Saving Women from Needless Deaths

Treated VVF patients at the Centre

To stem maternal mortality in Ebonyi State, the wife of the governor, Josephine Elechi has stepped up the campaign against obstetrics fistula, writes Jeff Amechi

Ebonyi may be considered the ‘Salt of the Nation’ but the state faces several challenges that impinge on its saltiness. With staggering statistics and the rising death toll from maternal mortality, Ebonyi loses her children everyday to obstetrics fistula, a disease associated with poverty for lack of access to good health care, especially where there is prolonged labour and cesarean sections cannot be accessed by pregnant women.

Since the creation of Ebonyi State in 1996, the rate of maternal mortality and child death due to poor health facilities has continued to increase. But now, the wife of the state governor, Josephine Elechi is changing all that.  In a battle to save the lives of women and their children in the state, Mrs. Elechi initiated the Mother and Child Care Initiative (MCCI) as part of her pet project under which a Vesicovirginal Fistula Centre was built for the reduction of infant and maternal mortality in the state.

The MCCI focuses efforts on obstetric fistula and provided welfare support to women and youths across the state.

Elechi is not alone in her drive to help women overcome, she has enlisted the support of the Federal Ministry of Health and the representatives of United States Agency for International Development (USAID), United Nations Population Fund (UNFPA) as well as United Nations Children Education Fund (UNICEF) to brainstorm on how to repair the indigent women who were affected by obstetric fistula and have lived with the disease for decades without solution.

In 2008, Elechi built a Vesicovirginal Fistula (VVF) Centre which was later upgraded to South-East Fistula Centre with the intention of repairing, treating and rehabilitating VVF patients free of charge.

She followed that action by facilitating the sponsorship of a bill on Mother and Child Initiative and related matters that captures maternal mortality monitoring in the state House of Assembly.

The aim was to have a law in the state that will make maternal death documented as well as provides for stipulation of 10-hours duration for referral of pregnant women labouring in minor hospitals in the state without childbirth. The bill was passed into law on May 21, 2008 and assented to by the governor on June 5, 2008.

The campaign and identification of fistula patients thus started on November 17, 2008 in collaboration with UNFPA following the official commissioning of the VVF centre by the wife of the late President Hajia Turai Yar’Adua on December 5, 2008. Training was organised  for the staff of the Centre to equip them with the modern concepts of infection prevention and hospital waste management while sensitisation campaigns and awareness creation was organised on the dangers of female genital cutting, teenage pregnancy, need for pregnant women to attend antenatal clinics and deliver in the hospital, girl-child education, constant self examination for early detection of breast cancer and need for annual screening for premalignant lesions of the cervix.

The fistula centre, since 2008, has treated over 1, 600 VVF patients from over 20 states of the federation with patients from Abia, Akwa Ibom, Benue, Cross River, Delta, Edo, Lagos, Rivers, Anambra, Enugu, Kogi, Imo, Bayelsa, and Ebonyi while 200 patients with the uterine prolapse have received treatment in the centre free of charge.

For the success that has been recorded, the federal government has formally taken over the centre to rename it National Fistula Centre for Excellence since June 2011 with Elechi as the pioneer Chairman of its Interim National Management Committee.

The MCCI also constructed an ultra-modern cancer screening centre which has commenced exercise for the screening of cervical and prostate cancer.

According to the governor's wife, teenage pregnancy often leads to death and in no small way contributes to the high rate of maternal mortality in the state.

The State Commissioner for Health Dr. Sunday Nwangele, commended the efforts of the wife of the governor who continue to put smiles on the indigent women saying that combating the dreaded Vesicovaginal fistula has reduced the rate of maternal mortality in the state and Nigeria as a whole. He also regretted that over the years, the state had been in the mainstream of battling with these problems, adding that a lot of mothers died during childbirth and through the disease.

The Commissioner noted that Governor Elechi has released N1.5 billion to the rural mission hospitals to combat the problem of maternal mortality in the state.

Mrs. Elechi said those who thought the scourge of vesicovirginal fistula was for those in the northern part of Nigeria alone should have a rethink, adding that the disease had gained roots in both the South-East and South-South zones over the years.

The Medical Director of the Centre, Dr. Sunday Adeoye said that the achievement recorded over the years was based on the encouragement and financial provision by the wife of the governor whom according to him after the repair and treatment of the patients free of charge also gives the patients transport fare and other gift items.

“Obstetric fistula is largely as a result of prolonged labour as a result of delay in accessing obstetric services or delay in intervention and inadequate obstetric services. These factors are present virtually in every state in Nigeria, hence obstetric fistula is a national scourge,” Adeoye stated.

He however charged the repaired and discharged VVF patients to abstain from sexual intercourse for at least six months so that they would be properly healed. They were also told that if any of them must give birth again, it has to be through caesarian operation and not through normal delivery.
Mrs. Elechi urged the women to always register with recommended hospitals for antenatal services, stressing that every VVF repaired woman that becomes pregnant must always tell her doctor about her medical record.

The governor's wife also told the patients that their VVF problem occurred because they had problems of their baby’s heads being bigger than their pelvic, which, according to her, can happen to any woman in any part of the world.
She said: “Some of our old men and young boys that put our teenage girls in a family way will now be forced to marry the girl or at least take care of the girl until she delivers of her baby because a lot of our teenagers die in the process while undergoing abortion.”

According to the governor's wife, teenage pregnancy oftentime leads abortion. She quoted a report that stated that many women and teenagers resort to clandestine and dangerous methods rather than evidence based safer method to procure abortion, which is to avoid long arm of the law and high cost of procuring abortion from qualified personnel.

Mrs. Elechi was of the opinion that the best way to get rid of teenage pregnancy which also contributes to maternal mortality was through a sensitisation and awareness campaign in the rural areas on the danger of unprotected sex.

Currently, the MCCI has over 1,000 orphans and vulnerable children on its list. Also in collaboration with Rentmeister Foundation of the Netherlands, over 1,000 orphans and vulnerable children have benefited from programmes in the areas of educational support like payment of school fees, provision of school uniforms and other instructional materials.
Also over 1,000 persons living with HIV/AIDS in the state through her support programme on quarterly basis receive food items while resource persons are made available to enlighten them on ways of promoting and maintaining their health and protecting their families and the society.
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The Consul-General of the United States Consulate, Lagos Mr. Jeffrey J. Hawkins during his visit in February this year commended Mrs. Elechi, the initiator of the fistula centre where  thousands of patients have been treated free of charge. He said the US government through its agency USAID will continue to partner with the centre.
Hawkins also stated the USAID has been involved in providing succour to the people living with HIV/AIDS and fight against malaria in the country.