EngenderHealth, the implementing partners of Fistula Care plus Project, have called for an end to sexual violence against children and women stressing that it is one of the major cause of traumatic obstetric fistula in Nigeria. They made the call during a media roundtable on fistula intervention at Sokoto, Nigeria.
This is coming at the heel of a recent groundbreaking survey, carried out by the National Population Commission, with support from UNICEF and the US Centers for Disease Control and Prevention, which found a high prevalence of violence against children in Nigeria. According to the report, one out of every four girls and one in ten boys experience sexual violence in Nigeria. From the report, approximately 6 out of every 10 Nigerian children under the age of 18 years, experience some form of physical, emotional and sexual violence before the age of 18 years.
Some of these sexual assaults against children such as brutal rape, introduction of sharp objects into the vagina, is one of the major cause of traumatic gynaecologic fistula, a clinical associate with Fistula Care plus Project, Dr. Suleiman Zakariya, explained.
“Although obstructed labour accounts for 80-90 per cent of obstetric fistula in Nigeria, we also have cases of traumatic gynaecologic fistula experienced by women, and children as young as two years. These children may have been violated sexually or victims of harmful practices”, he said.
The Chief Medical Director (CMD) of Maryam Achacha Women and Children Hospital, Sokoto, Dr. Bello Lawal, also mentioned that the traditional genital cutting performed on girl children (The Gurya cutting) contribute to traumatic fistulas in children.
Speaking about the implication of the Gurya cutting, he said; “the traditional barbers cause a lot of Hydrogenic fistula when they carry out the local surgery. In an attempt to cut out the supposed growth, they may injure the bladder or rectum and the woman end up with vaginal fistula.
“Also, the same barbers are also called to help a woman deliver when she has obstructed labour, and in the process, he tries to expand the side of the private part so the baby can come out. But in this process he may go anteriorly injuring the bladder and causing VVF or he may go posteriorly and injure the rectum and the woman will end up with rectro-vaginal fistula”.
For intervention, Dr. Zakariya, explained that Fistula Care Plus offer interventions in terms of prevention, treatment of condition as well as rehabilitation and integration of women back to their homes. “These interventions are key because it goes a long way to prevent new cases from occurring. Our partnership has always been with the Federal Ministry of Health, government has done a lot but there is still need to double our efforts by provision of needed infrastructures”, he said.
He called for implementation of policies against rape and other sexual abuse.
“There is need to do more in ensuring girl child education, women empowerment, Poverty reduction, Road Networks and other infrastructures. There should be policy changes that tackle the root causes of obstetric fistula, such as delays in accessing emergency obstetric care, there should be Increase political commitment to health budget, improvement of health infrastructure and national health system, promoting gender equity and reducing violence against women”, he added.