Gyang Bere, Jos
Women suffering from Vesico Vaginal Fistula (VVF) in Plateau State recently found succour courtesy of a medical outreach offering free surgery at Bingham University Teaching Hospital Shendam.
The treatment sponsored by CBM New Zealand, was executed in Shendam Local Government Area by Evangel Vesico Vaginal Fistula Center at the teaching hospital, in conjunction with Reproductive Trauma Eradication Center, Shendam and Wayep Family Specialist Hospital in Mabudi, Langtang South LGA.
The programme highlights the plight of women suffering from obstetric fistula, a birth complication usually caused by prolonged labour that results in abnormal opening coonnecting the vagina to another organ, leaving victims prone to incontinence (lack of voluntary control over urination or defecation.) Some of the women who spoke with Saturday Sun voiced a catalogue of woes and the succour they hope will come their way after the surgery.
A life of pain, stench and shame
One of the women, 28-year-old Shitnan Musa, developed the complication while giving birth to her first child in 2015. Married on May 15, 2014 at Kalon village, Shendam LGA, Shitnan, after a prolonged labour at home, was eventually taken to the hospital and for several hours was unable to deliver freely, leaving nurses no other option but to widen the birth passage to accommodate the child by using a razor to cut her vagina. She was able to deliver a baby girl few minutes later, but after the delivery, Shitnan felt an unusual pain in her vagina. Also, she found herself grappling with uncontrollable drops of urine. She managed the complication for a month before her husband started demanding for sex.
“The hospital tore my vagina before the baby came out after long labour and the bladder became weak. Since then, whenever I had sex with my husband, the place will pull apart and I’d be feeling pains. If I didn’t have sex, I’d not feel the pain, but with each sex, the hole would tear further and I’d be in severe pain,” she narrated and went on to state how her family life degenerated as a result: “Each time he asked me for sex, I told him the hole in my vagina was paining me, he’d beat me and force himself on me, and the hole would tear further.”
Through painful coitus, she conceived again and after nine months, was successfully delivered of their second child. Again, she went through hard labour and her condition worsened.
Unable to reconcile her dislike for sex with her husband’s insatiable demand, Shitnan eventually moved out of her marital home to live with her mother at Ungwa Zam. She was, however, dogged by the tragedy of losing her child and the indignity of her husband’s rejection of the child’s corpse for burial. At last, her husband decided to end their marriage, citing her refusal for sex.
This was formalized with a divorce letter served her by Ground I Area Court Shendam.
“I wasn’t the one who took him to court despite the pains I was passing through, I didn’t want the divorce,” she lamented.
Shitnan who had been living with urine leakage problem since their separation in 2018 was one of the beneficiaries of the free surgery. She hoped to bounce back to normal life soon.
Among the women also was 50-year-old Jumai Kop, from Longvail village in Qua’an Pan Local Government Area of Plateau State, who had been living with the condition for 20 years. Her vagina expanded during child birth which culminated in uncontrollable urination.
“What pained me was that, the child was stillborn,” she lamented. “I am still living with my husband, but we don’t sleep in the same room because of the stench from my body.”
Jumai, who had moved round from one hospital to another without finding a solution to her problem, claimed she had been traumatised by the way society responded to her health challenge.
“Nobody eat food from me again. I have lost all my friends. None of them want to associates with me,” she said.
Luckily, she heard about the programme and she had been one of those whose surgery was successfully completed.
Saturday Sun also spoke with 70-year-old Nanching Alex, who had the condition since her last pregnancy which ended in a stillbirth. Hers was a chronic case. She used to urinate uncontrollable. To worsen her situation, her husband, who had been supportive of her, took ill and died in 2005.
The aged woman complained of being “completely” isolated by the community, including some of her children, except the one who brought her to the VVF centre for the surgery.
“I have suffered humiliation, rejection and total discrimination,” she said, fighting back tears. “There was a time I wished myself dead. Nobody was willing to come close to me. I became afraid of going out because urine would be leaking uncontrollable. I thank God for sending these people to the village. Now, I can regain my dignity before I die,” she said.
More poignant stories came from the likes of 21-year-old Nancy Godwin, (impregnated by her boyfriend, she suffered a prolonged labour until the situation got out of hand and was taken to Shendam General Hospital where a dead foetus was evacuated from her womb in October 2019) and Nenyi Ali and Agnes Jacob, two women from Langtang South, both childless, both on the threshold of menopause.
Nancy ended her story on a sad note: “I urinated on my bed and the room smelt horribly. My boyfriend who promised to marry me after delivery rejected me.”
Nenyi and Agnes did not fare any better. They lived in the same house with their husbands but in different rooms because of the stench.
Nancy had lost count of the last time she had any sexual intimacy with her husband. Agnes on the other hand was unable to walk by herself because of pain. “My worst day was when I suffered urine leak at a public function. I was embarrassed, disgraced. Since then, my friends don’t go out with me again,” she recalled.
All three benefited from the free surgeries.
Cases of supportive husbands
While the programme was undoubtedly a women affair, a few men could be seen among the patients waiting for their diagnoses and treatments at the hospital. One of them, Samuel Ayuba, from Lafia, Nasarawa State, had followed his wife, Blessing, 23, to the VVF centre for the surgery, which he hoped would solve a predicament the couple had been battling with since 2018.
“Many people have advised me to abandon her but I refused because she got the health challenge in the process of giving birth to our child. I believe with the operation that is going on, she will bounce back to her normal life,” he said.
Another supportive husband, Nanmwa Lar, 23, from Langtang South, told Saturday Sun he was there to give his wife a moral support with a view to start life afresh after the surgery. Lar regretted that their child died at birth and vowed to continue to support his wife, Nan, 20, who developed the urine leakage after delivery.
He was optimistic the surgery will end the stinking smell he has perceived in the last one year. “This is the best Christmas gift I have ever received,” he said of the surgery that cost them nothing.
Project’s objectives
According to Dr Sunday Lengmang, the project director at Evangel Vesico Vaginal Fistula Center, 60 women are to be treated for obstetric fistula.
“So far, eight patients have been surgically operated in Shendam over two days,” he confirmed. “With 22 earlier operated in Gombe State, this brings the total to 30. Should another 30 patients be operated in Shendam, then the target of 60 women would have been realized.”
He further stated that 24 health care workers have been trained in Shendam in addition to 28 trained in Gombe, which bring the total to 52 trained out of a target of 60.
The primary objective of the outreach, according to Dr. Lengmang is to drastically reduce the number of women suffering from fistula in the country. A single surgery is what most of the women required, while some cases require more than one operation. The surgeries, he affirmed, will be performed at no cost to the women.
“The solution to the problem is to prevent early pregnancy, which has the tendency to lead to prolong labour. There is need to identify other risk pregnancies and refer them early enough to the hospital for experts to handle to avoid complications that can lead to fistula,” he counseled.
Harmful cultural practices such as female genital mutilation, use of family planning to reduce occurrences of unplanned pregnancies and discouraging birth at home, would reduce the instances of VVF to the barest minimum, he affirmed.