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End Fistula Day: Expert advocates free treatment for victims

Dr. Nathaniel Adewole, a Consultant Gynaecologist, University of Abuja Teaching Hospital, Gwagwalada, has called for more involvement of individuals and corporate bodies to make the repairs of fistula free and easily accessible.
Adewole made the appeal in an interview with the News Agency of Nigeria (NAN) on Thursday in Abuja in commemoration of this year’s International Day to end obstetrics Fistula.
The UN set aside the day since 2013. The day is meant to raise awareness of this issue and mobilise support around the globe.
The theme for 2019 is: “Leaving no one behind: Let us commit to ending fistula now!”
According to him, obstetric fistula is a medical condition in which a hole develops in the birth canal as a result of childbirth.
He said it can be between the vagina and rectum, ureter or bladder and it can result in incontinence of urine or faeces.
The expert said its complications may include depression, infertility, social isolation and poverty.
Adewole said other common types are Vesico-Vaginal Fistula (VVF) and Rectovaginal Fistula (RVF) or combination of the two.

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“The health system must be strengthened with appropriate trained personnel like at least midwives in Primary Healthcare Centres and doctors in health centres with good referral system.
“This would minimise the issue of prolong labour which is the main cause of obstetric fistula.
“There are a quite a number of NGOs already assisting in psychological support and repairs of the fistula,” Adewole said.
He said community advocacy cannot be overemphasised to avoid stigma and rejection, adding that it can help in rehabilitation and reintegration of affected individuals.
“The psychosocial effects of this are enormous. The continuous dribbling leads to smell, rashes, loss of confidence and self esteem.
“The rejection by spouse and the family is more than enough trauma. One of the cardinal approaches is education and empowerment of the girl-child.
“This will reduce the possibility of too early marriage and empowered to seek appropriate medical help when pregnant or in labour,” he said.
He said Nigeria was contributing about 150,000 cases out of 2 million cases of obstetric fistula worldwide, adding that it is time for holistic approach to end the menace.
Adewole said obstetric fistula was the most devastating of all long standing obstetric disabilities with great psychological trauma.
He said men must not be left out, especially in avoiding harmful cultural practices. (NAN)