 There's a breakfast in Plastivia, Africa. We head straight to your second conversation Well, we look at the international day to end Obstetric fistula that we have a guest messy up or who joins the conversation. She's a team lead Fistula care initiative Lagos chapter and mess is good to have you join us this morning. Thank you. All right Let's get straight to it. We understand that you know 2020 actually mark the countdown to ending obstetric Fistula by 2030 and that's the plan according to the reports being made available by the Secretary-General of the United Nations, but before we get to the conversation. What is obstetric fistula? Okay, so I'm obstetric fistula is an abnormal opening connecting the vagina to the evenly bladder or the rectum so it's an opening that makes a woman to Urine comes out from the vagina instead of the normal way and then sometimes we also have rectum Vaginal fistula where feces comes out from the vagina instead of the anus. So it's caused by several factors We have the physical factors and then we have the social cultural factors. So the physical factors include Improper use of Ostrichic instruments like when a woman is in labor or all those orthodox myth wives Where they when a woman is in labor the instruments that are used Doing label those things can cause fistula because it can create a wound on the pelvis And if it is not treated it can make that place to be rotten and before you know it There will be an opening there Then we also have Obstructed label when a woman is in labor for too long and probably the head of the child Will press onto the pelvis making the pelvis to be soft the membrane will get weak and that can lead to an opening Then we also have cases of abortion or other kind of surgeries that affect the vagina Then we have the social cultural factors definitely poverty where Persons who cannot afford medical health care can go to orthodox midwives and they'll be treated that way So those are the various causes of fistula Very very important topic to look at and Very great to give this a kind of awareness to the people out there because hearing you talk about it. It's really worrying Is this you know prevalent is it rampant in in in our society in Nigeria? Number of people coming down with this. Yes, it is so apart from the north where of course there are cases where they are early Marriages and all of that. We also have cases here in Lagos So like we the fistula care initiative we have two cases currently that we are tending to here in Lagos state So just the fact that it's not just initially we had the case of okay fistula can be caused by early marriages So our focus was on the north but right now we've realized that there are other cases just like I mentioned the obstructed label So those cases at those are that forms like 90% of the cases we have here in the south and it's also rampant in other areas in Nigeria What are the dangers, you know? Of of go having such an ailment fistula Is it terminal disease for instance if if untreated doesn't need to death You know does it affect child bearing, you know conception? Yes, it does. So If it is not cared for because you have urinary incontinence That's the case of vesicle vaginal fistula. What is urinary incontinence? So do not know take it take it easy on us. Okay. Okay. So urinary incontinence is you can't control your urine So it just comes out you move on road you you're sleeping and you just pass out urine So those cases if it's not treated for persons who don't have a proper hygiene It can lead to urinary tract infections and those infections can also lead to Problems during childbirth or it can even lead to miscarriages where they won't be able to You know carry a child for so long So those are a lot of the cases if it's untreated early So it is not basically a terminal disease because there's a surgery Surgical repairs for those who have the fistula care. So that is why we have some NGOs just like us that cater for Surgical repairs like that before it gets worse Okay, so let's get to I mean who can actually be affected by this because also Reports will say that there's a spectator 13 million Malt children or child would actually get married by 2030 due to the fact that You know families who want to find a way to you know, take away the burden of poverty Cost by different factors. So who is suitable? I mean who's subtle to having this Crisis or situation? Well, I can't say anybody is because as far as as long as your woman You have the there's a danger for you to have it is just for you to be careful So initially would it be more prevalent in children? Yes for children who maybe gets married early So they may have more danger in having this fistula because apart from the fact that They may have to have childbearing early They would be introduced to sexual intercourse early and that is another way of getting fistula Um, so you talked about the the the treatment The repair if you want to call about talking about you know of this injury you mentioned surgery So, so let's talk about that. What are the ways to? To repair this this injury? Well, just like I said is surgery. So the only way basically surgery Yes, that's basically the only way because it's here. It's an opening. So it has to be fixed Yes, and what's what are the chances? What's the success rate? You know for those who are able to undergo this surgery to repair The the city the fistula today today. Do we have a high, you know chance of coming out? Okay Yes, um so far we've recorded like 90% chances Okay, so it's just um for just as we said we need to equip the medical sector the health sector So that the facilities will be proper because sometimes you see few cases of People going for surgical repairs for fistula and they end up with a bigger wound due to the fact that the Facilities are not up to standard. So but so far we've recorded like 90% Jesus, that's that's that's really really sad if anyone is meant to go for surgical Repair and they have a something worse. That's really sad But I'm and you talked about early treatment. Have you mentioned early treatment? Yes, and is there is there a an early stage where one can detect in when we talk about breast cancer? We hear early detection. Is there a stage an