VESICOVAGINAL FISTULA (YOYON FITSARI)

[Dan-Borno]

Here is the story of a woman who made the Fistula journey — in her own words.


Abeba Zerehun
Asosa, Southern Region, Ethiopia
age 18


I studied in school until 7th grade. I helped my mother at home with housework, but I didn't have to carry too many heavy things.

I got married when I was 15. I met my husband for the first time on my wedding day. My parents chose him for me. I felt sad that I had to quit my education, but otherwise I liked my husband. He was a good man.

I got pregnant one year later. My pregnancy was fine. My labor started at three in the afternoon and my husband and my mother were with me. A traditional doctor told me to go to the hospital. I got a free letter from my kebele. I went to Asosa Hospital and they operated to take out the baby, but it was dead.

After the baby died, I went back to my village and two months later my husband married another woman. My friends were there to help me in the village. I lived with my mother. When I came to Fistula Hospital, I was very happy. I knew this was the place where I would get cured. It has been 15 days since my operation and now I am dry.

I have made friends here. We have fun together and we talk about our health and our operations. We ask each other, what will you do when you are cured?

When I am cured, I want to go back home and continue my education. I want to study and I want to become a doctor like the doctors here and help girls like me who have this problem.

When I go back to my village, I will tell other women to go immediately to a hospital so that they won't have a problem with their labor. Most people don't know that a hospital can help them, but if they knew, they'd go.

_____________________________________________________
A fistula is a hole between a woman's birth passage and one or more
of her internal organs. This hole develops over many days of obstructed
labor, when the pressure of the baby's head against the mother's pelvis
cuts off blood supply to delicate tissues in the region. The dead tissue
falls away and the woman is left with a hole between her vagina and
her bladder (called a vesicovaginal fistula or VVF) and sometimes between
her vagina and rectum (rectovaginal fistula, RVF). This hole results in
permanent incontinence of urine and/or feces. A majority of women who
develop fistulas are abandoned by their husbands and ostracized by
their communities because of their inability to have children and their
foul smell.  http://www.fistulafoundation.org.

The first day I was invited by a friend nurse to come and see for my
self the VVF patient is a day i will never forget, if not because of my
inability to weep easily, i would have weeped profusely right in front of
the patients.

For you to feel it, just imagine your daughter, sister or mother in this
kind of condition of yin fitsari without control - kai Allah ya kawo saukin
wannan lamarin.

The worst affected by this problem are young mothers living in the
rural areas who our government did not care to extend medical
attention to.  Sai kaje General Hospital zaka gansu, abin haushi
kuma wai mu maza ran away from them immediately and in most
cases har sake aure akeyi abandoning the infected lady with flies
as her body guards.  Namiji Mugu.

It is a challenge to our government, as we always say, though
masu kudi should also play a vital role.  Government should provide
enough medical services to the people in the rural areas while
Gogannin namu should be sensitize to exercise patient and not
to take them in while still tender.  If already taken, then adequate
provision of good food, periodic medical check up and constant
exercise be given and encouraged by the man.

An estimated amount to be spent on each fistula patient's surgery
is N60,000.00!!!! How many of our rural guys are ready to sell off
their dabbobi to cure his wife?  He opt to remarry and by so, yaran
mu mata diyewa have either lost their life out of frustration or they
become mad considering the stigma attached to this infection.
If left untreated, fistula can lead to chronic medical problems,
including ulcerations, kidney disease, and nerve damage in the legs.
Thanks to most of the FIrst Ladies for their effort in associating
themselves with the VVF patients and giving out a helping hand.

I want to seize this opportunity to call on all my people, especially
from the north to reach out and make a difference.  Visit any of
the VVF Clinic closer to you and see what you can offer to the
poor beautiful lady who was abandoned by your friend.

[gogannaka]

Nice one DB.
What exactly causes VVF?

I am aware that early marriage is a cause but yet most of our Ulamas vehemently deny this.
Their denial comes from the fact that the prophet SAW married Nana Aisha at a very young age and therefore  early marriage in Islam is accepted. Their common excuse is that relating VVF to early marriage is a western propaganda aimed at discrediting Islam and the Holy prophet SAW.

[abeeda]

i agree  that early marriage is not the culprit the problem is wen the girl is not fully devt as sometimes you find very young girls that are fully matured and those who are older yet to attain such devts. also small waists or birth canal also increases the risk and this is not necessarily an age related factor.
pls  pls pls our men should have the goodness of heart to stand by their wives that do develop such prolems

[Dan-Borno]

more grease to your elbow joint abeeda, i think i
will appoint you as my senior special assistant on
control of VVF.

you see its time we dont involve irin wadannan
malaman in our affairs, especially when we have
scientific prove at our disposal.

another cause that is aggravating the issue of
VVF is poor health facility within reach.  i come to
understand that prolong or disturbed labour is
also a major cause of this proble.

this is where our government will spend more
money than even the energy sector.

