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

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the remainder being state government owned, except the teaching hospital inEnuguFacilities for VVF RepairThe available facilities for VVF repairs are also assessed, both directly by theinvestigator and the interviewees. Of specific interest is access to theater facilitiesfor repair work. The data collected revealed that, there are no separate VVFTheatres in all the Teaching Hospitals and Medical Centres owned by the Federaland State Governments, except in the Ebonyi State Teaching Hospital, even that isa result of support to the institution by the UNDP. which is supported by theUNDP. The free standing VVF Centres have separate VVF Theatres, these areoften supported Donor Agencies like the UNDP, The Ford Foundation, Embassiesand other Faith Based and Philanthrophic groups and individuals. Some of theCentres with theatres solely dedicated to VVF repair are the Baban Ruga Hospitalin Katsina, the Laure Fistula Centre at the Murtala Mohammed Hospital Kano, theBirnin Kebbi Special VVF Centre, the Faridat Yakubu VVF Centre, Gusau, theMaryam Abacha VVF Centre Sokoto, and the Family Life Centre, Anua.The equipment in each of these theatres were assessed by both the field assistantsand the workers and the conclusion of that is that there are no Theatres that can besaid to be fully equipped as of the time of the assessment, they were either lackingor broken down, and some of the theatres do not have special instruments neededfor VVF repair, except in a few cases. The challenge in this regard is themanagement of the facilities with special reference to equipment maintenance andpurchase. The other challenge faced by Doctors is in relation to the type ofoperating tables available for repairs, these are not flexible enough for thepositioning of the patient for repairs.48
The other crucial need for VVF repair is the availability of pre and post operationbeds, in most of the VVF Centres, the commitment to VVF work is seen in theform of the provision of a hospital unit/bed for the purpose of Pre-operational andPost operational care. The free-standing VVF Centres have adequate bed capacity,Katsina has as high as 150 pre-operation beds, 40 Post Operation Beds and 24 forRehabilitation. The second largest centre is the Family Life Centre, in Anua, AkwaIbom State with provision for beds. The other centers with many bed spaces butyet not free standing VVF centers are, the Laure Fistula Centre with 30 preoperationbeds and 64 (including 9 matresses) post operation beds along with theECWA Evengel Hospital, with 50 beds, 30 pre and 20 post operation. There areseveral other medium to small VVF Centres and Units in the country.An assessment of the facilities across the geopolitical zones, shows that the NorthWest has the best facilities for VVF work, they have four VVF Centres withseparate VVF Theatres that are fully equipped, these have an average of 46 Preoperationbeds and an average of 32.8 Post Operation Beds. In the North CentralZone there is no free standing VVF centre, all of them are part of general hospitalservices, but the Evengel Hospital Jos, has the best facility for VVF repair, thisconsist of a unit of the Hospital which serves as a VVF centre. The other centresare the Teaching Hospitals and Specialist Hospitals, these are four, have skeletalfacilities for VVF repair as part of the general facilities available in the hospitals.In the other Zones, an average of 6 Pre-operative Beds exist and 4 Post OperativeBeds in the North East, there are three post and pre operation bed facilitiespreserved for VVF work in the South East, these are found at the Ebonyi StateTeaching Hospital. In the South West there are no special arrangements made inthe form of any kind of facility for VVF repair, the few repairs are undertaken in49
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 and 16: 2. Establishment of a VVF hostel an
Page 17 and 18: Other aspects that engaged the atte
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: Curative ActivitiesHealth Facilitie
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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report of the rapid assessment of vesico-vaginal fistulae in nigeria

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