Rakiya A. Muhammad
6 July 2008
Sokoto — The fact that early marriage could be one of the factors that causes VVF has again been proven in the case of one Nafisa Abubakar from Daura in Shagari local government area of Sokoto state who developed Vesico Vaginal Fistula (VVF) after she was given out in marriage last year when she was 10 years old.
After few months Nafisatu, who is now 11 years developed VVF, a condition which occur in females when the urinary bladder leaks urine through the vagina uncontrollably with some notable causes to include prolonged labour, instrumentation and female genital mutilation
Nafisa's mother had died when she was still very young, while her father was alleged to have left home following some family problems. The little girl was therefore left under the care of her grandparents who gave her out in marriage when she was only 10 years.
Her problems started when after marriage she was discovered to have Vaginal Septum. Her husband informed her grandparents and she was taken to traditional healers. After the traditional treatment, her situation became worse as she was leaking urine and could not walk very well. Her grandmother said they did not take her to the hospital because they could not afford it.
Nafisa therefore remained in that condition for eight months until few weeks ago when she was discovered by the wife of the Deputy Governor of Sokoto state, Hajiya Kulu Shagari who immediately sponsored her trip from the village to the Sokoto for treatment. She was immediately operated upon at the Maryam Abacha Women and Children Hospital, VVF Centre.
Mrs.Shagari who is Initiator, Kulu Shagari Girl Child Initiative spoke about how she learnt about Nafisa.
"We heard about her from a Good Samaritan who informed us of her problem and we decided to go to the village and bring her. Fortunately for us she was operated upon a day after she arrived because of our support and assistance. We have members of the NGO who are already working at the hospital. So they brought her from the village on behalf of the NGO".
Dr.Abba Wali is the Chief Medical Director, Maryam Abacha Women and Children Hospital Sokoto who performed the operation on Nafisatu.
He comments, "Actually it is a special case because of her age, she is just a girl of 11 years. she came in with catheter, it was installed at the Usmanu Dan Fodio Teaching Hospital, then the patient was referred to us because she has complete obliterated urethra, so when she was brought here, we sent her to the theatre and we found out that she had no urethra, we performed the operation and it took about four and half hours to restore the Urethra. Thank God, the urethra is now functioning"He adds, "we have been preaching and calling on people not only here in the towns but also in the countryside, we do advocacy, we go round telling people that when they have such problems they should come to the hospital but still our people feel it is easier to go to a traditional barber when their vagina is obliterated and here in the hospital it does not cost you anything."
For Nafisa, Mrs. Shagari says her NGO will ensure she goes back to school when she completely recovers
"We want to take Nafisa back to school. She is still of school age, she is just 11 years old and it is not too late for her to go back to school. We have already informed the grand parents that after this she is not going back to the husband until she finishes school and we will take care of her schooling by the grace of God."
She states that the Girl Child Initiative would continue to create awareness on the female problems and lasting solutions to them.
Mrs Shagari notes that VVF is one of the consequences of early marriage as the pelvis is still small. She identifies poverty as one of the reasons for early marriage because parents/guardians of such girls cannot take their children to schools.
"So what we are trying to do is assist girls to be admitted in schools and help them financially to enable them remain in schools," the deputy governor's wife pledged.
The problem of VVF has continued to pose serious challenge to the society. Though the Sokoto state government has made treatment of VVF patients entirely free at the VVF centre; many people with the disease especially rural dwellers are yet to adequately take advantage of this. Many VVF sufferers live with the disease for years without treating it.
However, the CMD, Woman and Children Hospital, Dr. Wali says efforts are being made by the state government in ensuring that all VVF patients come to the hospital for treatment and that the state government gives them free feeding, free accommodation and free treatment no matter the costs. He reveals that the hospital receive enough allocation every month to take care of patients.
Dr. Wali acknowledges that there is a rise in the number of VVF patients coming to the hospital and that they come from Sokoto ,Kebbi, Zamfara and also the neighboring country, Niger republic, and that there is no discrimination in treatment.
"People now come to the hospital that is why there is increase in awareness; they are becoming aware that there is a hospital where they can be treated free. There are cases where you have a patient who has had VVF for more than 10 years, but she will tell you that she had just heard about the hospital.
Here we always have nothing less than 60 patients on the ground waiting for VVF repair at any time. We have these patients, even when we finish 60 today, you come back in the evening you get another 60, because this centre is very well known for its non discriminatory attitude, and we give them feeding and other things free."
Construction of additional wards for the hospital is in progress. According to the Medical Director when completed, there would be space for another 20 patients, adding "as at now the hospital has space for 30 patients, with the additional wards that will be about 50 patients at any time on admission. We will be able to discharge between 30 to 40 patients every two or three weeks, he said"
He disclosed that after treatment, the VVF patients are taught how to knit and each of them is given free knitting machine, which is also being taken care of by the state government.
Another thing being taken care of by the state government, Dr. Wali states is advocacy, with a lot of people being trained to reach out and tell people that there is VVF centre and that everything is being done free of charge.
Dr. Wali said the Acquire Project under the USAID is also giving assistance in all parts of VVF treatment and prevention.
What could be the greatest challenge in the effort to address the problem of VVF in the stat, Dr. Wali points out "the greatest challenge is to get the patient to come to the hospital. A lot of them in the rural areas still do not believe in the hospital, they prefer to go to traditional birth attendants especially those who are pregnant."
He notes that a number of the VVF patients who report to the hospital are not first delivery, but second or even third delivery patients.
"You see a lot of people do not go to hospital for the ante natal care, they start their labour at home, maybe they would have prolonged labour and this might be due to the weakness of the uterus. And may be she has delivered not once, not twice, so the uterus is weak. So you find out that most of them come with VVF."
Dr. Wali however noted that some of the rural dwellers have the constraints of finance which makes it difficult to come to the hospital and mentioned that they planned to write to the state government on this.
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