12 Factors that makes a Woman Susceptible to Obstetric Fistula, Prevention & Care (Safe Motherhood #2)

Mama sat at the bedside of her daughter looking dejected at the hospital. She prays hard that God will save her daughter from this affliction that left them all in open disgrace and embarrassment. Her daughter had just put to bed but her vagina was leaking with urine. The young lady had sustained an injury during a mismanaged childbirth and was later brought to the hospital. Mama is burdened with caring for her daughter and newborn as the girl’s husband had abandoned them. He couldn’t cope with the mess as he referred to it. Mama believed that somebody had bewitched her daughter but at the hospital, she finds out that there is hope for her daughter. She prays hard that the surgery to the injury will work but also worry about raising enough money to pay for it.
This young lady has what is known as Obstetrics Fistula which occurred during childbirth with unskilled birth attendants: A sad story but hopeful.

The international Fistula awareness day comes up every 23rd May and this year’s theme is tagged: Hope, Healing & Dignity to us All.

Obstetrics Fistula is an abnormal hole in the bladder or rectum as a result of a traumatic birth experience. Urine drains uncontrollably through that hole to the vagina. It can also be termed to mean injury sustained in difficult childbirth or a birth not properly attended to.
Fistula occurs mostly in younger people (under 18 years) not old enough to give birth.

Factors that makes someone susceptible to Obstetrics Fistula:
1. Children below age 18 getting pregnant are a risk as their birth canal is not big enough for a baby. The injury is usually sustained during childbirth.
2.  Labor that is not managed properly especially when there is an obstruction. This is a situation a baby is too big to pass through the birth canal.
3. When a woman presents a breech baby she can sustain an injury during delivery or in the process of trying to assist her.
4.  During the operation of a woman to remove her womb probably because of fibroid mistakes can occur and she sustains an injury.
5.  Unskilled birth attendants in the rural or urban area can put a pregnant woman at risk of Fistula injury.
6. Quacks carrying out a caesarean section can injure the bladder or vagina of a woman.
7. Cancer of the neck of the womb can also erode into the bladder leading to Fistula.
8.  Female Genital Mutilation (Female Circumcision) could cause injury to the bladder. Also, infections may occur in patients not given any antibiotic after FGM. This infection can erode into the bladder and vagina.
9. Women who in an attempt to treat Fibroid or abort through herbal means take caustic materials are at risk of sustaining an injury in their vagina and bladder leading to Fistula.
10.  In some cultural or family practices where women are not allowed to go to the hospital to give birth but instead are required to give birth at home with spiritual chants, when there is an obstruction such women are at risk of Fistula injury.
11.  Lack of funds/poverty prevents people from going to safe hospitals to give birth. Stillbirth may occur and in an attempt to deliver the mother of the baby an injury can occur.
12. In remote villages/places distance to the hospital denies women access to proper care and therefore are exposed to quacks to monitor their labor. This is dangerous.

Prevention of Fistula:
Integration of family planning to reduce the number of abortion by quacks helps to reduce fistula cases.
Training and updating midwives to be able to detect when there is going to be a problem with a pregnant woman’s delivery. Such women are referred on time to a hospital equipped to care for them.
Provision of Maternity Health centers in remote areas will enable women to have access to proper maternal care.
Preventing underage marriage
Sex and health education of teenage girls to keep them from engaging the services of quacks to do abortion.
Health education on the importance of pregnant women registering with hospitals for proper care.
Government making maternal care cheaper or even free.

Why Fistula should be eradicated
A leak of urine or faeces through the vagina leaves the woman psychological traumatized and physically incapacitated. She cannot go to work or go about her business for fear of the smell and stigmatization. Therefore she is economically handicapped. This will also affect the income of her family and her wellbeing.
Some women have been abandoned by their husbands because he could not cope with the trouble of his wife wetting the bed and smell. This further affects her well-being and that of the family.

The Good news is that Fistula is repairable. Many do not know that this is possible. Share with a woman with a Fistula today that her case is treatable.
Right now the University Teaching College Hospital and Adeoyo in Ibadan are offering free Fistula treatment. It is from 22nd May – 26th May 2017.

Fistula is Preventable; It is treatable

Apart from the opening story and conclusion, this article was drawn from points on an interview with a team from the Engendered Health (NGO) and members from Ministry of Health in Oyo state on the radio station Premier F.M 93.5 in Ibadan on the 23rd May 2017.


