report of the rapid assessment of vesico-vaginal fistulae in nigeria

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general hospitals that operate on many VVF patients are General HospitalHadejia and Gambo Sawaba government Hospital Kofan Gayan Zaria.In recognition of the magnitude of the VVF problem in Kano and other parts ofthe country, the National Council of Women’s Societies, Kano state branch,organised the first national workshop on VVF in July 1990 funded by the fordfoundation. The workshop was aimed at sensitising traditional leaders, NGOsand governmental agencies on issues relating to VVF and encouraging them towork together to devise strategies on how to control and prevent the problem.At the end of the workshop, it was decided that a National Task Force on VVFshould be formed to effect the recommendations contained in the communiqué.The National task force was formed with Mrs. Amina E. Sambo as Nationalcoordinator and Dr. Clara L. Ejembi as secretary. The body was inaugurated bythe then Honourable Minister for Health and Social Services, Professor OlikoyeRansome Kuti during its maiden meeting in February 1991.The task force conducted fact finding visits to various centres across thecountry to;1) Assess the scope of VVF-related services being provided in these hospitals2) Document the level of utilisation of the VVF services and identify factors ifany, militating against optimal utilisation of these services3) Seize the opportunity afforded by these visits to sensitise various NGOs,relevant government functionaries, health workers and traditional rulers to theproblems of VVF to stimulate their interest in VVF related work.16
Other aspects that engaged the attention of the task force were manpowerdevelopment. The strategy adopted was training of indigenous doctors nursesand other paramedical staff in the skills of VVF repair, postoperativemanagement and rehabilitation of such patients at the Kano and Anua centresunder Dr. Kees Waaldijk and Dr. Ann Ward (gap)Obstetrics and gynaecology to ensure that a policy is developed that includepostings to VVF centres as part of postgraduate training for specialistgynaecologists.Community mobilisation and public enlightment were conducted bydisseminating information through print and electronic media and production ofeducational materials in various languages. Two national workshops wereorganised, one on counselling of VVF patients in Katsina and the other onprevention of VVF in Zaria in 1995.Efforts were made by the task force to set up a national database on VVF usingthe recommended WHO prototype. However, the response from the variouscentres was discouraging, and so no much success was recorded with regard toresearch. A documentation and resource centre was formed at the secretariat ofthe task force.The task force was dissolved in? 1997 and replaced by the national foundationon VVF. The foundation has carried on with the functions of the task force. Aninternational conference on VVF held in Abuja in March 1998.17
Page 1 and 2: REPORT OF THE RAPIDASSESSMENTOFVESI
Page 3 and 4: LIST OF TABLETable 1States policy &
Page 5 and 6: CHAPTER 1INTRODUCTIONIn the past de
Page 7 and 8: AimThe overall aim of the rapid ass
Page 9 and 10: • Officers in-charge of hospitals
Page 11 and 12: causes, cancers and radiation thera
Page 13 and 14: The work of Dr. Ann Ward OFR at St.
Page 15: 2. Establishment of a VVF hostel an
Page 19 and 20: Several hospital-based studies repo
Page 21 and 22: In August 1988, Dr. Altine Tongo of
Page 23 and 24: who provided controls. A second con
Page 25 and 26: In this study, it was found that th
Page 27 and 28: other sweet substances, thus preven
Page 29 and 30: on themselves (i.e. possible pathol
Page 31 and 32: OTHER CAUSESLabour and the factors
Page 33 and 34: epair while the patient was trying
Page 35 and 36: likely to have mid-vaginal and high
Page 37 and 38: secondary education and 33% primary
Page 39 and 40: All over the country male children
Page 41 and 42: again before any surgery. The attit
Page 43 and 44: faith it is at times difficult in t
Page 45 and 46: CHAPTER 4RESULTS FROM FIELD ASSESSM
Page 47 and 48: Curative ActivitiesHealth Facilitie
Page 49 and 50: The other crucial need for VVF repa
Page 51 and 52: ackgrounds, this makes their econom
Page 53 and 54: The data on the distribution of hea
Page 55 and 56: VVF Repair OutputAvailable evidence
Page 57 and 58: the details on the payments VVF pat
Page 59 and 60: • Rehabiltation• Training of Do
Page 61 and 62: CONSTRAINTS TO OPTIMAL VVF WORK IN
Page 63 and 64: IX. Lack of comsummables for VVF re
Page 65 and 66: The centre has seven doctors, ten n
Page 67 and 68:
NASSARAWA STATEWe were not able to
Page 69 and 70:
Patients profileThe few VVF patient
Page 71 and 72:
InfrastructureThe facility had an o
Page 73 and 74:
patients were expected to pay for a
Page 75 and 76:
thousand five hundred, surgery thre
Page 77 and 78:
Measures to reduce new cases- Econo
Page 79 and 80:
state government owned. Federal Med
Page 81 and 82:
STATE REPORT NORTH WEST ZONEStates
Page 83 and 84:
VVF work started here as far back a
Page 85 and 86:
to the patients. He identified the
Page 87 and 88:
Patient ProfileMost of the patient
Page 89 and 90:
gynaecologist in the hospitals and
Page 91 and 92:
patients come to the hospital from
Page 93 and 94:
equipment/theatre table trained nur
Page 95 and 96:
OGUN STATEAt the Ministry of Health
Page 97 and 98:
O & G state specialist Hospital Ado
Page 99 and 100:
RECOMMENDATIONSIn the process of th
Page 101 and 102:
Table 2: Facilities Involved with V
Page 103 and 104:
MedicalCentreQueenElizabethHospital
Page 105 and 106:
Table 4 : Doctors and Nurses Availa
Page 107 and 108:
UmulogboHoly RosaryHospital Emekuku
Page 109 and 110:
staff Working Trained Work VVFrepai
Page 111 and 112:
South East ZoneState Anambra Aghaez
Page 113 and 114:
HospitalAbohMbaiseFederalMedicalCen
Page 115 and 116:
REFERENCES1. Zacharin R.F. Obstetri
Page 117 and 118:
26. Lister U.G. Obstructed Labour-
Page 119 and 120:
Dear Sir or Madam:,We send you gree
Page 121 and 122:
(g) Name of the Hospitals involved
Page 123 and 124:
2. Trained VVF staffName ofYear ofD
Page 125 and 126:
5. How do VVF patients get their Su
Page 127 and 128:
Post operative; Cured, Uncured8. Wh
Page 129 and 130:
APPENDIX 2: LIST OF PERSONS CONTACT
Page 131 and 132:
KebbiKatsinawardVVF, Secretary Dr.
Page 133 and 134:
APPENDIX 4LIST OF DOCTORS AND NURSE
Page 135 and 136:
Dr. Sa’ad IdrisDr. Zubalru Iliyas
Page 137 and 138:
Medical anthropologistDr. Sandra BO
Page 139 and 140:
List of Nurses that receive trainin
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