The lamentations of women living with Vesico-Vaginal Fistula, VVF, leave much to be desired.
The stories of rejection and mental frustration abound of these helpless women are commonplace. And between 120, 000 and 150, 000 Nigerian women and girls out of the two million worldwide live with the despicable disease caused by obstructed labour.
Unfortunately, the most vulnerable group is the young, poor, illiterate and rural women, who are economically disadvantaged.“The unacceptable situation has risen to a level where the government is expected to declare a state of emergency on the economic depriving disease. Every year, over 12,000 new cases are diagnosed whereas only 5,000 are repaired by the not more than 20 Fistula surgeons in the country.
“Meanwhile, there seems to be a ray of hope for victims as the Minister of Health, Prof Isaac Folorunso Adewole, led a team of fistula surgeons to repair 26 patients at the Wesley Guild Hospital Unit, Obafemi Awolowo University Teaching Hospital Complex, Ilesa, Osun State.“For thirty-five- year – old Mrs. Bola Ige resident in Erinmo Ijesa, life almost lost its meaning for the three years that she had struggled to deal with the dehumanizing condition she had found herself after being diagnosed of obstetric fistula, commonly known as VVF.
“For thirty-five- year – old Mrs. Bola Ige resident in Erinmo Ijesa, life almost lost its meaning for the three years that she had struggled to deal with the dehumanizing condition she had found herself after being diagnosed of obstetric fistula, commonly known as VVF.
Despite being repaired during the just-concluded intervention facilitated by the Federal Ministry of Health, in partnership with Engender Health, implementing partners of USAID Fistula Care Plus Project, and Osun State government, she is yet to recover from the low self-worth and esteem she had suffered in past years due to the condition. “I still do not know where to begin,” she said. Victims like Bola might find it difficult to fully reintegrate into the society, going by the pyramid of challenges and condemnation she had suffered in the past.
The story of another victim, Hajia Safiyat Kolawole, a mother of two, from a Lagos hospital, was pathetic. Safiyat claimed she was abandoned by her family including her husband.
“I was abandoned by family, relatives and even my husband is nowhere to be found in the last two years. I used to be a trader but I have since been economically devalued as I can’t stand in public places for too long because of the odour emanating from my body,” she lamented.
Bola and Safiyat are among 26 women who were given their lives back. And 24 of them had either been divorced or separated. Obstetric fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labour, leaving a woman incontinent of urine or faeces or both. More than 75 percent of women with obstetric fistula have endured labour that lasted three days or more.
90 percent of the cases, according to researchers, is caused by prolonged obstructed labour during the first or second child bearing process which is often associated with marked pressure necrosis, edema, tissue sloughing and cicatrization. Studies have shown that cultural beliefs of marriage and conception at a very young age, often before full pelvic growth has been achieved, is the most prevalent causative factor, coupled with no supervised antenatal care by quack medical professionals during
Studies have shown that cultural beliefs of marriage and conception at a very young age, often before full pelvic growth has been achieved, is the most prevalent causative factor, coupled with no supervised antenatal care by quack medical professionals during child birth and prolonged labour
In the western part of Nigeria, cases of obstetric fistula are usually from the havoc caused by Traditional Birth Attendants, TBAs, and from mismanagement of Caesarean Section, CS, in the hospital.
Sadly, these women become a financial burden to their communities as they are not employable due to the stigmatization and serial loss of dignity over time. It also affects profoundly their emotional and psychological well-being.
According to the Country Project Manager of USAID Fistula Care Plus, Chief Iyeme Efem, during the flag off of the surgery, the deafening silence and long years of medical denial that VVF is only restricted to the northern axis of the country and has, in no small measure, affected intervention.
Efem explained that the massive turnout of people for the project in the South-West has revealed that many sufferers were hiding as none of the 26 patients was a northerner. He admonished VVF victims to seek medical help by reporting to the nearest teaching hospital in their locality.
The initiator of the three-day marathon surgery, a professor of gynecology and obstetrics, is the Minister of Health, Prof. Isaac Folorunso Adewole.
