From Dr. Femi Daniyan 94 set
Good Day, distinguished ladies and gentleman,
Thanks for the opportunity, To talk about health issues......
I'll be talking about something I'm passionate about -
Obstetric Fistula (OF).
And I urge you all to kindly share in that passion.
OF = Obstetric Fistula...
OF is one of the most serious health problems in the developing world today.
It's not just a medical problem but also a social problem.
It directly affects women, but in the bigger picture, it's a problem of everyone, both male and female.Actually it's no longer seen in the developing world.

So what's OF?

OF is a hole in the vaginal causing continuous leaking of urine or faeces or both following childbirth.
It's primarily a problem of women in the childbearing age but some women continue leaking till old age if nothing is done.
Affected women suffer a lot of shame from the odour of uncontrolled urine and/or faeces.
It's a problem for the entire family and a lot of men have absconded from such marriages, And many of the women have committed suicide.
It's one o af the most devastating health conditions known to mankind.
Sadly in the 21st century, it's a reality, unknown to many of us.

So why talk about OF?

The whole world has now realized that OF is a form of injustice against the women folk especially those who sustain injuries in the course of executing their divine mandate of procreation.
This is a form of sensitization so everyone can know about this problem and help those who are affected.
Currently there's a presidential mandate to eradicate this scourge from Nigeria.
Anyone who can assist to fish out all those affected is welcome on board this rescue mission because it's treatable.

How serious is OF?

It's a problem of the poorest of the poor, The sufferers are all over the place but we don't know because they've gone into hiding.Some liken it to conditions like leprosy etc.
It's a problem of the developing world, Especially common in Sub-Saharan Africa and South- East Asia.
Very common in Nigeria, Niger, Chad, Sudan, Ethiopia, Uganda, Ghana, DRC, Bangladesh.
There are currently over 500,000 such women in Nigeria.
Every year 12,000 new cases are seen in Nigeria. Cases are seen in every geo-political region and state of Nigeria.
Seen in the NE, NW, NC, SE, SS, SW.
The SW appears to be less hit compared with other regions Without being partisan, Ondo State is not as affected.
Courtesy Iroko's Abiye Programme.
I think I've seen only one woman with OF from Ondo State this year.
There are many of them from Lagos State.
Especially the Badagry axis.
In the Southern part of Nigeria, the SE and SS are hot spots.
The various IDP camps across the country are also hot spots.

What exactly is the cause?

OF is a problem of access to quality healhcare, Caused mainly by prolonged obstructed labour, ie difficult protracted labour.
Also by caesarean section done by quacks And wrong manipulations in labour.
Over 90% caused by prolonged obstructed labour, So we need to be careful of the places we take our love ones for care in pregnancy and labour.

How can we identify women with OF?

The hallmark is continuous leaking of urine or faeces, After delivery - either vaginal delivery or CS.
In many cases, the baby does not survive.

What is the treatment of OF?

Surgery......
Some women small fistulas however can be treated with catheter.
Yes surgery so they can live a normal life again.

How can we eradicate OF?

We need to ensure the people already affected have access to surgery.
The surgery is free courtesy the FGN.
Also medications, lab tests and feeding- all free.
it's been there since but some lady Some have been told it's incurable, And some were told it's punishment for witchcraft etc.

There are 3 National Centres - Abakaliki (Ebonyi State), Katsina (Katrina State) and Ningi (Bauchi State) And other smaller centres across the country.
None in South West or North Central? As in National Centres.
But But there are other smaller centres or faith-based centres, For instance Adeoyo in Ibadan, ECWA in Jos, etc
And.... Secondly, we need to ensure we don't have fresh cases of OF.
That means quality ante natal care and care in labour. And timely caesarean sections when indicated.
It is 1million times better to have a CS than to have a fistula.
Let's tell our women and save our sisters from this scourge.
Thirdly, education and women emancipation.
And This is where our brethren in the North have a lot of work to do.
Because when you educate a girl, you have educated the society.
And let's leave in peace so there won't be conflicts and there won't be need to keep girls and women in IDP camps because they may get pregnant and they will have to deliver.
I think I should stop here...
Thanks for giving the opportunity to share my thoughts.

How does this affect Men.?

It's a big cross for men to carry. Many husbands have fled such marriages leaving the women abandoned, And after repair, there may be difficulty getting pregnant.
They' re very different. Obstetric fistups is a hole between the vagina and the bladder or rectum. Anal fistula is a hole between the anus and the exterior.
The pains, anguish and stigma of VVF is a lot more than the stress of CS.
Fistula or VVF can indeed result from different kinds of surgery. But I decided to restrict the discussion to the ones following childbirth. These are the ones we describe as obstetric fistula. ie the ones associated with childbirth which is where the real problem is. lace racer back homecoming garments of chiffon in short length