Confronting the scourge of fistula

By Saidu Idris

365Daily – The pathetic issue of women living with obstetric fistula and its complications came to the fore again in Abuja, at the launch of the Momentum Safe Surgeries in Family Planning and Obstetrics Activity.

According to the Ambassador of the United States of America to Nigeria, Mary Beth Leonard, who delivered the keynote address at the event that took place on Monday, June 28, 2021, at Transcorp Hotel, Abuja, “Nigeria has the single largest burden of fistula globally, accounting for 40 percent of cases worldwide.”

She noted that while the condition is surgically treatable, “more than one hundred and fifty thousand (150,000) Nigerian women languish on waiting lists for the procedure, and an estimated 12,000 new cases arise annually.

“These women and girls of childbearing age are amongst the most vulnerable Nigerians. They are often unable to live a dignified, rewarding life due to this debilitating and stigmatising health condition.”

Ambassador Leonard disclosed that
the United States has been pivotal in partnering with the Government of Nigeria in improving primary health care, adding that USAID supports primary health care through more than 1,500 hospitals, public and private primary health care centres, and patent medicine vendors in five states and at the national level.

“This new $10 million activity builds on the gains of the previous USAID funded fistula interventions in Nigeria, which conducted over 18,400 fistula surgical repairs and about 800 non-surgical repairs in 14 fistula centres in 13 states.

“The previous USAID Fistula Care Plus activity also trained more than 50 surgeons in fistula repair, and 2,700 other healthcare workers in fistula prevention and treatment.

“Equally important, those activities supported nearly 1.2 million birth spacing counseling sessions, while building strong partnerships with the federal and state ministries of Health and Women Affairs, leading to the development of a National Strategic Framework on the Elimination of Fistula in 2019.

“USAID also supports communities, states, and federal institutions to prevent and respond to the drivers and root causes of obstetric fistula – namely early and forced marriages, and other forms of gender-based violence.

“These activities crucially involve religious and traditional leaders to evolve social norms away from antiquated and dangerous practices regarding women and girls.”

She expressed confidence that the United States’ assistance will help Nigeria’s health care providers, professional bodies, and communities to identify, manage, and prevent obstetric fistula, female genital mutilation, and other forms of gender-based violence in a complimentary manner.

Leonard continued: “Healthcare and community workers in the field must not only be well equipped to treat and manage fistula clinically, but they must also work as agents for the prevention of future cases and the reintegration of survivors into society.

“To that end, the Momentum activity will work closely with the Ministry of Women’s Affairs to link mothers who have undergone fistula repair to Ministry-led rehabilitative, empowerment and reintegration services in their respective communities,” the US Ambassador said.

Traci Baird of EngenderHealth, who joined the event virtually, said “EngenderHealth envisions a gender-equal world where all people achieve their sexual and reproductive health and rights.

Baird added that to achieve this vision, EngenderHealth implements high-quality, gender-equitable programmes that advance sexual and reproductive health and rights.

“EngenderHealth’s work on female genital fistula prevention and treatment embodies our organisation’s mission. Treating fistula requires the attention and expertise of fistula surgeons and other clinical partners. But, ending fistula also requires that we give equal or even more attention to prevention.

“This includes access to quality maternal health services, especially emergency obstetric care and safe cesarean section. And, of course, this includes advocating for and building policies and programs so that women and girls meet their full potential, including promoting girls’ education and ending practices such as child marriage and female genital cutting.

“Engender Health is committed to working with the Federal and State governments of Nigeria, along with many local partners, to advance the goals of the MOMENTUM Safe Surgery in Family Planning and Obstetrics project,” Baird stated.

In her remarks, the Minister of Women Affairs, Dame Pauline Tallen, lamented the high rate of fistula cases in Nigeria, describing it as “unacceptable”.

She disclosed that she was moved to tears when she visited the National Fistula Hospital in Abakiliki, Ebonyi State capital, recently.

According to her, “Nigeria is among the nations with the highest incidents of fistula in the world is not acceptable at all. This confirms that we have a huge task ahead of all of us, so we invite all hands to be on deck to support the government’s efforts at the elimination of Fistula in the country.

The Minister commended the wife of the Governor of Kebbi State, Dr. Zainab Shinkarfi Bagudu, for her laudable commitment to the health and good of women.

Dr Bagudu, in her remarks entitled ‘Child and Early Forced Married (CEFM) and Fistula’, advocated for laws and policies to keep the girl child alive by ensuring they have access to quality healthcare services, adding that this programme would “help us build on the gains we recorded with the support of the Fistula project in our state.

“We will similarly work closely and firmly with this new project to achieve the best for our women.”

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