Even before he became a Minister, he had been a leading voice on issues affecting women. Free fistula surgery is just one of his many interventions. Others include free cervical and breast screening for women, and the North East Emergency Nutritional and Medical Response. He has promised to implement more VVF surgeries under the 2018 budget. Already, measures are being taken to clear the backlog of fistula cases through the establishment of more fistula centers across the country.
According to Adewole, the Federal Government, alongside concerned stakeholders, is determined to eradicate obstetric fistula in Nigeria within the next 10 years.
He had, last year, he led a team, including the National President of the International Society of Fistula Surgeons, Professor Oladosu Ojengbende, to the Federal Medical Centre Jabi, Abuja, where surgeries were carried out on more than 50 VVF patients.
Ojengbende and the Minister`s Special Adviser, Dr. I.O Morhason Bello, also a consultant genitourinary & Urogynecology, also joined Adewole and other surgeons for the VVF surgery at the Wesley Guild Hospital, Ilesa.
Speaking at the event, the Minister said: “This is our small way of showing leadership and concern for the plight of the suffering masses, and our display of affection must be a thorough practical approach of putting smiles on their faces, removing shame and reproach, restoring dignity to womanhood and more importantly lifting the undue financial burden the disease has placed on them”
Ordinarily, the cost of VVF repair is not less than N500, 000. This is what the leadership of the Federal Ministry of Health under Adewole, with support from USAID, is embarking on free.
“We still have a large backlog of women living with fistula in the country, and there is need to close the tap and clear the backlog, which is why we intend to open up more centres across the country. We will make Wesley Guild a Federal Medical Centre and a centre of excellence for fistula intervention, to show equity in the distribution of healthcare in the country. We will make fistula repair one of our cardinal issues this year. We also need a crop of seasoned people ready to operate on these cases,” the minister added.
According to him, one of the simple ways to prevent obstetric fistula is to be delivered safely by a skilled medical personnel.
Governor Yahaya Bello, has expressed deep concern over 62 dead victims of an unknown disease and has directed that all the affected patients be treated at no cost.
A strange disease struck the eastern part of Kogi State few weeks ago, claiming the lives of both children and adults within the area. Ongoing medical investigations have shown that it is not Lassa Fever, or any known epidemic.
According to reports, the State Commissioner for Health Dr Saka Haruna, said information reaching the Ministry shows that unknown disease has continued to claim the lives of some children, and Adults for the past few weeks in Koloke, Okuna, Isanlu-Isa and adjourning Hausa-Fulani communities, all in Yaba-West Local Government Area of Kogi State.
“So far, about 62 people have been killed by this mysterious disease. When I visited the affected communities with my team, samples taken from some of the victims were sent to Federal Teaching Hospital Irua, Edo State, for definitive investigation, which turned out to be negative for Lassa Fever.
“On arrival at the community, we interacted with the locals and samples were taken from their water sources and food supply. It was discovered that the people affected showed common symptoms including abdominal pain, vomiting and stooling. Few of the patients, however, had Hematemesis and Hematochezia.
“Those found still manifesting the disease were transferred to Kogi State Specialist Hospital for proper management where an empirical diagnosis of Food Poisoning to rule out Gastroenteritis was made.They are, however responding well to the instituted line of treatment. ”
The Governor also charged the State Ministry of Health to conclude the investigation within the shortest possible time and prevent further spread of the disease.
The Kogi State Government has confirmed that about 62 people have been killed by a strange disease in the Western part of the State.
As at Thursday, 17th August 2017, the death toll was at 50.
Speaking with DAILY POST on the latest development on Friday, Dr Haruna, however, said Governor Yahaya Bello, has expressed deep concern over the incident and has directed that all the patients be treated at no cost and
“The patient was discharged after medical examination certified him free of Lassa fever infection.
It is medically proven that the case was not Lassa fever as earlier suspected,” he said.
He said that the state government had also stepped up surveillance to contain the spread pandemic diseases in prone area.