early stage where one can detect to be able To embark on that early treatment and if so, are there any signs to look out for? Yes The signs are so glaring because just as I said you're narrowing contours You won't it's it's won't hide So you may be sleeping on your bed and you wake up with urine everywhere And you may think oh, maybe I just bed wet but when you're moving you see that maybe you're stained or your wet or something So the signs are there from the beginning So the only problem we have is that a lot of people cannot pay for the surgery So before they can get to somewhere because we have some sentence in Nigeria that undergo free surgical repairs So before they can you know reach out to those people and all of that and a lot of people fall into depression so basically within that time there are a lot of Speculations and because some people don't even know about fistula. So they may term it as being spiritual Oh, really? Yes. So the special how I mean is it them one attack on village people So one of the current cases we have The but the lady is into depression right now and she initially she has turned it to the spiritual So it was after some series of tests and even after it. She was diagnosed of having fistula She's couldn't still believe it because you know, it's a bit rare in the south So it's one of the things we preach that if there are a lot of people like you can reach out to them People who have the same case you can reach out to them and know that you're not the only one with that disease so basically within that time within from Feeling depressed and trying to look for money for surgical repairs. So it may take a lot of work Okay, so apart from the fact that one of the Symptoms that you have mentioned is that you have urinary Inconsistency, what are the symptoms you should one look out for? You may have fever and all that Other symptoms of an infection But the main cause sometimes some people don't even have other symptoms. They just have the Urinary incontinence some people usually have difficulty passing out urine by themselves or Those who have the rectal vaginal fistula. They have difficulties passing out feces. So those are the early signs You talked about the the cost of treatment It sounds from what you say in this quite expensive. What's the average cost of this? the surgical repair in Nigeria Basically we have 400,000 Naira So but it doesn't include the tests because you have to undergo series of tests before the So so if you want include the tests on an average how much will everything cost? About 500 600 about 600,000 that's a lot for a lot of people in this part of the world And so so you've talked about the challenges and what what the authorities government and indeed society can do number one Providing avenues for affordable or even free Surgery and tests I believe and I also had you mention equipment to be able to have the surgery carried out professionally and properly and Have you have it apart from the non-governmental organizations of working in this space other government? It has taken me local government fellow government programs Addressing fees so that you are well well, I was aware of one in a quai bomb states that was sometime in 2019 well The first lady of a quai bomb state organized some kind of outreach for women Generally, and it also included fistula and then there are some other there are some health centers Sometime last year Lagos state governments made a recommendation that Government hospitals should carry out free surgical repairs for fistula patients So there are others, but it's a gradual process For those who are listening this morning who may have such a you know Nailment I think the important thing is that they're getting to hear from you that this is not spiritual They're not is not rare. It's not something they should hide You know if it's just them it happens to people as an explanation to this. All right, and then they can get help Is there a number to call for instance your organization or organization? Isations or government helpline? What can they do once they discover this is a problem I need to solve? Okay, so basically when you go online you see International or government organizations or NGOs that care for fistula patients So for we are the fistula care initiative. We are Instagram Just the name and we have numbers to call for Lagos chapter We have the head of the Lagos chapter. Okay, so When you go to the Instagram page you can get that or you can just call 08137382200 Once again 08137382200 All right, so on Instagram, it's called fistula care initiative It's very important conversation with hard mercy really really Scary, you know what some women would have to go through and she said the leading course One of the causes be early marriage or early exposure to sexual activity at a young age And that's why that's it's worrying, you know And that's why the statistics that has been put out that you have about 1.3 million children Going to be married of by 2030 Course for a lot of concern. I wish that and I'm also hoping that this would not be in vain because it's a campaign to actually end You know these fistula concern. Thank you once again messy are both for coming. Thank you All right. Well for one messy to another messy All right, anyway two for the price of one you may say messy it's been a thrill this morning on on the breakfast interesting conversations and of course ending on a good note With some awareness on something that's really important for the public to know about so that we can take action to save lives And that's it many thanks for being part of the breakfast and thank you so much myself We're for being part of the show as well We hope that you seek all of the help that you can get to reach out the internet is available with all of this information and We hope that Everyone all hands would be on deck so we can put an end to all of this And that's the size of our conversation on the breakfast if you missed that on a part of it at our it if all us on Facebook Twitter and Instagram and please do not forget to subscribe to a YouTube channel as a plus TV Africa and plus TV Africa lifestyle I am messable for we return tomorrow. Good morning. My name is Kofi Burcells. Thanks for joining us