What is the update on the Centre so far?
The Centre is the first National Fistula Centre in Nigeria and as much as possible, a lot of activities have taken place since the federal government took over the hospital. Before now there’s just one operating theatre and it is in that theatre that we have done all the surgeries that we have done and we are talking about almost 2,500 fistula surgeries.
We have done 80 ureteric re-implantation surgeries, sling operation for women with Urinary Incontinence (UI), all in that single theatre and we have done close to 700 pelvic organ prolapsed surgeries and of course a lot of other procedures we have conducted which include, over 250 breast biopsy, prostrate biopsy, cervical biopsy of about 400 all in that same theatre.
But now, we have a new building courtesy of Federal Government with about five operating theatres that means that once the building is fully operational we are definitely going to do more in what we have done in a single theatre before now.
Outside your primary mandate, do you charge any fee for other treatments?
No. Like the ureteric re-implantation surgery for instance, if the patient was to pay in a private hospital it will be pretty expensive such that an average income person might not be able to afford it. But, here we offer the treatment completely free.
All the VVF surgeries we perform are completely free, including the ureteric and sling operations for women.
After women with VVF are repaired, some of them cannot control the urine even when the fistula has been closed and what we want is a woman who is dry, not just closing the fistula. Closing the fistula is one thing, but making the woman dry is another thing, so that’s why we have to incorporate some of these sling procedures into what we do so that the woman could be dry. All the treatments are free.
What is your advice for women who introduce chemical substances in their vagina to tighten it?
Well, we have seen some that put different kinds of substances such as herbs, Alum among other dangerous chemicals to tighten the vagina, but it ends up burning the vagina, giving them VVF and blocking the vagina following the occurrence of fibrosis.
The fibrosis leaves scares on the vagina and the extent of the damage might be mild, moderate or severe depending on the extent of corrosion produced by the chemical inside the vagina.
So, my advice is simple, there is no need introducing such chemicals inside your vagina to tighten it, because the outcome may be worse than what you bargained for.
What is the recommended approach to tighten the vagina?
There are plastic surgeons that do that, just like you have surgeons who do breast enhancement.
What is your office doing in the area of sensitisation to ensure that women in the rural areas are properly educated on what to do to avert VVF?
Well, in the past we had a very robust community outreach programme, where we go out at least within Ebonyi State to talk to people. Presently, we are still talking to people, that is why this interview is good because it will help in disseminating the information about VVF, causes, implications etc.
We have done quite a lot, but of course, there is always room for improvement.
At a time we were even targeting school children, because we feel that if we are going to reduce obstetric fistula in the future, one of the ways of going about it is by giving culturally sensitive health information to the children at the Secondary School level because it is the child in JSS1 today who would be the father tomorrow. It’s the little girl in JSS1 today that will be the mother tomorrow, so if you provide them with enough information, they will be able to take better informed decisions as husbands and fathers, as wives and mothers in the future.
So at a time, we even had a programme on that and we are still looking at how we can partner with agencies, especially on that school programme to give children the correct information. Let the child know he has a responsibility to his wife in future when he gets married, that if he doesn’t look after the pregnant wife properly, there are consequences.
He may not understand it completely as it is now, but as he grows up, that information you have given him as a child will be there and will help him to make better informed decisions. That will in turn make him a better father tomorrow, likewise the little girl today that is still in JSS1.
We feel that if we are going to create a fistula free next generation, if we continue to target the adults of today that alone will not create a fistula free next generation. So for us to have a fistula next free generation, we need to have a combined approach. An approach that addresses the information to the adults now and an approach that will equally give information to children now, such that in 50 years’ time we will still not be talking about fistula.
If we continue to target only the adults of now, sorry, in 30 to 40 years’ time, we may still be talking about fistula because we didn’t use the right approach.Do you suggest that the Federal Government should include this education in our Primary School curriculum so that instead of the individual campaigns, teachers can be teaching the students about the causes, dangers of VVF and ways of averting it?
Well, there were some efforts made regarding that, though I wouldn’t want to go into many details. We had made some efforts before to see how that would be done, but regrettably it didn’t work out the way we planned.
So, the way we are going about it now is to start from our little place here, and if we have the right partners to work with in this regard then subsequently we will extend it to other areas.
It is not difficult to sell a good market, if the market is good, the market will sell itself. So, if we probably record success on what we had tried to do locally and it becomes obvious to everybody that it is a good idea, it will eventually spread like wild fire.
What are some of your challenges?
Our major challenge is staffing. You can see we started as a fistula repair hospital, but with what I told you, we now engage in a lot of highly specialised services. You need more staff to be able to produce more result. The number of staff we have has not significantly changed from what we had some years ago, though our services have increased.
We have one theatre where we have been doing all these surgeries, but now we are going to have four theatres, that show clearly we need people to man these theatres.
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Having those theatres means that you are going to do more, if you don’t have increased staff to man four theatres, it is going to be a problem, so that is a significant challenge.
Also, funding is a challenge anywhere and it is a challenge also to the hospital. Our services are predominately free, but if at the end of the day you can’t pay your electricity bill, among other bills, they won’t listen to any story of your services being free because they have their own mandate to carry out, so these are some of our challenges.