24 January 2013

Nigeria: Katsina - Providing Succour to VVF Patients

One of the major public health problems bedevilling Nigeria, like most other developing countries is Vesico Vaginal Fistula (VVF) where it is estimated that between 400,000 and 800,000 women are living with the scourge. It is widely believed that about 20,000 women more develop the problem every year.

As a demonstration of commitment to provide treatment for women suffering from VVF, the Katsina state government recently established the Babbar Ruga VVF centre, which has been providing treatment to patients drawn mostly from states in the North West and the neighbouring Niger Republic.

Only recently, the Katsina state government, in collaboration with the state office of the Millennium Development Goals (MDGs), provided empowerment support to about one hundred women who were treated of VVF at the Babbar Ruga center in Batagarawa Local government area of the state.

Some of the items distributed with the support of a non-governmental organization tagged 'Service to Humanity', include 50 sewing machines, 50 grinding machines, 25 knitting machines. In addition to cash donations ranging from N10, 000 to N50,000 benefitting about 50 VVF treated patients from the state, with others from Jigawa, Borno and Niger Republic.

At the Babbar Ruga, Katsina VVF centre, patients receive skills acquisition training after their treatment, and supported further with empowerment incentives like machines and startup capital as is usually offered at the end of successful treatment and graduation.

VVF which has continued to pose serious reproductive health problems for women in the country resulting from obstruction during child birth, often causes tissue damage and continuous leakage of faeces or urine and in some cases, both.

Women who suffer from this problem have in most instances, faced social isolation as a result of the offensive odour occasioned by the continuous leakage of urine and or faeces or both.

As with most health and social indicators, Nigeria's ranking of the global fistula prevalence is worrisome because the nation accounts for 40% of the world wide prevalence with approximately 20,000 new cases occurring each year.

Little wonder in Nigeria, findings revealed that the VVF burden is mostly affecting the poor, illiterate and young women who live in rural areas, with little or no access to information and health care services, and this situation is identified as a major factor that contributes to the rising incidence of VVF.

Contrary to the erroneous believe that early marriage was responsible for the problem of VVF, health experts say the inability of pregnant women to attend ante-natal remained the major contributory factor.

The VVF Desk Officer at the Federal Minstry of Health, Dr Dogara Okara, disclosed during a recent workshop on the dissemination of national strategic framework for elimination of fistula in Nigeria, that before the end of June this year, FG will take over the Babbar Ruga Katsina VVF centre and upgrade it to an international fistula research centre.

He disclosed that there are not fewer than 12 dedicated centres offering VVF services in Nigeria out of which the Katsina VVF centre has the highest number of patients with about 70% of total surgery being conducted by one Dr Kees, a Holland national.

Speaking at the workshop with participants drawn from the seven North-West states in the country, supported by the USAID Fistula Care Project, primarily aimed at discussing ways to improve maternal health through elimination of fistula, Okara said the FG was determined to address the challenge of VVF, "Beyond mere focusing on repairs and rehabilitation of VVF patients,' explaining that efforts are being made on total prevention through ensuring that pregnant women attend clinic for ante-natal care."

The Katsina state first lady, Fatima Ibrahim Shema who reaffirmed the commitment of her NGO to support VVF patients in the state and beyond, disclosed that her NGO has already constructed and equipped a theatre to ease operation of VVF patients.

As the Katsina state first lady rightly observed during a speech to mark the presentation of economic empowerment incentives to some treated VVF patients, 'what is required is the collaborative efforts of all and sundry,' she said.

While reaffirming the commitment of her nongovernmental organization - Service to Humanity - to provide providing support services to victims of VVF as well as championing the cause of eliminating the problem, Mrs Shema said, "there is the need, now more than ever before, for all and sundry to join in the fight to eradicate the scourge of VVF in the state."

To demonstrate its commitment, the federal government introduced a national strategic framework for the eradication of fistula in the country. According to a policy document, the framework which was developed in 2002, was in appreciation of the fact that fistula efforts should not be addressed in isolation, but as part of an overall effort to improve reproductive health in the country.

Interestingly, there are numerous policies both directly and indirectly relating to obstetric fistula in Nigeria, among which are: the behavior change communication strategy for the national reproductive health policy and framework, national planning/reproductive health policy service protocols, national human resource for health policy and road map for accelerating the attainment of the MDG's related to maternal and new born child health. What still remains shaky is the dutiful implementation of this, among other numerous such policies.

Indeed, the prevention of VVF depends mainly on knowledge, participation and quality health services. The numerous rural women and some urban poor who still lack adequate knowledge about the problem, need nothing short of sensitization just as government at all levels, must be taken to task on the need to provide functional healthcare services in every nook and cranny of the country.

For those who have been unfortunate enough to have the VVF problem, emphasis needs to be intensified to ensure their rehabilitation and reintegration into the society.

It is in this regards that the Katsina State initiative needs further commendation.

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