Health
Agony of 46-year-old Woman Living With Irreparable VVF , RVF
Zuwaira Iliya, 46, sits quietly on her hospital bed with catheter showing from the side of her
wrapper as she slowly narrates her 30 years of struggle, living with continuous leakage of urine and faeces.
Iliya of Makarfi Village in Makarfi Local Government Area of Kaduna State has been grappling with Obstetric
Fistula but has kept hope alive in spite of what appears to be a hopeless situation.
She told a correspondent who was at the Vesico Vaginal Fistula (VVF) Unit of
Gambo Sawaba General Hospital, Zaria in Kaduna State, on a special interview to mark the 2023 International
Day to End Obstetric Fistula (IDEOF) that she would be healed against all odds.
She had lived with VVF and Rectovaginal Fistula (RVF) for 30 years, as she contracted the
condition at the age of 16 after her marriage.
Iliya said that she became pregnant soon after her marriage but experienced prolonged labour during childbirth,
adding that she lost the baby and also developed both VVF and RVF in the process.
VVF or Obstetric Fistula, also known as fistula, is a childbirth complication which leads to abnormal opening between
the bladder and the vagina, causing continuous and unremitting urinary incontinence.
The condition is among the most distressing complications of gynecologic and obstetric procedures which can
cause discomfort, and if left untreated, it may lead to serious bacterial infection, which may result to sepsis, a
dangerous condition that can lead to low blood pressure, organ damage or even death.
Similarly, RVF is a communication between bladder and rectum, where faeces pass before getting to the anus, leading
to intermittent leakage of faeces into the vagina.
The development of these conditions, therefore, plunged the young Iliya into a life of agony, and for the past 30 years,
she said she had been struggling with depression, rejection, ridicule and abandonment.
She said “I was married off at the age 16, and immediately became pregnant. When it was time to deliver the baby,
I went into labour for three days.
“I was taken to the hospital for delivery but had a big cut to enable the baby to come out and that was how I developed
VVF and RVF.
“Thereafter, I was taken to a hospital in Kano, where I underwent surgery three times without success. And from
there, I was taken to another hospital in Jos, Plateau State but instead of performing a surgery, the doctor referred
me to this VVF Unit in Zaria.
“Here in Zaria, I was operated twice but still I continue to leak urine and faeces. Notwithstanding, I am still hopeful
that maybe, just maybe if I undergo another surgery, I will be healed.”
Describing her life as “a very sad one”, Iliya said that her husband divorced her in Kano because of the condition
and she returned to her parents’ house.
She added that while trying to get better when her parents took her to the hospital, her mother and father died, leaving her all alone.
She explained that “my life is a life of agony because I was with my mother here in the hospital when she became ill and died,
four days after my second surgery. I went to her burial with this catheter on me.
“And just when I was waiting for another surgery, I received a message that my father was ill. I left the hospital to look after him
and he also died.”
However, in spite of the visibly hopeless situation, relentless Iliya said she would not give up, saying she hopes to get better and
one day give birth to a child.
She said “I have seen how some VVF survivors were operated on and were healed, went back home, became pregnant and
then returned to the hospital and delivered their babies through Caesarean Section (CS).
“This is why I am still hopeful that all is not lost and I have resolved to stay and get well so that maybe God will give me a child,” she said.
On her part, Hajiya Fatima Umar, the Head of the VVF Unit at the Gambo Sawaba General Hospital in Zaria, said there are
more than 20 irreparable fistula cases on the hospital list waiting for help.
Umar said some of the women have even made the hospital their homes, while others live in communities but maintain
contacts with the facility.
She added that “actually, the women have not been finding it easy staying in their environment or in their homes.
Sometimes if they come and they are examined, or if they hear that other doctors are coming from somewhere, they will come.
“If they come, the doctors will examine them. Even if the doctors say they can’t operate on them, they
will still come after a while because they are already comfortable with the hospital environment.
“They prefer to be in the hospital than their homes because nobody is rejecting them here.’’
Also, Dr Ado Zakari, the Fistula Surgeon and Consultant, Public Health Physician, said most of the irreparable
fistula cases were caused by quacks.
According to him, there is nothing doctors can do if the fistula is too wide, and the damage is extensive.
He said “there are situations where the damage becomes extensive and there is nothing we can
do because it is just the question of getting available tissue to repair.