Mshelia stressed that River blindness and cholera diseases were more prevalent during the rainy season, adding that proactive measures had been put in place to contain the disease.
“Assorted drugs are distributed to endemic areas. State preparedness for endemic disease such as cholera is in place,” he said.
The commissioner added that the state government in collaboration with development partners was providing free treatment to leprosy and tuberculosis patients.
He further said that more than 2.7 million mosquito-treated nets were also distributed to households while 888, 905 doses of malarial drugs were distributed to children under five years of age in the state.
Health experts have identified consumption of contaminated food, unclean water and intake of drugs as the major causes of various categories of hepatitis.
Recently, the disease has been a scourge as it has gained prevalence in the past few years. Federal Government has also embarked on immunizing people, especially children and young adults, freely against the viral disease.
According to Healthline, Hepatitis refers to an inflammatory condition of the liver. It’s commonly caused by a viral infection. However, there are other possible causes of hepatitis. These include autoimmune hepatitis and hepatitis that occurs as a secondary result of medications, drugs, toxins, and alcohol. Autoimmune hepatitis is a disease that occurs when your body makes antibodies against your liver tissue.
The disease has been termed dangerous and a potent killer, as it has no treatment especially for acute cases. Actually, it is avoidable by adopting a healthier and a cleaner lifestyle.
Dr Johnson Ogunmade speaking during an Annual Health Seminar, organized by Ogun State Ministry of Health workers with the theme, “Reducing prevalence of hepatitis disease: Role of Community Health Practitioners” held in Abeokuta said, hepatitis “C” and “D” can be transmitted through unprotected sex and blood transfusion respectively while hepatitis E could be transmitted through water borne diseases.
Symptoms to watch out for all categories of hepatitis include fatigue, fever, nausea, vomiting, paleness, stooling, abdominal pains and loss of appetite.
Ogunmade said hepatitis “A” that is the most common, is as a result of drug abuse, unclean environment and taking of contaminated foods and water.He added that hepatitis “B”, if not quickly diagnosed could kill faster than HIV/AIDs and can easily be transmitted through body fluid.
Charging participants to advise patients to imbibe good hygiene, maintain a clean environment, avoid the intake of contaminated foods, washing fruits before consumption and staying away from undercooked food, Ogunmade said hepatitis could be greatly reduced when people imbibe the habit of regular hand washing.
World Health Organisation, WHO, has disclosed that many hepatitis cases could be prevented if hospitals reduced the vast number of reused injection tools and injection treatments, that help spread the disease.
The UN agency launched a broad campaign against unnecessary injections on the eve of World Hepatitis Day, which is celebrated every year on July 28.
“Every year, contaminated needles and transfusion equipment cause nearly 2 million infections with the virus causing chronic liver disease, as well as nearly 34,000 HIV infections.
“Up to 70 per cent of injections are either totally unnecessary or could be replaced by oral medicines,” the WHO said in Geneva.
WHO expert, Lisa Hedman, in a press briefing, said Egypt is one of the countries that have been affected by this problem.
“Injection equipment was reused on multiple people and created a spike in the transmission of hepatitis C that has been difficult to control ever(sic) time.
“As part of its campaign, WHO is asking health authorities to switch to equipment that cannot be used twice in a bid to protect health workers from getting pricked.
“WHO also wants patients to know about the risks so that they can ask their doctor for a tablet instead of a shot.
“This is everybody’s responsibility. We are asking everybody to pay attention,’’ Hedman said.
According to the latest globally available WHO data, some 325 million people lived with chronic hepatitis in 2015.
WHO noted that about 1.3 million people died of a liver disease that year.
A new treatment for Hepatitis C has been recommended to be extended, to other Sub-Saharan African countries, after clinical trials proved effective in three countries of the region.
Karine Lacombe, an associate professor at Saint-Antrine Hospital, Inserm, France, made the disclosure at the ongoing Ninth IAS Conference on HIV Science in Paris on Monday.
She said the test conducted in three African countries – Cameroon, Cote d'Ivoire and Senegal – revealed that the efficacy achieved was very close to that seen in the developed countries.
