VVF,and the Health Hazards of Early Marriage
Early marriage or Child marriage has magnatized scathing arguments against its practice for some days now,wherein the most heart-wrenching presented yet,is a convulsive tale of a particularly disturbing birth complication.
Campaigners would shudder us off guard with extremely gory pictures of sufferers loosing control of their bladder ,unknowingly passing out urine at inappropriate locations,and in some instances,passing out faeces through the same tract meant for urination.
While #ChildNotBride activists may be absolutely correct about the sufferings of these mothers, pegging early marriage as the overriding cause of the ailment is mischievously misleading at best,and a dirty blackmail at worst. The above rebuttal shall be corroborated by compelling evidence from world class authorities on the worrying defect called Vesico Vaginal Fistula.
Vesico Vaginal Fistula (VVF) is an abnormal link between the woman’s private part and the urinary bladder, which results in an involuntary release of urine into the part( Spurlock, 2011). While the case of an abnormal link between the rectum and private part ,leading to involuntary release of faeces into that part is called Recto Vaginal Fistula (Taylor ,2011). The general name for both conditions is called Obstetric Fistula.
A condition that arises from prolonged/obstructed labour of 3 to 5 days,in which a ceasarean section cannot be accessed,eventually resulting to malfunctions or death. In that light,and contrary to #ChildNotBride narrative,early marriage is not the underlying cause of obstetric fistula. Indigence and dearth of amenities are the cause.
Poor infrastructures and malnutrition have been agreed by leading experts on Fistula to be the primary causes of birth complications in Africa. In a study done on Nigeria by the International Journal of Obstetrics & Gynaecology in 1983,it was gathered that 64.5 per cent of women who developed VVF had tried putting to bed at home due to total absence of clinics in their localities. Which is also exacerbated by a comatose transportation means needed to convey the birthing mothers into cities with available facilities. Not to mention the fact that virtually of all these mothers are so hidden in the rural enclaves that even a taste of prenatal service most times becomes wishful luxury.
Besides,when they sometimes go to clinic for delivery,many hospitals in the North lack the facilities and personnel to perform caesarean section(operation) which the Fistula Foundation in USA has enumerated as the “most effective preventive measure of VVF”.
In going forward, World medical practitioners had explained why in error of commission, early marriage instead of malnutrition and poverty has been dubbed the direct cause of fistula. They contend that since there is so much poverty in Africa (in this case the North) and lack of proper nutrition thereof,most women tend to become stunted in growth. Experts explained further,by saying this malnourishment, mostly prevalent among poor Africans of adolescent ages as much as in middle age people could sometimes lead to skeletons unequipped for proper birth.This weak and underdeveloped bone
structure increases the chances that the baby will get stuck in the pelvis during birth, and resulting to complications.
Showing that other factors(poor health service and poverty) and not early marriage is the primary cause for VVF,we shall make reference to comments by champions of anti-early marriage before the brouhaha of Senator Yerima took center stage.
In a seminar held earlier this year in the Cross River capital of Calabar, the State Ministry for women affairs disclosed that as at November 2012, some 638 women –and growing– had made themselves available for treatment on VVF. In his speech, the Women Affair’s Director of Administration, Mr. Vincent Egbe, supported the poverty angle of fistula when he opined that: “The finds indicate VVF was much in the rural areas where most of the affected women
have no easy access to health information and facilities.” This finding which shows more than disproportionate percentage of the sufferers are women of middle age baffled the state Commissioner for Health, Dr. Angela Oyo-Ita into saying”it was surprising to note that there were fewer cases of VVF among teenagers, but more cases among the older women.”
In a clear departure from her recent outburst against early marriage, the State Commissioner for Women Affairs, Mrs. Edak Iwuchukwu,also had admitted then that “obstetric issues, lack of trained
birth attendants, and poverty” are the main causes of VFF. Unfortunately all these turncoats, in a shattered leftover of their former selves ,last week blamed early motherhood for fistula. However, as a vindication for supporters of #BrideNotSlaves,the US Fistula Foundation responsible for treating VVF world wide contended in 2011 that “Any woman who can gain access to emergency obstetric care such as a caesarean section(operation) will not
develop a fistula.”
It is against this background of evidence both by Nigerian and foreign experts that one can say Early Marriage is not the immediate cause of VVF; which takes us to the solution for the ailment. Obstetric fistula as pointed out by Fistula Foundation can be treated permanently through a surgical session costing just $450( N67,500). Again on poverty,since most of the victims in the North cannot boast of that amount in a financial year,they just live with VFF instead–Our donations and not protest would help them.
In a similar vein,as a preventive mechanism to this societal scourge of fistula, The United Nations
Population Fund (UNFPA) in 2011 suggested we avoid” delay
in seeking medical attention; delay in reaching a medical facility; and delay in receiving medical care once arriving at a health care facility”.