The team includes:
Prof. Oladosu Ojengbede – Chief Surgeon Obstetrics & gynecologist UCH.
Dr. Doyin Bello (Gynaecologist)
Mrs. Olajumoke Adekogba (Rep. Engendered Health – Fistula Care Plus (USAID)
Mrs. Oluwakemi Olawoyin( Rep. Commissioner for Health)

Adebisi Adetunji (C)

Girls are beautiful Just as they are – Stop the Cutting #FGMC

fgmc-beautiful-as-god-made-them
My daughter and friends from church

6th  of February has been set aside as the International day of Zero Tolerance to Female Genital Mutilation and Cutting. Recently through the awareness on FGMC created by the radio drama serial, “Pim Pim Pim”, three girls ran to their local church to prevent being circumcised. Fortunately their local Pastor had the number put out on radio and so he called the line. The girls have since been rescued. Child protection is working on their case.

If only more parents will protect girls from having their vagina cut in the name of tradition.
This is still an issue in many communities in different parts of the world.

Some Reasons why it is practiced:
* FGMC is believed to be a girl’s right of passage to womanhood in many communities where it is practiced.
* To prevent a girl/woman from being promiscuous.
* To show chastity in a woman and therefore bring honor to her family.

Cost of Not Circumcising a Girl
* It is a cultural practice that is entrenched so much in communities where it is practice. Any girl who is not circumcised will not have a man willing to marry her.
* It is believed that such a girl/woman is loose. This tarnishes hers and her family’s image in the community.

Effect of FGMC on the wellbeing of a girl/woman
* Bleeding and loss of life
* Infection that could lead to difficulty in achieving pregnancy later on in life
* Difficulty in enjoying sex becomes a source of conflict between the woman and her husband.
* Mutilated vagina
* Complications during child birth

How can we stop this practice?

Engaging communities in the discussion about Female Genital Mutilation and cutting.

Creating more awareness that FGMC has no benefit

FGMC does not prevent promiscuity. There are girls who were circumcised and still keep chains of men.

Speak up and do more to STOP FGM/C

UN Women Statement on this year’s (2017) International Day of Zero Tolerance to Female Genital Mutilation

Adebisi Adetunji (C)

Pim Pim Pim! What?? Where? #Radio Drama Breaking

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Pim Pim Pim literarily means, “Cut cut cut”. What is been cut? Who is cutting? Is it painful? Is it harmful?

Someone is definitely cutting something and it turns into a serious saga!!

Pim Pim Pim is the story of a princess and her twin babies. What she proposed to do is a taboo in her community. The Royal chiefs become enraged…Her father the King might lose the throne if she insists. The whole community goes agog… who is going to save the day?!

Maybe the young doctor in the community, maybe the women, maybe the youths who are protesting….ITS A SERIOUS “SAGA” OR “GBEGE” AS WE SAY IN PIDGIN LANGUAGE.

It was fun producing the story for Amuludun F.M 99.1.       I had a great team to work with.

So do you want to know what is up with the Princess, her babies, the king, and community? Tune into radio stations in these states weekly:

SUPPORTED BY UNICEF
EBONYI, EKITI, IMO, OSUN AND OYO
MEDIUM: RADIO
PERIOD: 13 WEEKS: FROM JANUARY TO MARCH 2017
DURATION: 15 MINUTES

SOUTH EAST

1. HEARTLAND FM 100.5, Owerri (Radio Nigeria)  Wed 3.45pm Imo  Pim Pim Pim English

2. ORIENT FM 94.4, Owerri (Imo Broadcasting Corporation) Fri 10.45 am Pim Pim Pim Igbo. Repeat Broadcast Tues – 7.00pm

3. UNITY FM 101.5, Abakaliki (Radio Nigeria) Ebonyi  Sun 10.30am Pim Pim Pim English. Repeat Broadcast Tues- 1.45pm

4. SALT FM 98.1, Abakaliki (Ebonyi Broadcasting Corporation) Ebonyi Sat- 11.00am Pim Pim Pim Igbo Repeat Broadcast Wed – 5.00pm

