Rising cases of obstetric fistula

Written by the Editorial Board of The Guardian Newspaper

With the report that 12,000 new cases of obstetric fistula, a form of morbidity from pregnancy and childbirth, are now recorded among Nigerian women every year, an appropriate alarm has been sounded on a condition that needs not be added to the nation’s health-care challenges. With its most vulnerable group being the young, the poor, illiterate and rural women who are economically disadvantaged, it is important not only to urge immediate action and concerted effort against this needless suffering of Nigerian women, the message must be clear that failure to end all causes of obstetric fistula jeopardises a nation’s future and makes mockery of any claim to the citizen’s human dignity.

Sadly for the victims, with the agony of losing their babies often come the mockery of others, the rejection of friends and family and even stigmatisation by the society. Although, prolonged obstructed labour is the single most causal factor for obstetric fistula, there are other factors, like female genital mutilation (FGM), surgeries, girl-child marriage, among others. However, many communities, especially in the rural areas often associate the problem with witchcraft or other myths.

Experts say that the best way out of obstetric fistula is prevention, avoiding a child giving birth to a child, pregnant women attending regular antenatal care, hospital delivery, uptake of family planning methods, zero practise of FGM, good and proper nutrition during the upbringing of a female child as well as during pregnancy, and through awareness campaigns. However, if it occurs, it is treatable as about 5,000 cases are surgically repaired yearly in Nigeria, leaving a negative balance of 7,000 victims per year, who are either not aware that there exist surgical interventions that can correct the health issue or are unaware that there are centres for free treatment.

Notwithstanding, it is heart-warming that some states in northern Nigeria are collaborating with the United Nations Fund for Population Activities, UNFPA, in the campaign to end obstetric fistula and help prevent, treat, rehabilitate and reintegrate women and girls who have fallen victim. But these efforts would seem insufficient, hence the 12,000 cases still recorded yearly. Putting an end to obstetric fistula is, therefore, a priority and all stakeholders should intensify efforts towards its elimination within this generation by addressing the circumstances that perpetuate it, which include poverty, lack of access to health care, child marriage and early childbearing.

This calls for increased commitment on the part of government at all levels in promoting programmes that could prevent and reduce the needless suffering from obstetric fistula. Furthermore, though the Federal Government provides free surgeries for women living with fistula in the country, there remains apathy among the victims in coming forward for treatment, as majority of them are unaware that there exists cure for their ailments; hence the need for sensitising all and sundry that there exists free surgical treatment for the health condition. Therefore, the three tiers of government, organisations and communities should sensitise Nigerians on the need for females suffering from the health condition to come out and access free treatment.

Also, the community service programmes of the wives of public officials should turn their searchlights on obstetric fistula prevention, treatment and management by advocating, mobilizing support and expanding access to treatment. In addition, because information is quite important in this battle, the relevant ministries and agencies, the Federal Ministry of Health, Federal Ministry of Women Affairs, Federal Ministry of Information and Culture and the National Orientation Agency should embark on intensive campaigns, especially using radio and community mobilisation towards the prevention, treatment and management of obstetric fistula.

There is need for improved working relationship between the media and the health sector for increased and effective coverage of the condition. The media can help raise awareness and educate women and men on obstetric fistula. Educating men is critical because arguably, most men undermine the severity of maternal morbidity as some of them marry girl children, who when giving birth are most likely to be victims of obstetric fistula. Some do not give their wives the necessary support needed to attend ante-natal clinic (ANC). Once men understand the negative implications of girl-child marriage, a child giving birth to a child and women not attending (ANC), they will not only join but lead the campaign against such practices. The fight to stop mortality and morbidity from child birth must be a collective one.