cases occurring every year.”

“No matter how much we try, we can only repair 5, 000 which mean that 7, 000 cases keep adding to the backlog. It’s as if we have a bucket filled with water and the tap still running and someone is given a teaspoon to empty,” he said.

Responding, the Chairman, House Committee on Health and Member
representing Bakassi State Constituency, Dr Ekpo Ekpo Bassey, assured on the committee’s readiness to come up with laws and budget proposals which will support fistula prevention activities in the state.

He said “It occurs in the population of those teenage pregnant women. I didn’t expect Cross River to have such a high number of fistula incidences because here, we are not like the Northerners that marry very young girls and when such a child gets pregnant, the body is not well developed to stand that delivery process and the baby’s head naturally will be bigger than the pelvic space. So there is going to be that obstruction and blood supply will be compromised which can lead to the death of that tissue and eventual fistula.”

“Also activities by fake baby birth organisations that make our women not to attend antenatal services but are encouraged to deliver in churches. When they do that and there are complications that would require surgical intervention by the caesarean section, they will still manage that and this will prolong the already bad situation. Because of this reason, Cross River State will have cases of fistulas,” he added.

Dr Bassey advised that obstetric fistula can largely be avoided by delaying the age of first pregnancy, by the cessation of harmful traditional practices and by timely access to quality obstetric care.

Medical experts say that obstetric fistula still exists because health care systems fail to provide accessible, quality maternal health care, including family planning, skilled care at birth, basic and comprehensive emergency obstetric care, and affordable treatment of fistula.

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