SOUTH WEST

5. SPLASH FM105.5, Ibadan Oyo  Pim Pim Pim English – Sat 3pm

6 AMULUDUN FM 99.1, Moniya, Ibadan (Radio Nigeria) Oyo  Thurs 6.15pm Pim Pim Pim Yoruba

7. LIVINGSPRING FM 104.5, Osogbo (Osun State Broadcasting Corporation) Tues – 3.45pm Pim Pim Pim English

8. ORISUN FM 89.5, Osogbo (Osun State Broadcasting Corporation) Thur- 6.00pm  Pim Pim Pim Yoruba

9. EKITI RADIO FM 91.5, Ado Ekiti (Broadcasting Service of Ekiti State)   Fri 11.45am Pim Pim Pim English

10. PROGRESS FM 100.5, Ado Ekiti (Radio Nigeria) Thurs – 6.15pm Pim Pim Pim Yoruba.

Good news…The story is broadcasting in English, Yoruba and Igbo languages.

For comments, questions or inquiries call: 08173330586 OR email – pimpimpimng@gmail.com

Adebisi Adetunji (C)

Fibi- Pregnant but must go Through a Rite

Fibi was eight months pregnant. It was time for the rite to be performed. She dreaded it but it must be done. Everything was set for the celebration. Her entire family was not going to be quiet about it…they wanted to show her off. Their eight months pregnant daughter must go the way of other women in their community.

The day finally arrived  and the circumciser was ready with her tools.

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Fibi’s screams could be heard miles away as she was cut. Dancing and celebration filled the atmosphere, Fibi had made them all proud. Her unborn child can now safely pass through the birth canal without fear of been touched by the forbidden clitoris.  The community’s belief is that it would cause the baby’s death. 

But Fibi started to bleed. She was later rushed to the hospital. No one was sure mother and baby would pull through.

Another case of female genital mutilation and cutting only this one endangers pregnant women as their culture demands that they get circumcised at 8months into conception.

As a mother I know what it is like going through Labour pains. Already without been circumcised, the  birth experience for any mother can come with a number of  complications so why increase the risk.  I have undergone surgery at the hospital during the birth of my first baby due to excessive bleeding. My  vagina was also cut (not circumcision) by my doctor as my second baby found her way into the world. She was a big baby. The after effect of these cuts is best imagined.

Why should a woman be circumcised one month to the delivery of her baby? This is simply a double torture.

As to the believe that the baby can die if the mother is not circumcised before birth… This is not TRUE. I am a living proof and so are many other mothers who were not circumcised and had healthy and living babies.

Please help spread the word:

Female Circumcision /genital mutilation and cutting has no medical, physical or Spiritual benefits.

Instead many girls /women struggle on with the negative effects years after it had been done. That is if they live to tell their stories.

Female genital mutilation and cutting is a known cause of prolonged Labour as the scared birth canal might be too narrow for the baby to pass through. It simply puts mother and child at risk.

#EndFGM.

Photo Credit : Unicef

Adebisi Adetunji (C)

Why would a Bride do this…?

bride-veil-2Martha (not real name) fell in love with a young man, John (not real name). They both had just graduated from school. Everyone loved the couple; it felt like a relation made in heaven. Their love blossomed and soon talks about marriage popped up. Martha and her fiancé decided to tie the knot and their families began the wedding preparation in earnest. Everyone looked forward to a memorable day.
It was a bright and sunny morning. Jubilation was in the air. The wedding guests who had come from the community and nearby cities bustled with laughter and jesting filled the atmosphere. Other young ladies were teased to hurry and invite them for their own celebration.

The groom was ecstatic and couldn’t wait to take the vows with the love of his life. He waited at the altar smiling and waiting to catch a glimpse of his beautiful bride in her cutely sewn wedding gown. A gloomy face emerged and ran to the altar towards the groom… everyone wondered, the news soon filtered around, “Martha, the bride to be had run away”.

It looked like a scene from the movie, “Runaway Bride”, as I listened to this story but no it was a true life‘s experience.

Why did Martha run on the day she had looked forward to all her life? She ran because she couldn’t face John. She had a secret… “Her vagina was covered with keloid. Martha is one of many girls who gets cut on their vagina when they attain puberty. The flesh around her vagina had been cut and it formed a big scared tissue. She was ashamed, she was afraid to let John see that ugly overgrown scared tissue, now formed keloid on her vagina.

