There is a particularly devastating complication of childbirth, known as VVF, the effects of which often cause young women to be ostracized by their families or discarded by their husbands. In Kaduna, Nigeria, physicians perform surgeries to try to correct this condition, but poor equipment and limited resources often result in botched procedures, or the inability of patients to reach the places where they could receive care. A team of volunteers from Physicians for Peace recently completed a successful mission to Kaduna, carried out in support of the Millennium Cities Initiative, to help perform surgeries on VVF and RVF patients.
VVF/RVF – vesicovaginal or rectovaginal fistula – describes a condition where prolonged labor results in serious tissue damage and creation of holes between the vaginal wall and the bladder or rectum of a woman. Both conditions cause leakage through the vagina. There is a high prevalence of these cases in Northern Nigeria, where many girls aged 11-15 become mothers, either after early marriage to older men, or through accidental pregnancy. The small pelvic size of these young girls causes them to experience obstructed labor (sometimes lasting for weeks) causing damage to their internal organs and resulting in VVF or RVF. Sometimes VVF or RVF is also caused by unskilled birth attendants simply cutting through the vagina of young girls suffering prolonged labor to create a passage for the baby. The constant leakage of urine or feces that results from this condition often results in these women being abandoned by their husbands, families, and neighbors, condemned to living the life of social outcasts. With no means of supporting themselves or their children, they often end up homeless.
The PFP team worked at the Gambo Sawaba General Hospital in Zaria, Kaduna during the first week of April 2008. Dr. Margie Corney, Dr. Olugbenga Oredein, and Frances Dargan together with Dr. Sa’ad Idris (a local Nigerian physician) were able to perform 25 surgeries in 5 days, 18 of those being serious cases. The women ranged in age from 16 to 50+ years, many of whom had been living with VVF/RVF for years. A number of these cases were the result of previously botched VVF/RVF repairs. Frances Dargan, a surgical assistant, was also able to educate the local hospital personnel in hygiene and pre- and post-operative care of patients. The Physicians for Peace team also delivered badly needed basic medical supplies to make these surgeries possible.
The impact of missions such as these are profound and far reaching. Woman who are able to have VVF surgery are literally given a whole new life. During the six-week convalescent period in the hospital, they are given the opportunity to learn a skill, such as weaving or sewing, that they can use to support themselves financially when they are finally discharged. The hospital itself benefited from the mission, learning new hygiene procedures, and the American doctors were continually inspired by the skill and flexibility of their Nigerian counterparts, who were able to accomplish so much with so little.
There is still much to be done!! The United Nations Population Fund estimates the number of VVF and RVF cases in Nigeria to be over 400,000. Unofficial and NGO sources put this number much higher and continually growing. Physicians for Peace is committed to working with health officials in Nigeria to help women suffering with this horrific condition, which scars them physically and emotionally. A number of VVF/RVF repair missions, along with educational campaigns to help young women, midwives, and birth attendants recognize signs of complicated labor and correct birthing procedures are needed to assist women currently living with VVF/RVF and to reduce and prevent future cases. Peace recently donated a 40 foot container of the medical/hospital supplies needed to help various health facilities in Kaduna State, but this is only a drop in the bucket in terms of meeting the need there.
The task is enormous and the need is urgent: Physicians for Peace needs your help to reach out to and, literally, repair the lives of these remarkable women living with the terrible burden of VVF and RVF. Even small financial contributions or donations of medical supplies, including quality needles, sutures, antibiotics, hospital gowns, and anesthesia medications will go a long way in making the next VVF/RVF mission possible. VVF clinics in Nigeria are in particular need of catheter kits, which cost as little as a dollar a piece, and can help a woman to be mobile after surgery instead of carrying around a bowl into which the catheter must drain.
The faces in the pictures above show the incredible courage of Nigerian woman who have lived with shame and neglect, but who smile with hope at being given the chance to start a new life.
