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Nigeria records new obstetrics fistula cases

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By Abiodun Okunloye

12,000 women suffer from fistula due to childbirth complications yearly.

At the commemorative event of International Day to End Obstetrics Fistula, which was organized by the Medical Women Association of Nigeria (MWAN)-Kwara Chapter to educate the general public about the risks associated with obstetric fistula for women. Dr. Shukura Okesina, a Nigerian Consultant Obstetrician as well as Surgeon at the Aishah Buhari Mother and Child Hospital in Eiyekonrin, Kwara State, North Central Nigeria, when speaking to the media revealed that Nigeria accounts for 12,000 new instances every year.

Speaking on the theme: “20 Years on-Progress but Not Enough! Act Now to End Fistula by 2030”, she remarked that the day was significant because it brought attention to and support for women and girls impacted by obstetric fistula. She estimates globally that between 50,000 and 100,000 women are affected by obstetric setbacks each year. According to her, Nigeria bears 40 percent of the impact, recording 12,000 new cases each year; approximately 150,000 to 800,000 women in the country suffer from this, thus creating a challenge for the country.

Lack of emergency obstetric treatment gives it high prevalence.

Dr. Okesina said that obstetric complications are among the most significant and devastating childbirth injuries. She emphasized that it is a hole within the birth canal and the bladder and/or rectum and that it is brought on by delayed labour obstruction in which the labouring woman does not have access to early, high-quality medical treatment. The prevalence is greatest in the country’s northern regions due to the lack of emergency obstetric treatment as the root cause and long-term obstructed labour.

The Consultant listed a number of characteristics that increase the likelihood of complications during childbirth, such as poverty, poor diet, lack of education, lack of health care access, absence of antenatal care, and refusal or delivery delay by medical professionals. However, she added that corrective procedures are typically performed three months after the injury if the woman has tried catheter care for four weeks; however, it continues to leak urine uncontrollably from the vagina or leaks faeces.

Condition is a birth injury and is not contagious.

Furthermore, she noted that the condition is not spreadable because it results from a birth injury, the bladder/urethra being compressed from in front, and the rectum/anus being compressed from behind, caused by the position of the foetal head. According to her, this causes pressure necrosis, which results in the formation of a hole in the vagina through which urine or faeces can escape. She advises that those with fistula should not be stigmatized and emphasizes the importance of showing understanding and compassion to them.

Having lost babies and husbands, these women often find themselves rejected by their own families and communities. She added that they are economically disadvantaged and unable to find assistance. Dr. Okesina said that fistula surgeons and Uro-gynecologists are available at specialist hospitals across the country and that the first repair has a 97-100% success rate if performed by trained professionals. She also mentioned that the Aisha Buhari Mother and child hospital in Eiyekonrin and the University of Ilorin Teaching Hospital (UITH) have fistula clinics and repair units.

Public awareness and education for young girls is crucial.

Lastly, Dr. Misturah Adana, who is the Secretary of MWAN-Kwara, during the ceremony emphasized the significance of taking preventative steps to avoid developing fistula. She advocated for legislation that would address harmful cultural behaviors, public awareness campaigns, neighbourhood access to obstetric care, and education for young girls. Dr. Adana stressed the significance of taking into account a number of factors, including the age at which a girl experiences her first pregnancy, in order to bring down the prevalence of genital fistula.

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