What this means for Martha/How Keloid in the vagina can affect a person’s wellbeing and life:

  • Scar  which grows excessively into Keloid tissue can be embarrassing to the individual; create uneasiness.
  • Affects the person psychologically as she might feel less beautiful about herself.
  • Keloid tissue scar makes the skin around the area it occupies less elastic which can affect certain nerves causing pain.
  • Martha is likely to experience itching and  pain during urination, menstrual flow and sex.
  • Would her husband/partner be willing to accept her as she is. He might be turned off sexually and this will not do their relationship any good.
  • She might need a cosmetic surgery and the process of treating Keloid might be a long journey. That is the swollen tissue every clears completely.

This is one of the heartbreaking stories i came away with from a radio drama script writing workshop on Female Genital Mutilation/Cutting (FGM/C) organized by Unicef in partnership with the Ministry of information Nigeria. It was an eye-opening experience.

You know sometimes we think that we know so much about a subject or issue simply because it’s a familiar subject. I am very familiar with and have lend my voice to creating awareness about the effect of female circumcision known as female genital mutilation /cutting in the past. But statistics and real life stories told by facilitators and other participants showed that the consequences of female genitalmutilation/cutting is far deeper and grave than i thought.

One thing is clear that a lot still needs to be done about changing perceptions and achieving behavioral change towards the practice of Female genital mutilation/cutting.

Many women and families suffer great consequences long after the female genitalia cutting. #EndFGM/C

end-fgm

Why is this tradition and practice still been upheld in many communities around the world?

Some people have replaced genital cutting with another practice and they justify it. What is the new trend?

I will be sharing more stories from FGM/C world in a series of  posts.

Photo Credit: DHgate.com – Wedding Veil Cathedral Thick Lace Manthila bridal veil.

Adebisi Adetunji(C)

A Mother on the run

Recently i heard this true life story and found it amusing but i also realize the seriousness of the issue. So follow me and read the story:

MOTHER ON THE RUN

A mother whom i would call Kikelomo is happily married to her dear husband who loved her and their girls however one thing cast a shadow on their relationship.

Every time Kikelomo gave birth her mother in-law showed up to perform a family tradition. Every girl born into their lineage must undergo the necessary rites of circumcision. Unfortunately Kikelomo kept giving birth to girls and every time her mother in-law showed up a battle ensued in their home. Kikelomo fought tooth and nail to prevent her two girls from going through this gruesome practice but every time her mother in-law’s wish prevailed. She tried to make her husband see what carrying out the circumcision meant to their health and future but he was a strong believer in his family’s long aged practice. After their second baby girl was circumcised the little girl fell ill and it took sometime before she recovered that was when Kikelomo promised herself that it won’t ever happen again!

Kikelomo  began to dread getting pregnant but she did again. All through the period of her pregnancy she was tensed and when she found out through a scan that they were expecting another baby girl she knew it was time to fight back.

Finally her day of delivery came and she had a healthy baby girl. Kikelomo smiled and thought of what her plan would mean to her family but it had to be done. As far as she was concerned it was the only way out. She never went back home; in fact her husband on returning to the hospital to take his wife and baby home found an empty hospital bed. He found out a few days later that his wife and baby girl were now in France – out of the country. He couldn’t believe that she would go to that length to  protect their baby girl from been circumcised.

As i listened to this woman’s story i couldn’t hold a smile and i said out aloud…“she made a smart move”. Thank  God she could at least afford the trip. They say desperate times call for desperate measures, Kikelomo was desperate enough to protect her girl from been circumcised. I don’t know how this family ended up sorting out the matter and i wondered whether her husband finally realize that it was indeed a serious matter.

Some reasons people give for carrying out Female Genital Mutilation is unbelievable. In my culture i have heard that girls are made to go through circumcision so that they would not be sexually promiscuous. What an ignorant ideology!

Take a look at some costly effect of FGM on girls:

  • Complications can occur leading to bleeding
  • High risk of been infected with HIV
  • Complications during childbirth later in life (Prolonged labor)
  • Urinary track  infection, VVF
  • Complete Virgina obstruction can occur
  • Psychological effect such as anxiety and depression, lack of trust for  carers, sexual dysfunction, and more.

Protect girls from female genital mutilation!

GIRLS FGM
Young girls dressed in Fulani attire dancing 

For more up-date on questions about FGM,you can check out UNPA

Photo Credit: Thank  you wierdlittleworlds.com

Adebisi Adetunji