“A situation where the entire tissue has been damaged, there is no way it can be repaired.
“This is because most quacks have no knowledge of anatomy; they operate anyhow. They take out everything,
even the bladder tissue and when you look at it, there is no way you can repair it.
“You cannot create any tissue anywhere and close the fistula. Fistula is a hole, it is a communication, and if it is so wide,
where will you get the tissue to repair it?.
“We have such cases; they are irreparable. We cannot repair them,” Zakari said.(NAN)
Health
Expert Advocates For Elimination of Mother-to-Child Transmission of HIV Through HIV Self Testing.
From Attah Ede, Makurdi
Eliminating mother-to-child transmission of HIV in Nigeria is an achievable goal, but it requires innovative approaches that can address the unique barriers faced by women in underserved communities.
An expert on health related matters, Dr Godwin Emmanuel stated while interacting with newsmen as part of activities commemorating the just concluded World Aids Day in Makurdi, the Benue State capital.
Dr.
Emmanuel who is the Managing Partner/Impact Officer of MOZUK Future Solutions Limited, stated that the World AIDS Day have come and gone, yet Nigeria government must not fail to examine some of the gaps that must be urgently bridged as a nation.He explained that each year, thousands of children are born with HIV, largely due to inadequate access to testing and treatment during pregnancy, disclosing that the Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that Nigeria contributes about 22% of global paediatric HIV cases which indicates the urgent need for innovative approaches to curb MTCT.
“This brings me to a recent study in Lagos and Kano which demonstrated how HIV self-testing kits offer a practical, effective, and scalable solution to our MTCT challenges.
“The study interrogates an initiative seeking to integrate HIV Self-Test (HIVST) kits into TBA services as part of a broader strategy to eliminate MTCT.
“The intervention targeted underserved communities where healthcare access is limited, leveraging the trust and accessibility of TBAs to distribute self-testing kits and provide essential counselling”.
According to him, the study, led by Dr. Toriola Adebayo of Lagos State University Teaching Hospital and Dr. Usman Bashir of Aminu Kano Teaching Hospital, articulated the role of local expertise in advancing healthcare solutions tailored to community needs.
“In this intervention, 182 TBA clinics across three local government areas (LGAs) in Lagos and Kano States were equipped with HIVST kits. TBAs received extensive training on the administration of the tests, pre- and post-test counselling, and linkage to care for those who tested positive.
“Among the 1,982 pregnant women enrolled in the study, pre-intervention testing rates were markedly low, with just 60% in Lagos and 38% in Kano having ever been tested for HIV. After the introduction of HIVST, testing uptake surged, with all participants voluntarily using the kits during antenatal visits.
“The results were promising:
HIV Positivity Rate: An overall positivity rate of 0.8% was recorded, with slightly higher rates in Lagos (1.1%) compared to Kano (0.8%).
“First-Time Testers: Remarkably, 80% of those who tested positive were undergoing HIV testing for the first time.
Linkage to Care: All HIV-positive individuals were successfully linked to ART services, demonstrating the effectiveness of the TBA-led model in bridging gaps in healthcare access.
“The success of this initiative exemplifies how HIVST can become a cornerstone of affirmative action against paediatric HIV infections, which was also a critical focus of World AIDS Day observances.
“As evidenced by the success of the Lagos and Kano initiative, when confidentiality, stigma reduction, and leveraging trusted community figures like TBAs are prioritised, HIVST has the potential to transform PMTCT efforts across Nigeria.
“This is even more so with sustained investment, community buy-in, and political will. This can move us closer to a future where no child is born with HIV and every mother has the opportunity to live a healthy, fulfilling life”, Dr. Emmanuel alluded.
He further revealed that HIV self-testing kits offer a simple, private, and effective means of determining one’s HIV status, adding that the kits allow individuals to test themselves using a saliva sample or a small drop of blood, with results available in minutes.
Highlighting the importance, the health, said the convenience and confidentiality of this method are particularly appealing to those who might avoid traditional testing due to stigma or fear of disclosure.
He stated that the fear of being judged or ostracised often prevents pregnant women from seeking HIV testing, stressing that HIVST kits allow individuals to test in the comfort of their homes or a private setting, without fear of disclosure. This is particularly crucial for pregnant women, who may face compounded stigma if diagnosed with HIV.
