Expert attributes VVF rate to poverty, early pregnancies
Expert attributes VVF rate to poverty, early pregnancies
By Blessing Odega
Fistula
Jos, June1, 2018 (NAN) Dr Sunday Lengmang, the Project Director, Evangel VVF Centre (EVVF), Bingham University Teaching Hospital, Jos, has identified poverty and prolonged obstructed labour as the common causes of Vesico Vaginal Fistula (VVF).
Lengmang, a consultant family physician, fistula trainer and surgeon, also attributed VVF to adolescent pregnancies.
He disclosed that the centre had conducted 452 surgeries (repairs), including VVF (an obstruction between the bladder and vagina which causes the patient to leak urine uncontrollably) and Recto-Vaginal Fistula (RVF – in which the patient leaks excreta).
The expert however said that some victims suffered from both the VVF and RVF in some cases, and constructive surgeries were carried out on them.
According to him the centre is handling cases tagged as “Fistula Deemed Inoperable” or “Irreparable cases” by the transplantation of both of the ureters into the pelvic colon.
Lengmang explained that in this case the patient after the surgery now passes both urine and excreta from the anus,
He disclosed that two of such patients who had their cases considered irreparable were repaired and they are living their normal lives and serving as workers of the centre and the hospital.
The director further disclosed that the centre had carried out 216 constructive repairs and surgeries at no cost to patients from January 2018 till date.
According to him, the EVFC perform surgeries free of charge and offers physiotherapy, psychological counselling, health and nutrition classes, and a post-surgery skills acquisition programme to the victims.
Besides, Lengmang said the centre also carries out extensive community outreach and patient screening, identification and offer training opportunities for healthcare providers and surgeons from across the globe.
“The centre trains community health workers, nurses and doctors especially those in the rural areas on how to use a pathograph (instrument use in monitoring labour) from the time the victim arrives to see how opened her cervix and check the foetal heart beat to determine if the labour is heading towards an obstructed one to reduce cases of fistula.
He said that the centre also provides free caesarean section for all patients who have had repair surgeries at no cost since they can’t have vaginal births to avoid the re-occurrence of the fistula.
In addition, Lengmang said victims and their spouses enjoy counselling services to encourage them and discourage divorce, rejection by relatives and social stigma as it can be repaired.
“We let the patients who have had their repair surgeries and are now dry and awaiting to be discharged share their own stories with the new patients and their spouses and relatives to let them know that what they are currently encountering can be handled and it is not peculiar to them alone,’’ he said.
The consultant said that the patients while awaiting surgeries and after surgeries are given talks on the causes fistula, how it can be prevented and on ways to prevent re-occurrence.
According to him, the EVVF centre has adopted a three-phase strategy of treatment, rehabilitation and reintegration of VVF patients.
The centre is also training the victims to acquire various skills such as tailoring, knitting, bead making and baking to enable them have relative economic independence.
However, the director said the centre is facing various challenges like shortage of human resources, funding and research.
“The centre has only four nurses and two surgeons; so there is a dearth of manpower,” he said.
He added that funding for rehabilitation has been a major challenge as most donors are more passionate about donating for the repair surgeries and for the women who have been repaired to give birth by Caesarean section to avoid a reoccurrence.
Lengmang commended the Fistula Foundation in the U.S. for picking the bills of the surgeries.
He therefore called the Federal Government and philanthropists to support the centre to provide more services, including research.
Some recovering victims at the centre told NAN that they were ready to reunite with their respective families after the corrective surgeries performed on them.
Mrs Ene Adah, a victim of VVF, who is currently recuperating after the corrective surgery and a mother of nine months baby, said she experienced prolonged labour that lasted for four days which led to her leakage and smell of urine.
She said prior to the incidence, she was a seamstress from Benue and her husband, friends and customers immediately abandoned her due to the stench of urine.
Adah, who is elated that she no longer leaks and has been dry after the corrective surgery, says she intends going back to her sewing business as soon as she is discharged.
But she appealed to her brother to get her a new shop so that she could get new set of customers who would in turn tell other people that she longer leaks or smells of urine.
Similarly, Mrs Amina Musa, another victim of VVF from Kano State, said the prolong labour she experienced had disfigured her permanently as her legs are curved.
She said that as soon as it occurred, her husband catered for her for a while, but he later divorced her when he noticed that her condition wasn’t getting any better.
According to her, an NGO, the Fistula Foundation in Nigeria, founded by Mr Musa Isa, picked her from the streets in Kano as a beggar and brought her to the EVVF.
She said the successful surgeries had stopped her leakage of urine and stool.
Musa said that the NGO has assured her of counselling and a milling start-up grant as soon as she recuperated, to enable her live a normal life. (NAN)
UBO/MST
Edited by Muhammad Suleiman Tola