Federal Health Minister Lends a Hand to USAID Fistula Surgical Repair Clinic at Osun State Medical Center
USAID supports Ministry efforts to develop hospitals as ‘centers of excellence’
- By Brandon Brooks
Minister of Health Professor Isaac Adewole took the Health Ministry’s efforts to rid Nigeria of untreated obstetric fistula into his own hands by “scrubbing in” at a free surgical repair clinic for fistula patients at an Osun State hospital in late July.
The Minister led a team of Nigeria’s top obstetric surgeons at the United States Agency for International Development (USAID)-supported event, which marked the commencement of a joint initiative between USAID and Osun State government to expand access to fistula repair treatments within the state. The initiative is part of a nationwide push to improve public access to health care services.
“We still have too large a backlog of women living with fistula in the country,” Minister Adewole said after completing a successful surgery on Sarah, a 37-year-old mother of four who has needed the operation for four years. “There is need to close the gap, which is why we intend to open up more fistula centers across the country.”
Obstetric fistula is the result of prolonged labor without prompt medical intervention, and is most common among women living in impoverished households. The condition leads to the formation of a hole in a woman’s birth canal, which causes pain, chronic incontinence and threatens the health of the baby.
Yet few who suffer from fistula ever receive treatment in Nigeria. In rural areas, women may be unaware of their condition, and those who are seldom acknowledge it, fearing social marginalization. Women with fistula are often abandoned by their husbands and shunned by the members of their village.
For Sarah, an unsuccessful repair resulted in a four-year wait for further treatment. Her family simply could not afford the $400 procedure. Finally able to make the payment, Sarah and her husband were surprised to find out the treatment was free that day. “We are grateful for the care and happy Sarah is free of fistula,” her husband said after the surgery. “It has been a long and difficult ordeal.”
The repairs took place at the Wesley Guild, a Federal Medical Center in Ilesha. It is one in a series of nationwide hospitals that boosted its fistula treatment capacity under a new Ministry initiative supported by USAID to establish centers of excellence for fistula intervention across the country.
To date, USAID has supported thirteen state governments in their efforts to reduce incidences of fistula by providing materials, training and logistical support to new and existing medical centers. In Osun State, the Ministry of Health will partner with the hospital’s management staff to incorporate fistula surgeries, urethral catheterization and rehabilitation into medical doctors’ residency training. Osun health officials are encouraged by the successes they have seen in other participating states, where more than 47,000 patients have received treatment in the last decade.
Still, further progress is needed. More than 500,000 Nigerian women suffer from the painful and debilitating condition — half the cases in the world, according to the National Strategic Framework for Fistula Prevention and Control. With up to 12,000 new cases each year, the backlog for surgical interventions is at more than 200,000, exacerbated by high medical costs and a dearth of surgeons qualified to perform the repairs.
“Far too many women in Nigeria needlessly suffer through life with fistula after having given birth,” said USAID Mission Director Stephen M. Haykin. “This initiative, in partnership with the Ministry of Health, will free thousands of women from this burden and allow them to once again lead healthy and productive lives.”
The USAID initiative, known as Fistula Care Plus, also rolled out a set of awareness-building activities to coincide with the event. Implemented by Engender Health, the campaign intends to educate women on ways to diagnose and treat the condition.