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

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STATE REPORTSNORTH CENTRAL ZONEThe States surveyed are Plateau, Nassarawa (no data obtained) Benue, Federalcapital territory Abuja, Kwara and Niger States. In all the states, top rankingofficer of the ministry of health were interviewed and where possible, the officer incharge of the facility that did VVF work was also interviewed.PLATEAU STATEThe officer interviewed was the Director Planning, Research and statistic and theinterview was on 12/2/02. He agreed that the state has problems of VVF, but hadno documented information on VVF. Government work on VVF was the healthtalks and occussional surgeries done in government hospitals and clinics, but therewas no policy or data in the state MOH on VVF. The ministry identified twofacilities involved in VVF work and they were the Jos University TeachingHospital and ECWA Evangel Hospital Jos. Beside the two facility, and theEvangelical Church of West Africa. The officer was not aware of any otherorganization working on VVF in the state. He was not also aware of any VVFrelated work on VVF going on with government and neither any government workplan on VVF.The Health Facility During VVF work:This was the ECWA Evangel Hospital in Jos, Jos North Local Government ofPlateau State. The hospital has a dedicated unit doing VVF work call the EvangelVVf Centre. It was a Mission/Church Organization that started the VVF work in1992.64
The centre has seven doctors, ten nurses, one social worker, the rehabilitationworker, three gynaecologist (who could do 30 repairs in a month) and two trainedVVF nurses committed to the VVF work. See table for the names of the trainedstaff. There was no visiting VVF surgeon.Infrastructure:The facility had an operating theatre with two surgery days and full complementsof instruments though inadequate set because of the workload. The centre has fiftybeds for VVF:- thirty for preoperative patient and those under going skills trainingand twenty post operative beds. All surgical consumables are supplied free andcost covered by the hospital and donors. The actual average cost per treatmentsession was twenty five thousand as per the time of interview. This cost was madeup of one hundred and fifty Naira for card, fifty Naira consultation, investigationscost one thousand five hundred Naira, surgery fifteen thousand Naira, bed feesthree thousand five hundred Naira, food two thousand Naira and drugs fivethousand Naira. Of these costs, the patients paid four hundred and fifty Naira only.For this all the patients were able to pay, and the balance covered by the hospitaland donors. Even where the patient cannot pay, the required N450.00 she is stillnot denied surgery. Some times the patients were also from transported back totheir villages when they have no transport money.ECWA Evangel Hospital, SIM Mission and Christophel Blinden Mission (CBM)were the main donors to the centres via grants.RehabilitationThe facility also had a rehabilitation programme for the VVF women, which waspart of the centre. The bed allocation for the women undergoing rehabilitation wasnot specified but as at the time of the interview there were fifteen women undergoing the skill rehabilitation and it was a mix of all the patients (pre-operative,65
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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
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• Officers in-charge of hospitals
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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 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: IX. Lack of comsummables for VVF re
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
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26. Lister U.G. Obstructed Labour-
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Dear Sir or Madam:,We send you gree
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(g) Name of the Hospitals involved
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2. Trained VVF staffName ofYear ofD
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5. How do VVF patients get their Su
Page 127 and 128:
Post operative; Cured, Uncured8. Wh
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APPENDIX 2: LIST OF PERSONS CONTACT
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KebbiKatsinawardVVF, Secretary Dr.
Page 133 and 134:
APPENDIX 4LIST OF DOCTORS AND NURSE
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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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