Hence,activists of #ChildNotBride could best help the women affected by VVF by tasking the corrupt and dysfunctional senators(Yes, I agree) to influence legislation that would reduce poverty in Nigeria,build maternity centers in remote enclaves of the country,and lastly foot the surgical bills of VVF patients across Nigeria. That is the least we could do to help these suffering brides.
Omasoro Ovie Ali
Lagos,Nigeria
omasoroo@yahoo.com
27/07/2013
8:41 AM
omasoro99's Blog 
Reblogged this on naija infoman’s notes and commented:
This excellent article, Ovia Ali Omasoro exposes the lies and ignorance of the #ChildnotBride campaigners as it relates to their claim that early marriage is the leading cause of Vesico Vaginal Fistula (VVF). It is an intellectual contribution to this debate that have been promoted by anti-Islam elements with ignorance, bigotry and hate.
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Fantastic write up,unbiased and professional presentation.May Allah reward U abundantly.I’m really well informed on this issue.
Salaam. This is a good write-up, very factual and written from a well-informed perspective. I appreciate the research, but I’m going to have to refer you to Dr. Brimah’s article. He stated all these things too, but there was one thing at least that he acknowledged – we do not have the health facilities to reduce the alarming statistics and that is why the issue of marrying girls (and most specifically consummating such marriages) while they are still too young is being discouraged here. My point? We can’t keep saying that it’s as a result of poor healthcare and then persist in doing something which could otherwise curb it. For as long we do not have the necessary facilities to ensure that VVF does not occur so often, then we might want to drastically reduce that thing that seems to contribute largely to it; sexual intimacy with girls who are not fully mature, and who are therefore more likely to develop that as a complication of childbirth.
Also, early marriage and child marriage are two different things – the first is encouraged (even advisable), the second is not. My opinion on this matter is something I’ve previously stated, even though I agree that I may have not have expressed myself clearly enough – protests won’t solve anything, screaming at people won’t change anything, passing a bill won’t change anything because we also have a bad enforcement culture. What we ought to do is put our current social, health, and environmental conditions into consideration and determine what’s best for us as a people. Many Islamic countries have age limits on marriage, even Saudi is contemplating adopting one. Betrothal is one thing, marriage (i.e inclusive of consummation) is another. In the meantime, since these hospitals aren’t functioning and VVF is still a risk, why don’t we do what we can? That’s the whole point of this issue. This is like saying: ‘Having children while not fully developed contributes to the risk of VVF, but the main reason is because hospitals don’t have surgical facilities so tell the government to improve healthcare, don’t tell us to stop’, or ‘assuming we could operate on these girls on time, it would be okay for them to get pregnant while they are children’. We also have a responsibility as a people to put an end to this.
I understand why most people are on the defensive, but as far as I’m concerned, until you visit VVF clinics and see these women, hear tales of how they’ve been abandoned and how they had still-birth children, and then of those who died along with their babies in the course of childbirth, you won’t understand. The disadvantages are mainly for the women to bear and that’s why you’ll find that most arguments against child marriage (and consummation) are from women.
Ms. Rinsola thanks for the compliments.
However,there are few topics you broach that I cudnt quite agree with.
For clarity,in the piece,it was said that fistula existed because most mothers (in the North 65 %) try to give birth in their homes;without access to medical facilities. And we supported our stance on “poverty and lack of amenities” as the causes of fistula,by giving example of Calabar where more aged women develop fistula cos of non-existing health services in the rural areas.
And it was concluded indirectly that mothers should be asked to go to clinics for their birthing process,and not from their toilets,in order to reduce cases of fistula and death.
And as regards marriage age in Muslim countries. I think that point raised by Fani Kayode is being confusing a lot people. The age limits for those countries do not hold water in reality(except for Bangladesh). Because Muslims can marry 13-years old brides through the Sharia courts in all of those states. A preference that is given to Muslims in India,and Philippine(Non-Muslim countries).
Lastly,I know you speaking through the prism of a female intuition,I still want u to know that marrying a 13-year old is not hazardous to the bride and society. If possible, check the piece again for clarity.
Ms. Rinsola Abiola, thank you for your comment. As she said, the needed level of healthcare is one we do not have yet in this Country. Therefore, it is important that we stop comparing ourselves to other countries and face our situation squarely. These other countries can afford to take care of young mothers, Nigeria can’t (Well, we should be able to but the decay in the system makes it unrealisable now). This is about cutting our coat according to our cloth(not to our size).
Yes, we need a transformation in this country. Transformation is a gradual process. It will not happen overnight. The needed healthcare will not happen overnight, but meanwhile, child marriage can be stopped as a prevention mechanism.
Bukola, the piece made it very clear that early marriage is not the cause of VVF with facts from calabar.
In the case of the North,women shud be encourage to give birth in hospitals and not from the theatre of their bedrooms. Since almost all the vvf victims had tried to put to bed at home. And men shud not discourage their wives to visit clinics for fear a male doctor may look at the women’s private concerns.
VVF and early marriage are not linked.