[SpeakOut]

Still on VVF,

Abeeda is correct. VVF is more caused by carelessness than age. There are cases of women getting during the third or fourth deliveries. When labor is elongated with no attention from trained birth attendant, anything can happen. life can be lost. Age facilitates because most first pregnancies meet inexperienced ladies. This becomes catastrophic where there is no trained hand to offer assistance.

We are aware of girls getting married at tender ages in the past in Hausaland, but we are also aaware that these are married to responsible husbands who nursing them to maturity before first sex. Today husbands are reckless, impatient.

A stitch in time will always save nine.

Thank you Danborno for bringing me back to kanoonline.

SpeakOut (Haladu)

[HUSNAA]

Very interesting topic.. why did i never join in at its inception?

Kai I have a grouse with these malamai of ours who say that early marriage is not a culprit. Well maybe it isnt, but they shouldnt point to the fact that the Prophet SAW married Nana Aisha (RA) at such an early age and that is why early marriage can't result in VVF. What they dont associate with this fact was that Nana Aisha (RA) NEVER GAVE BIRTH. I am not saying that she would have experienced that condition at all, but it would have been a more solid proof, had she given birth, then we will be more sure that early marriage will not result in VVF.

Another thing kuma is that women in tropical or hot climates are said to physically mature more quickly than women in colder climates. The Ulamas point this out when they discuss the case of the youthful marriage of Nana Aisha (RA) to the Prophet SAW. If we take that in to consideration, then we can conclude that early marriage will not significantly increase the chances of a woman's having vvf IF she lives in the tropical regions of the world. That just about takes care of all the  women living in lower latitude regions of the world.

On the other hand if a woman lived in the temperate and arctic regions of the world, then this wont apply to her. So she is subjected to a higher probability of getting vvf as a consequence of marriage at a very young age. The irony though is that  it is not part of the culture of ppl living in temperate high latitudes of the world to marry early. So that effectively solves the problem for them.

As for us here in the tropics, diet probably plays a very important role in the sexual development of the young girl. I do know that if a girl gets a nutritious and balanced diet from the early stages of her life, she will develop much quicker than a girl who doesnt get  a balanced or nutritious diet. Her period will certainly start as early as 10 or 12 yrs old. In contrast, a poor diet will result in some girls starting their periods at the age of fifteen or so. So in the cases where girls do get pregnant at age 12, 13 then the likelihood is that genetics contributes to their physical underdevelopment rather than the environment.

Thus if a girl has to get married at an early age, then the best thing is to avoid pregnancy altogether till a later age like 16 or 17. The reason for this is that the girls or the men who marry them, do not do so with having babies immediately, as the primary aim of the marriage. The primary aim for parents who marry off their very juvenile daughters is to avoid promiscuity. Therefore as such, one can have the best of both worlds. Eat yr cake and have it so to speak. Marry off the child at the early age to avoid her getting spoiled by some unscrupulous characters (especially in tana talla a waje), but assure that she postpones having the kids until her body is physically ready to bear the burden. At any rate, the early marriage will act as a catalyst to that physical and sexual development of the body.

One thing I forgot to mention is that another very big culprit that results in girls getting vvf is female circumcision. Some weeks back, the BBC and DW Hausa sections aired programs to do with this horrible cultural practice. The practice is widespread amongst the arabs and the sudanese. It is also prevalent in Niger and in some parts of Nigeria and Ghana. The way a girl is circumcised varies greatly from region to region or culture to culture. The Sudanese version amounts to female genital mutilation. So does the Niger way. In Nigeria, it is more mild. The effects are not as drastic. The bottom line however is that a woman experience horrendous problems when she comes to give birth not least of which VVF is one of them. So if we could get rid of these awful practices that really do the female injustice then the incidence of VVF may be mitigated.

Finally, why dont women go for Caesarian sections as preventive measures against VVF? (especially if the girl is so small)

[Dan-Borno]

good work, and i just hope when ur back you will head the
proposed NGO to fight this genital mutilation and under aged
marriage which consequences are numerous among them is
the present VVF we are discussing.

i only wanted to make comment on your statement:

Finally, why dont women go for Caesarian sections as preventive measures against VVF? (especially if the girl is so small)

it may interest you to note that, these cases of VVF only
come to the hospital after it has occured and in majority
cases has reached a danger level which makes it difficult
for our medical personnel to attack the ailment unlike if it
is being brought at an earlier stage.

as i used to say, our northern governor's are not too serious
about this issue and other health matters that affects their
people, this led to foreign NGO establishing hospitals in
Africa for the sole purpose of curing VVF patients.

our educated and enlightened women should raise to the task
and spread the message across.