Until last year, women in the old Ogoja province suffering from VVF could not access treatment within. But with the establishment of a VVF centre in the area, their dignity is being regained, writes JUDE OKWE to VVF Clients

They are all women fated by a peculiar health challenge - Vesico Vagina Fistula (VVF). For years they had lived with this disease with hope of any cure becoming forlorn. Like HIV/AIDS patients, life had no meaning again but unlike them they knew the infection was curable but could not access the relevant health institution within.

The story of VVF clients at the Ogoja General Hospital in Cross River State is that of sadness and joy, sadness while the condition lasted and joy after undergoing repairs. The centre was established last year by the United States Agency for International Development (USAID) under its Fistula Centre Programme but Engender Health, an international NGO is responsible for its management. The Ogoja centre is the ninth in Nigeria.

Women on the 30-bed space of the centre have varied accounts about their ailments just as VVF infection is varied too.

Here, stories bordering on divorce, rejection, isolation and stigma as a result of the infection are common. Some sufferers confessed to being sent packing by their spouses while others following discrimination became a recluse. But myth, misconception and witchcraft cannot be divorced from their tale of woes.

Vesico Vaginal Fistula according to medical expects is a condition that leaves a hole in the birth canal of a woman. For teenage girls, it is caused by narrow Pelvis which prevents a baby from coming out easily. But the women  who spoke to THISDAY recently at the Ogoja VVF Centre revealed three major causes: obstructed pregnancy, complicated caesarean section and incompetent abortion/surgery.

Miss Patricia Adie, 25, of Ukwel-Obudu, Obudu Local Government Area of Cross River State said she contacted VVF in 2004 from caesarean section (CS) complication. The surgery took place eight years at Ikom Local Government Area where she resides with the parents. But the boyfriend whom she simply identified as Santus has not rejected her.

“I was admitted here on May 11, 2012. I went through CS at a private clinic in Ikom but lost the baby girl. My elder brother, Mathias directed me to this centre on learning about it. He sponsored my treatment here. My boyfriend has not contributed to my treatment. He only call on phone from time to time.

“I’m feeling fine after the repair. I’m no more leaking. Though I managed to conceal this problem from people, I was not feeling comfortable inside me at that time. The secret was that I bathed regularly and used sanitary pad always hence I did not smell,” she said.

Having undergone repair, Patricia said the task before her now is to direct women with similar condition to the centre for cure. She does not want them to suffer in silence again. She was taken to the theatre on May 15, 2012 and spent only N5, 000 on food and other items. With her mother around to help prepare food, Patricia enjoyed the free treatment and is full of praises to God and USAID.

If Patricia was able to manage her condition, Mrs. Paulina Alulu, 59, was not. For the 10 years that she lived with VVF, Paulina was unable to walk about freely let alone go to farm. Her friends, siblings, husband and even children were no more comfortable with her. She felt depressed, dejected and rejected.

For the ten years, the Assemblies of God Mission Bebuabong, Obudu provided for her upkeep and drugs. But today she is a happy woman. After one month admission at the VVF Centre, her condition is gone for good. The same church sponsored her to the centre. Now that she is free, Paulina hopes to tell other women found in similar circumstance to go for free treatment at the centre holding tenaciously to their faith in God. Once she is discharged, the mother of five who contacted the infection through complicated surgery will organise a thanksgiving service at the church to thank God for healing her.

Other women at the centre that spoke to, THISDAY, said VVF for the period of infection, they suffered isolation, foul body odour, emotional pain and outright segregation. Some said they were waiting for death to do them part until USAID came to the rescue. All of them expressed gratitude to the agency, the Cross River State Government and Fistula Centre for opening the Ogoja Centre.

The Chief Nursing Officer, VVF Unit of the hospital, Agnes Polycarp advised pregnant women to  register in hospitals or health centres for safe delivery. She is convinced that non-antenatal registration and post natal check up contributes to the rampant cases of VVF in Northern Cross River and beyond.

Besides pregnancy, Mrs. Polycarp said in this 21st century, young girls and women should stop patronising quacks and traditional birth attendants as they contribute to their health hazards. Only qualified doctors and nurses should be consulted for medical help whenever the need arises.

She enumerated the challenges of the centre to include shortage of trained doctors and nurses on VVF, feeding of clients as some are abandoned by family members upon admission and transportation of those repaired home. Another challenge is inability to cope with the influx of those infected as the centre has only 30 beds and cannot admit above this number.

“We are mobilising women suffering from VVF to come for treatment which is free. We do this through radio and television announcement and jingles. We also make use of town criers in rural communities. So far the response has been wonderful. It has shown that this disease is also common in this part of the country”.

“We’ve not recorded any casualty since last year that this centre opened. We follow carefully all the stages involved in repair. After treatment, we also counsel the women. The state government has been helping with consumables, drugs etc. I was sponsored alongside five other nurses for training at the VVF Centre in Kebbi State”.

“In order to reduce pressure on facilities at the Ogoja VVF centre, I hereby call on government to establish another VVF centre in the sate preferably in the Southern Senatorial District. We are grateful to USAID for this centre as it has brought relief to women with this condition. Such repaired women are now free, interact freely with other people and are no more discriminated against”, she stated.

According to her, in order to prevent VVF, couples should take to family planning. They could use condoms or make love only when it is safe to do so. Couples including single ladies who are sexually active should know that witchcraft does not cause fistula as it is believed so, medical help should be sought only where the personnel are qualified”, she added.

The Deputy Country Project Director, Fistula Care Programme, Dr. Isa Adamu had told journalists during a workshop on reporting fistula that Nigeria has a backlog of over 250,000 cases of VVF with 12, 000 fresh cases added every year. Since 2007 that fistula centres of USAID opened in Nigeria, 7,000 cases have been repaired, he revealed.

He explained that “repair” as a parlance in this field refers to the stitching process of the surgery on clients (patients). Given the awareness about fistula treatment, Adamu revealed that with only 32 doctors nationwide trained on fistula, only 4, 000 cases are repaired in the country annually.

His boss, Chief Iyeme Efem disclosed that worldwide, Engender Health has so far supported the repair of 11, 000 women with Nigeria recording over 45 per cent of this number. He listed the challenges of the programme to include lack of fistula surgeons and getting government to release budgeted fund for the treatment. Nigerian doctors, he said, are coy about specialisation in fistula treatment as it is believed not to be lucrative.

For women in Ogoja and its environs with fistula, the era of hopelessness is gone for ever. None admitted at the centre has returned without being repaired. And paced by a smelling optimism that the greatest challenge of their lives is over, their health has turned decidedly upward. Life is once again lived on a roller coaster because their dignity has been restored