“The treatment of chronic Hepatitis C by Direct-Acting Antivirals (DAAs) is possible in the African context with good adherence, good safety and a laboratory follow-up that poses no particular difficulty,” she said.
Ms Lacombe said that the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) had conducted the first trial designed to assess the efficacy and safety of the new anti-HCV treatments in sub-Saharan countries.
“Each of the three most frequent HCV genotypes (1, 2 and 4) were represented by 40 patients.
Patients with genotype 2 HCV were treated with the DAA sofosbuvir plus ribavirin.
“Those with genotype 1 or 4 HCV were given a combination of 2 DAAs (sofosbuvir and Ledipasvir) in the form of a single tablet for 12 weeks.
“The preliminary results presented today relate to 110 patients, 32 of whom were HIV/HCV-co-infected and 11 of whom had hepatitis C at the stage of compensated cirrhosis,’’ she said.
Ms Lacombe said that the interim analysis found a sustained 89 per cent virology response in all patients after 24 weeks of follow-up.
She said that “the only patient who discontinued treatment after eight weeks of follow-up was nonetheless cured with no severe adverse effect observed.”
Similarly, Francois Dabis, the Director, ANRS, called attention to the lack of data on the efficacy of the drugs in resource-limited countries.
“The first results of the ANRS TAC trial now argue strongly that access to DAAs should be extended without delay to HCV-infected patients in Africa and other resource-limited countries,’’ Mr Dabis said.
Hepatitis C is an infection of the liver caused by the hepatitis virus and of various types.
The Nigeria Society of Neonatal Medicine, NISONM, a sub-speciality group of paediatricians, on Thursday have called on the government to undertake a welfare support system for mother and child health to reduce neonatal mortality rate and make progress in newborn health.
Prof. Chinyere Ezeaka, President of the society, spoke at a news conference in Ibadan as parts of the activities marking its Annual General and Scientific Conference.
Describing infant mortality as the worst health challenge in the country, Ezeaka said that compared to interventions in other health sectors, there had been minimal progress in efforts to reduce mortality among newborns in the country.
The expert said that of the seven million births recorded yearly in Nigeria, no fewer than 254,000 of those babies died annually.
“We are worried with the dismal figure of newborn morbidity and mortality in Nigeria.
“Nigeria has the highest number of newborn deaths in the whole of Africa and second highest in the world after India. The statistics is quite grim.
“Where we lose about 254,000 newborns every year, which comes to about 700 newborn deaths everyday and when we break this down to hours you will see that we have lost about 30 newborns per hour.
“Fifty per cent of these deaths also occur within the first 24 hours of the baby’s life. This is totally unacceptable,” she said.
The society President said that progress in addressing the high death rate had been slow due to inadequate training of front-line health workers and ignorance among mothers.
“To ensure that newborns in Nigeria survive, thrive and live to attain their life potential, attention needs to be focused in the area of newborn health.
“Poverty, illiteracy and ignorance are underlying causes of infant mortality.
“No matter how poor or ignorant they are, they don’t want their babies to die.
“We need the government to come to their aid and give some insurance cover and ensure more women register for antenatal care where they can get adequate information,” she said.
According to her, while the death rate is dismal, 90 per cent of the deaths in newborns are preventable.
She identified prematurity, asphyxia, infections and neonatal jaundice as the major causes of neonatal deaths in the country.
“Majority of these deaths are preventable by improving existing care and eliminating underlying causes of neonatal mortality.
“A major underlying problem is lack of respiratory support in our health centres, because when the babies are delivered, especially the premature babies, you must make them to breath.
“Respiratory support is very critical and an ambu bag, which costs less than N5, 000 is not available in majority of our birthing and maternity centres,” she said.
The World Health Organisation has warned that an untreatable strain of gonorrhoea is spreading worldwide after the super bug was discovered in at least three people.
The bug is said to be “very smart,” evolving to develop resistance to antibiotics every time a new one is used against it. Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae or gonococcus.
It is mainly found in discharge from the penis and in vaginal fluid, and can easily pass between people through unprotected vaginal, oral or anal sex.
