Government of Nigeria Expands Treatment and Care for Fistula Patients

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Medical Director Dr. Iloegben Sunday-Adeoye conducting USAID staff around the ne
08/11/2011

Growing up as a young girl in south-eastern Nigeria, Josephine Elechi, wife of the Governor of Ebonyi State, noticed many women being ostracized by their communities because they suffered from obstetric fistula. She remembers promising herself that she would do something to reduce the needless deaths of women during childbirth and the discrimination against women affected by fistula.  Fistula is the result of prolonged labor without prompt medical intervention, resulting in damage to the woman’s birth canal, causing chronic incontinence and in many cases, death of the baby.  Nearly half of world’s fistula cases occur in Nigeria. It is estimated that about 150,000 Nigerian women are affected, with 12,000 new cases every year. 

In 2008, through the Mother and Child Care Initiative (MCCI), Mrs. Elechi established a center for the care and treatment of women with fistula in Abakaliki, Ebonyi State, the first of its kind in south-eastern Nigeria. A year later, USAID’s fistula care project ACQUIRE began providing consumable supplies, equipment and training support to the center, and integrated fistula repair and family planning services. The center now has 100 beds with 35 staff comprising of doctors, nurses, pharmacists, and technicians trained by ACQUIRE. 

As most of the patients who attend the center cannot afford the cost of treatment, MCCI and the Ebonyi State Government began paying for their treatment and food.  Patients from neighboring states also receive treatment thus putting pressure on the limited facilities provided by the Ebonyi State Government.  
To address this challenge, ACQUIRE project partnered with various stakeholders and persuaded the Government of Nigeria to assume management of the facility and to make it a regional center. Extensive advocacy meetings were held with the state and federal Ministries of Health, the National Council on Health, USAID, United Nations Population Fund and the Government of Nigeria. The National Council on Health recommended the upgrading of the facility to a regional center and managed by the Federal Ministry of Health. This decision was approved by the Government of Nigeria’s Cabinet in May 2011. To provide similar fistula services to northern Nigeria, GON will also upgrade another facility located at Babbar Ruga General Hospital, Katsina in the near future.

Through the work of ACQUIRE project, a sustainable, regional center owned by the Government of Nigeria, was established in Ebonyi State. Since inception, the center has treated more than 745 women with obstetric fistula; and thanks to the mediation of various stakeholders, many more affected women will be treated.  Mrs. Elechi is also fulfilling her promise. “I don’t want any of our women to die during childbirth” she said.