Experts raise concern over rising cases of VVF/RVF in A/Ibom

Reproductive health experts have expressed worry over the rising cases of Vesicovaginal fistula (VVF and Recto-vaginal fistula (RVF) in Akwa Ibom State, saying there has been no decline in the reported number of those coming down with the disease condition yearly since 2002 when repair surgeries began in the state.

The common causes according to experts are obstructed labour, early marriage, poverty and women’s limited control over the use of family resources, which oftentimes result in involuntary leaking of urine and faeces, a condition which ‘dehumanises those afflicted who are always abandoned by their husbands and isolated from the community.

According to Sylvia Ndubuaku, the coordinator of the Family Life Centre and the VVF hospital in Mbribit Itam in Uyo local government area of the state, run by the Medical Missionary of Mary of the Catholic Diocese of Uyo, the centre registered 145 cases in 2021 with a breakdown showing that 111 were VVF, 27 RVF, while 7 were both RVF/VVF cases.

In an interview with BusinessDay in her office, she said 92 new cases have so far been reported while the number of operated cases stood at 93 last year.

Ndubuaku, who spoke during the free surgery programme of the hospital called Minicamp, said the total number of dry cases, those who had successfully undergone repair surgeries last year were 78 ( no more leaking of urine and faeces) while those who were still wet stood at 15 and would require further repairs. She said 53 old cases were registered while 52 others were deferred.

She disclosed that the free surgery programme which is done quarterly was being supported by international organisations while the minicamp of last year was funded by the United Nations Fund for Population Activities (UNFPA) adding that despite the awareness through its outreach and sensitization programmes to various communities and worship centre, the cases were still on the high side.

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“We have so far registered 27 patients for the ongoing Minicamp which began on Monday, some are VVF, some are leaking urine or faeces or both. Today we have about 8 cases, so far we have 16 cases that are fit for surgery,’’ she said.

She lamented the dearth of healthcare professionals who are committed to the challenges of reducing the burden of the ailment, saying that those trained usually leave for greener pastures.

She said the free surgery service is usually supported by voluntary agencies and health workers from within and outside the state, who include Sunday Adeoye, a professor and chief medical director of Edo Specialist Hospital and the executive secretary of International Society of Obstetrics and Fistula Surgeons and other doctors with the complement of 10 nurses.

Ndubuaku said some of the patients after they had successfully been treated are often rehabilitated by the hospital and trained to acquire skills to help them to become self-reliant. She said some of them do not always want to return to their communities due to stigmatisation as the disease condition “takes away the dignity of the patients.”

She said though some of the conditions could be repaired, some were irreparable, pointing out that apart from rehabilitating them, they are also given funds and tools to start their business so that they could be integrated into the society.

“Our aim is to see that VVF/RVF comes to zero level in the state, we will celebrate that day but last year, we had new cases which were so complicated,’’ she said.

Speaking also, Adeoye said he was also worried by the number of patients coming for treatment, adding that since he had been part of the Minicamp, the cases have not reduced.

Factors giving rise to VVF/RVF which he identified as giving birth at healing homes, unskilled Traditional Birth Attendants (TBAs) and wrong gynaecological procedures.

“The burden has remained unchanged since 2002, we need to join hands to make sure that our sisters and mothers do not have to go through this trauma.

“As much as possible, pregnant women should go to health facilities to be delivered of their babies, if they require gynaecological procedures, it should be handled by health professionals,” he said.

According to Ndabuaku, one of the success stories was that of a 19-year-old lady, Imeh who said she was pregnant when she was 14 years and due to prolonged/obstructed labour, she was diagnosed with VVF.

Imeh in an interview said though she has been fully treated and repaired and was undergoing rehabilitation and skill training, she was still sad because she could no longer have her regular monthly menstruation as a result of the damage she suffered from VVF.

“Since last year, I have been here, I have undergone many surgeries and I have been told I still need more so that I can have my monthly period,’’ she said.