It is estimated that 78 million people are infected with gonorrhoea every year, affecting genitals, rectum, and throat.
Surveillance in two-thirds of the countries that report resistance data to the WHO, particularly high income ones, are finding cases of the gonococci infection that are untreatable by all known antibiotics.
“These cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common,” Teodora Wi, a Medical Officer, Human Reproduction at the World Health Organisation.
The three cases of which no known antibiotic is effective are said to be in Japan, France and Spain.
Currently, only three new drugs are being developed, because pharmaceutical companies know that the bacteria will soon become resistant to any new antibiotic.
To control gonorrhoea, doctors not only need new medicines, but also a rapid diagnostic tool and a vaccine, which are yet to be developed, WHO Antimicrobial expert, Marc Sprenger, said.
The House of Representatives have given the Minister of Health, Isaac Adewole, an ultimatum to reinstate the suspended Executive Secretary of the National Health Insurance Scheme (NHIS), Usman Yusuf, within a week.
The Lower House also demanded that the Minister temporarily stops the re-accreditation of Health Maintenance Organisations, HMOs, pending the outcome of an ongoing investigation of the scheme by the House.
The directives followed a motion by the Chairman of the House Committee on Health Services, Chike Okafor.
The Health Minister had suspended Mr. Yusuf over corruption allegations, one of which was the procurement of a N58 million SUV without due process.
Mr. Yusuf became the Executive Secretary of NHIS in 2016 and in his short tenure, has been faced with different allegations of fraud.
The Health Minister later explained the reasons for the three months suspension, saying it was to allow investigations into the allegations.
The suspension came weeks after the Senate launched investigations into his activities as the NHIS chief.
The lawmakers accused Mr. Yusuf of “corrupt expenditure of N292 million” which he allegedly spent on health care training “without recourse to any appropriate approving authority.” The NHIS chief has denied any wrongdoing.
His suspension also comes in the middle of an investigation by the House Committee on Health Services on the implementation of the NHIS.
Mr. Yusuf had at the public hearing in the course of the investigation blamed the HMOs for the failure of the NHIS to deliver services.
He attributed the alleged corruption by the HMOs to fraud in the fuel subsidy scheme, stressing that enrollee figures were being padded.
News reports has it that the House had in an unanimous decision on Wednesday, resolved to invite the Minister of Health to explain the reasons for the suspension and also directed him to recall Mr. Yusuf.
Despite the House resolution, the Ministry is not expected to recall the suspended official as such resolutions are not binding on the Executive and its Ministries. Many of such resolutions have been ignored in the past.
A spokesperson to the health ministry, Boade Akinola, said the ministry had not been informed of the resolution.
The National Emergency Operations Centre EOC, has disclosed that about 1,166 persons have died of cerebrospinal meningitis, Subtype C, across 25 states in the country.
They made this revelation in a new report which indicated that over 14,518 have been affected, said there has been a decline in the outbreak.
According to the statement: "The outbreak has been in constant decline for eight weeks and the affected states have recorded fewer new cases. In the last four weeks, no local government area has reached outbreak alert threshold."
"As at May 9th 2017, 13,420 suspected cases had been reported from 23 states with 1,069 deaths, giving a case fatality ratio of eight per cent.
In the previous two weeks, the most affected states were Zamfara, Sokoto, Katsina and Kebbi states, which recorded a drop in the number of cases. Kebbi and Niger states reported zero deaths over this period," the statement added.
However, reports say that centre's claim was contradictory to the Nigeria Centre for Disease Control, NCDC. The report says that there are more cases of meningitis today than last month.
The Chief Executive Officer of the NCDC, Dr. Chikwe Ihekweazu, said the planning process to prevent future outbreaks has begun.
Ihekweazu said the laboratory capacity has also been improved upon with the recent operationalisation of the new National Reference Laboratory in Gaduwa, Abuja.
The facility is supported by the Federal Ministry of Health, the United States Centre for Disease Control (US CDC) and the World Health Organisation, WHO.