“Increased Testing Uptake as demonstrated shown the intervention in Lagos and Kano demonstrates that when provided with confidential and convenient testing options, more women are willing to know their HIV status. Early diagnosis is key to initiating ART, which can reduce the risk of MTCT to less than 1%.
Prof. Mojisola Adeyeye, the Director-General, National Agency for Food and Drug Administration and Control (NAFDAC), says she supports herbal medicine production in the country.
She said this on a Forum in Abuja.
She, however, explained that for NAFDAC to accommodate herbal medicine as part of its regulated products, such herbal preparation must go through clinical trials.
She disclosed that the major challenge to herbal medicine practitioners is how to secure resources to finance clinical trial for their products, which she said cost a lot of money because it is a major aspect in medicine.
She added that “I believe in natural medicine, I was brought up with it, like the Agbo that we were taking and it was working.
“Herbal medicine or natural medicine work, before I came back home from the United States, I started a research on natural medicine for the cure of sickle cell, my niece who is a sickler got on it and her episodes decreased by 70 to 80 per cent.”
She explained that the agency gives approval for natural medicines once proven it is not toxic, and they have been used and tested before.
“We approve them for two years and then they can renew if they do clinical trial because it is something we are not used to in Nigeria.
“China supports many of these herbal practitioners.”
The director-general also spoke about using fruits and vegetables as medicine to cure some illnesses, adding that some of these fruits contain antioxidants that prevent cancer. (NAN)
The Nigeria Centre for Disease Control and Prevention (NCDC) has allayed public fears over the detection of the SARS-CoV-2 XEC subvariant globally.
The Director-General of the centre, Dr Jide Idris, did this in a public advisory issued on Saturday night in Abuja, made available to newsmen.
Idris reassured Nigerians that the variant, though identified in 29 countries, has not been detected in Nigeria.
He said that the XEC subvariant, a descendant of the Omicron JN.
1 lineage, was currently classified as a Variant Under Monitoring (VUM).According to him, this means that it is being closely observed for potential concerns but does not yet pose significant risk.
“The XEC sub-variant has been reported in Europe, Asia, North America, and Africa, with Botswana being the only African country to record cases so far.
“While the sub-variant exhibits higher transmissibility, there is no evidence of increased disease severity,” he said.
The NCDC boss said that Nigeria had been monitoring the JN.1 variant, classified as a Variant of Interest (VOI), which has been present in the country since January.
He assured Nigerians that the National COVID-19 Technical Working Group was conducting continuous surveillance and data analysis.
Additionally, he said that a dynamic risk assessment was being organised to strengthen the country’s preparedness and response capabilities.
He urged health facilities nationwide to ramp up COVID-19 testing and forward positive samples to accredited laboratories for genomic sequencing.
He encouraged the public to maintain vigilance and adhere to basic health protocols, including handwashing, mask usage in crowded spaces, and ensuring proper ventilation indoors.
He advised vulnerable groups, such as the elderly and those with underlying health conditions, to remain cautious.
“COVID-19 remains a significant risk, particularly for the elderly, individuals undergoing cancer treatment, organ transplant recipients, and those with suppressed immune systems.
“We urge Nigerians to get vaccinated and receive booster doses as recommended,” he said.
The director-general also called on state governments to enhance public health infrastructure, provide resources for improved surveillance and diagnostics, and promote public health education.
He reaffirmed the agency’s commitment to providing Nigerians with accurate and timely information on the evolving COVID-19 situation globally.
He urged citizens to avoid misinformation and rely on verified updates from its platforms.
“For assistance, the public is encouraged to contact the NCDC via its toll-free number 6232 or, WhatsApp: 07087110839, Twitter: @NCDCGov and Facebook: @NCDCgov,” he said.
Report says that the XEC variant of COVID-19 is a recombinant strain, meaning it results from the combination of genetic material from two or more existing variants of the SARS-CoV-2 virus.
Recombinant variants can emerge when different strains infect the same individual and exchange genetic material during replication.
This process may lead to new variants with unique properties, such as increased transmissibility, virulence, or resistance to immunity.
While thousands of mutations have been tracked globally, only a few variants are monitored for public health significance.
Nigeria’s NCDC and global health organizations like the WHO continue genomic surveillance to monitor and respond to emerging variants.(NAN)
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