HEALTH INTERACTIVE WITH DR AMINU MAGASHI My Visit to Dambatta VVF Center When I wrote my price entitled ‘ Traditional Practices And Community Intervention that was published on this page of 6th April, 2004, my objective then was to critically examine the practices, why they are being perpetrated and recommended that the best approach to all the preventable cases is nothing other than community intervention. I dispassionately discouraged the attitude of Reproductive Health NGOs and their donor partners sitting down in workshops in urban areas under flamboyant atmosphere in luxurious hotels to engage in reciting figures , reviewing statistics and also adopting a communiqué that is never meant to be implemented , while abandoning the vulnerable and impoverished women and youths in villages and rural areas in a dilemma and despair and regrettably just a quarter of what is being spend in those workshops will be more than enough to address , halt and reverse the complications of those traditional practices. In
line with that article, I received an E
: mail from a woman leader
, Dr ( Mrs. ) Rah mat Mohammad who
was at that time in United Kingdom for a course
also has an NGO in Nigeria that is doing something more or less
similar to what was advocated in that article. Although the mail was
brief but she urged me to visit The
Vesico-Vaginal- Fistula ( VVF ) center in
Dambatta LGA of Kano state, a center being
manage by an NGO by name Foundation For Women’s Health ,
Research And Development ( FORWARD ) One thing lead to another, I couldn’t made such visit until when she come back to Nigeria and informed me of her arrival, I regrettably told her of my inability to visit the center and jointly agreed to have the visitation together, at least that would provide the enabling environment to ask all necessary questions , share information and if possible pass some recommendations on areas to improve on.
On
Saturday, 26th June, 04 around VVF,
an abnormal connection between vagina and the wall of the bladder is a
complication or a sequlae of some traditional practices but however ,
over seventy percent of all
cases is due to prolonged /obstructed labour which could be due to small
pelvis that cannot allow fetus to come out or a contractile pelvis due
to diseased bone
and deformity. As we are aware that the growth and development of
pelvic bones are
proportional to increase in
age, hence the basis of finding VVF more among underage women. Other
issues are to do with traditional delivery procedures
by birth attendants
where by in trying to widen
the birth canal , end of traumatizing the genital part and damaging the
bladder wall to cause an abnormal connection with the vagina. Other more
worrisome factors are Ignorance
and Poverty which resulted in not attending antenatal care and in
some cases even if there is an existing health post in the village, it
is only a building with no human resources and facilities. From
available information majority of VVF cases occur in northern part of It
was due to some of the social problems mentioned above and as a
collective responsibility that the then For VVF patients whom the abnormal connection is repaired, although some school of taught discourage vaginal delivery but a caesarean section (CS). I am of the opinion that from care full observation, those women who develop VVF are very young with small pelvis, but by the time the fistula got repair and are reintegrated in to the society, they are more matured with wider pelvis and improved on nutritional status and are empowered to be attending antenatal care, by that the earlier factors causing prolonged/obstructed labour are removed , as such nothing stop them from trying vaginal delivery under supervision in a hospital and of course when one weigh the risks attached to C.S ( trauma, infection and tissue damage and with array of quack health personnel parading as experts ) it is better to allow the women to try labour vaginnaly. In conclusion , although the initiative by Dr Rahmat and Forward Nigeria and other sincere NGOs else where that are engaging in community projects is highly commendable but I urge and enjoy them to be more transparent and accountable not only to their donors but the community where the projects are cited by involving the local people from needs Assessment, Design, Implementation, Monitoring And Evaluation. Lastly,
as the saying goes, prevention is better than cure, apart from repair,
rehabilitation and reintegration of VVF patients, I call on all
stakeholders ( Governments ,
Civil Societies And Donors
) to know that no society can fully develop without investing in Antenatal
Care And Education (particularly Girl Child); the two interventions
are part and percel of the
most important goals in the Famous
Millennium Development Goals (MDG) that
was developed by heads of governments and member nations of U.N in year
2000 Dr
Magashi Is The Executive Director Of Community Health and Research
Initiative, |