VVF: Reflection of chronic health imbalance, human rights abuse

Zainab Ahmed is a twelve-year-old girl from the Northern part of Nigeria. “I wanted to become a doctor,” she says. “I don’t know if that can happen now that I am married and I am also ill,” she added. Zainab was a brilliant pupil as a child and always had the desire to become a doctor but was given away in marriage when she was eleven.

Now she is twelve years old and she walks around with her urine bag; she has been confirmed to have Vesico Vaginal Fistula (VVF). VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault.

VVF is not peculiar to young girls forced into early marriage alone. Not too long ago, Queen Akindeleni, of Anu Oluwa Complex, Jolu Road, Sango-Ota, Ogun was in the news and she narrated her ordeal with the police, of how an iron rod was forcefully inserted into her vagina to make her confess because according to them, she was responsible for the death of her husband.

Due to the severity of the injuries incurred, Queen was confirmed to have Vesico-Vaginal Fistula (VVF) as she had continuous involuntary discharge of urine, because of the abnormal openings in the internal parts of her genital caused by the metal the police officer inserted into her vagina.

Read also: Reps task FG on adequate funding of VVF corrective centres to save over 8 million lives

Between two and three million women and girls in developing countries are living with obstetric fistula, a condition that has been virtually eliminated in industrialised nations.

“It is often caused by childbirth (in which case it is known as an obstetric fistula), when a prolonged labor presses the unborn child tightly against the pelvis, cutting off blood flow to the vesico vaginal wall. The affected tissue may necrotise (die), leaving a hole. Vaginal fistulas can also result from violent rape or forceful sex which is common with young girls when they are made to marry while very young,” Femi Olaleye, managing director/CEO, Optimal Healthcare company, reveals.

United Nations Population Fund (UNFPA) revealed that more than 50,000 new cases of fistula develop each year.

For Babatunde Osotimehin, executive director, UNFPA, “The victims of obstetric fistula are women and girls, usually poor, often illiterate, who have limited access to health services, including maternal and reproductive health care.”

“More than 200,000 women in Nigeria are currently suffering from Vesico-Vaginal Fistula (VVF) condition,” Iyeme Efem, programme manager, USAID Fistula Care Project in Nigeria, has said, adding that “the disturbing magnitude of VVF prevalence in the country had forced the Federal Government to order care of 66,000 patients in 2013.”

Osotimehin has also noted that it is the poorest, most vulnerable women and girls that are mostly affected adding that the prevalence of VVF is a proof of human rights abuse. “It reflects chronic health inequities and healthcare system constraints, as well as wider challenges, such as gender and socio-economic inequality, child marriage and early child bearing, all of which can undermine the lives of women and girls and interfere with their enjoyment of their basic human rights,” Osotimehin said.