For each maternal death 10 to 20 women suffer permanent injuries or disability during the process of child birth. The most prominent among these injuries is obstetric fistula called Vesicovaginal fistula (VVF). Vesicovaginal fistula constitutes a major gynecological problem in developing countries. It is prevalent in communities where malnutrition and untreated infections stunt the growth of future mothers during their childhood and adolescence leading to contracted pelvis. In Situation where maternity services are scarce or far or even mistrusted contract pelvis go undiagnosed and survivors of obstructed labor may be left with bladder or rectal injuries resulting in constant uncontrollable loss of urine or stool into the vagina. The women if not treated are likely to suffer consequences ranging from physical disability, psychological, social, and economic consequences. They may also be ostracized from their own community; some become homeless, divorced or abundant by their husbands. The trauma is often compounded by the psychological trauma of delivering a stillborn baby. VVF is a major public health issue in Northern Nigeria where the prevalence is on the raise because of increasing poverty, girls are married off at early (under 19 years), high school dropout and low girl school enrolment are school.
Although the campaign to end VVF in Nigeria is ongoing over the last 20 years, little attention has been paid to prevention of new cases. The government and national foundation of VVF campaign (NF-VVF) and other non-governmental organization have their focused on the repair and treatment of the over 200000 thousand backlog cases. Currently there are 8 VVF centers in Nigeria mostly in the northern states caring for VVF cases. According to Dr Kees Waaldijk over 25000 repairs were performed since the inception of the foundation. 488 health professional trained in the pre and post-operative care for VVF. USAID developed a strategy they called pooled effort for fistula repair, the society of obstetrics and gynecology encourage trained gynecologist to repair and manage VVF cases, the ministry of women affairs in Jigawa state are working in collaboration with USAID to clear the backlog of fistula case. All these efforts are curative and none are preventative efforts.
Neglecting preventive strategies will only make matters worse as new cases add to the backlog every day. The NF-VVF acknowledges that there are no national VVF policies or policies that support prevention of VVF. Less than 7% of girls are enrolled in school in Jigawa state, followed by large drop after the first year. This is when the girls get married. The girl child has no say over her choice whether to be in school or to be married, that decision is left with the father.
Let us therefore end this mayhem by educating girl child. Putting girls in school will delay early marriage and delaying marriage will lead to reduction of teen pregnancies hence reduction in pregnancy related complications such as VVF and maternal mortality. Other benefits of girl child education include development of essential life skills, such as self-confidence, the ability to participate effectively in society, and protect themselves from HIV/AIDS, sexual exploitation. Additionally they will contribute to national wealth, their children are more likely to go to school and, consequently, this will have exponential positive effects on education and poverty reduction, reduction of VVF for generations to come.