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Health expert attributes obstetrics fistula problem to poverty

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By Ruth Oginyi

The medical director of National Obstetrics Fistula Centre, (NOFIC), Abakaliki, Ebonyi state, Dr Johnson Obunna, on Monday, said that ignorance, poverty, poor health-seeking behaviour and refusal to go for a caesarean section when circumstances call for it during labour are major causes of fistula problem. He expressed regrets that, for every one fistula case,15 women had died.

Obunna stated this during advocacy, sensitisation and case identification activities for journalists in Ebonyi state. The activity had been organised by the fistula centre in collaboration with a consulting firm with the aim of arming journalists in the state with information about the dangers of vesicovaginal fistula, VVF, so that they will enlighten the public properly through their media channels.

The director urged women to make sure they delivered in standard hospitals whenever they were pregnant.

He said that “the disease is more associated with the poor, though we have got some cases where even the educated ones have a fistula; it’s poor. And we have kept quiet about it and that is why the federal government engaged a consultant to make noise about it, and the best people to create awareness about it are the journalists.

“The society has to be enlightened so that more women will avoid fistula. We sent a publication to the US and England on fistula. They turned it down because they don’t understand what we’re talking about. They were saying how can this kind of thing happen to a country. You go to medical textbooks except those written by indigenous people, you won’t see fistula in the content. They have forgotten what it was.

“A woman can go for a delivery, the baby dies and there is a disruption of the intact bladder and the rectum and now there is a connection between the bladder and the vagina and connection between the rectum and the vagina, thereby causing urine and faeces to be passing through the vagina. When this happens, the man abandons the wife because that has distorted one of the reasons he married the woman.”

He stated that NOFIC was running maternal services to help women manage their delivery to avoid VVF.

Obunna said that fistula patients who had been repaired in the centre would receive maternal services free of charge, including child delivery, while those who have no recorded case of fistula are allowed to access maternal services at a very cheap rate.

“We did small research work. We went around the facilities in Ebonyi to know how they charge to deliver and we made our own the least for those who don’t have fistula.

“I can assure you delivery here is the cheapest in the whole of Ebonyi state. By April the centre will be commissioned. We discovered that if a tap keeps on running and you do not close it, the tap will keep on running. That is why we said let’s start maternity services that will help these women to access free maternity services, including care for their newborn”, he added.

The director, training, research, and mobilisation in the hospital, Prof. Henry Urochukwu, appealed to media houses to enlighten the public on fistula instead of encouraging quackery and the consumption of unrefined products, that do not have a dosage, indication, and damages the human system, adding that the media was the conscience of every society.

He was optimistic that if journalists played their role in enlightening the people, by giving them the right information, the problem would be half solved.

“So many people have died after consuming these unrefined products; so many have caused themselves several damages; so many women can no longer deliver because, out of desperation, they have to take these concoctions,” he noted.

Urochukwu said the centre also screens for cervical and breast cancer, stating that the government should vaccinate women at the age of 15 against human papillomavirus.

He said the sexually transmitted disease can be in a woman’s body for 30 years with the carrier knowing, advising women who are sexually active to go for screening to detect and start managing it on time.

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