Gombe: For many women living with Vesico-vaginal Fistula (VVF), life becomes a cycle of shame, humiliation, and social isolation. Rejected by spouses, stigmatized by communities, and often abandoned by family, they are pushed to the fringes of society. But that tide is turning in Gombe State where a beacon of hope now shines through the efforts of the Fistula Foundation funded by the United Nations Population Fund (UNFPA).
According to News Agency of Nigeria, Dr. Isa Musa, Executive Director of the Fistula Foundation, emphasized that the foundation’s effort was more than a medical programme. He asserted that the foundation’s work was restoring dignity, purpose, and identity to women who were once cast aside. Since its inception in 2023, 291 VVF cases have been successfully repaired-a monumental achievement in North-East and Nigeria at large. However, the real miracle happened beyond the operating theatre. The foundation is not only stitching wounds but also stitching hope back together. In 2024 alone, 50 women who underwent successful surgeries were enrolled in post-surgery rehabilitation, which includes vocational skills training. Another 50 are slated for the 2025 intake.
The most profound impact comes from the advocates-women who were once patients themselves. These trained community educators now sensitize traditional birth attendants and local women, encouraging early treatment and dispelling myths surrounding the condition. These advocates are breaking the chains of ignorance and cultural shame; they are changing mindsets and helping women seek help with dignity. One such advocate has already identified and referred 30 women to the centre.
Dr. Garba Buwa, a fistula surgeon at a specialist hospital, explained that while fistula surgeries had previously been conducted in the state through outreach programmes led by former governors’ wives, the centre began its first surgery as a recognised facility in September 2023. Buwa, who is the Deputy Director of Medical Services at the Gombe State Ministry of Health, elaborated on the process, describing it as a ‘pool effort’ that brings patients from across the country following a nationwide call via media. Each session treats 30 to 50 women, and surgeries are held at no cost, with patients provided meals and transportation.
The UNFPA funds the pool effort through the Fistula Foundation, while routine Thursday procedures are backed by the National Health Insurance Scheme (NHIS) via the Federal Ministry of Health. To date, more than 500 women have registered under the programme. Of those, 291 received surgeries; others were managed conservatively-some healed with catheter isolation, while others had conditions unrelated to fistula, such as overactive bladders or urinary tract infections. The centre collaborates with an internationally recognised fistula surgeon who handles complex cases and trains upcoming specialists.
Empowerment remains key as the government has empowered 50 women in 2024 and plans to support 50 more. With more partners, the centre can achieve even better outcomes. However, it faces serious challenges, including a shortage of trained fistula surgeons and nurses. Some doctors are interested but require specialised training and certification. Space is another constraint, as the centre operates in a borrowed facility. Both the federal and Gombe State Governments are constructing a dedicated fistula theatre to address these issues.
Dr. Habu Dahiru, Gombe State Commissioner of Health, highlighted the state’s progress. When the administration came in 2019, maternal mortality was high, with fistula a key contributor. Today, with improved antenatal care, surgical interventions, and partners like the UNFPA and Fistula Foundation, visible progress is being made. Meanwhile, Dr. Faruk Usman, Federal Ministry of Health Fistula Desk Officer, noted that Nigeria accounts for 40 per cent of the global fistula burden. The commitment to reducing this aligns with the global target of eradicating fistula by 2030, as this is not just a health issue but a human rights matter.
UNFPA’s Gombe Coordinator, Dr. Olarenwaju Bajuwa, observed a growing confidence among previously silent sufferers. People are beginning to seek treatment, which is a positive development. Obstetric fistula is more than a medical condition; it is a life-altering experience that often leaves women isolated, ashamed, and forgotten. Many affected women endure years of pain and stigma, waiting for the chance to reclaim their dignity. Women who have faced unimaginable hardship but emerged with resilience, hope, and a renewed sense of purpose-thanks to timely intervention, surgery, and empowerment-recount their experiences.
Malama Jummai Ibrahim lived with fistula for over 20 years, enduring continuous urine leakage after childbirth complications. In 2024, the Fistula Foundation gave her a second chance. She is now an advocate, referring several women to the centre, and expresses gratitude to the foundation and the Gombe Government. Another survivor, Malama Naziyatu Adamu, developed fistula after a botched surgical procedure. She suffered in silence for months until the Foundation intervened. She now visits houses in her community to identify sufferers and ensure they receive help. Adamu has helped two women get treated and received a sewing machine that now supports her family.
Malama Safiya Hussaini developed fistula after a complex home birth. For 14 years, she lived in shame, but her husband stood by her. She urges other men to support their wives, emphasizing that treatment, not rejection, is the answer. Stakeholders acknowledge that obstetric fistula remains a major health concern in developing regions, caused by prolonged and obstructed labour without timely medical care. The condition often leads not just to chronic health issues but also social exclusion, psychological trauma, and economic hardship. Health experts advocate for a holistic approach-combining surgical care with emotional support, empowerment, and sustained community engagement-as the solution.
