For years, Vesico Vaginal Fistula (VVF) shaped the lives of 58 women in Kaduna, leaving many to cope with pain, emotional distress, stigma and social isolation.
But after successful surgical repairs, the women have begun another phase of recovery through skills acquisition and economic empowerment.
At a graduation ceremony in Kaduna, beneficiaries received skills and starter packs aimed at helping them rebuild their livelihoods and reintegrate into their families and communities.
For Rahma Ibrahim, living with VVF had been a painful experience marked by emotional distress and isolation.
Ibrahim expressed appreciation to the Kaduna State Government and its development partners for providing free treatment and skills training, saying the intervention restored her confidence and hope.
Similarly, another beneficiary, Khadija Yusuf, said living with VVF was painful and emotionally difficult.
Yusuf said treatment and subsequent skills training had given her an opportunity to rebuild her life and work towards becoming economically self-reliant.
Their experiences reflect the wider burden of obstetric fistula in Nigeria, where an estimated 114,048 women and girls are living with the condition and about 12,000 new cases occur annually, according to the UN Population Fund (UNFPA).
VVF is a childbirth-related injury that occurs when prolonged or obstructed labour damages tissue between the birth canal and bladder, resulting in continuous leakage of urine.
In some cases, fistula may also affect the rectum, causing involuntary leakage of faeces.
Beyond the physical effects, the condition can have serious social and economic consequences, including stigma, marital difficulties, isolation, loss of livelihood and reduced self-esteem.
For many women, therefore, surgical repair is only the beginning of recovery.
The treatment gap also remains significant.
According to UNFPA, Nigeria has about 20 dedicated fistula treatment centres, with capacity to provide surgical care to about 5,000 women annually.
At that rate, UNFPA estimates that clearing the existing backlog of women requiring surgery could take about 30 years, assuming no new cases occur.
Against this background, the Kaduna State Ministry of Women Affairs and Social Development combined medical treatment with rehabilitation and skills acquisition for the 58 beneficiaries.
The intervention is also part of a wider expansion of fistula care in Kaduna.
In March, UNFPA said 702 fistula repair surgeries had been performed across two supported centres in the state, with an average success rate of 90 per cent eight weeks after discharge.
The expansion included a new 12-bed comprehensive fistula centre at Yusuf Dantsoho Memorial Hospital and a renovated 48-bed ward at Gambo Sawaba General Hospital.
Three doctors and eight nurses were also retrained in fistula management.
Speaking at the graduation ceremony, Kaduna State Deputy Governor, Dr Hadiza Balarabe, said the occasion marked a celebration of healing, recovery and renewed hope for the beneficiaries.
Balarabe, who conveyed the greetings of Gov. Uba Sani, said the administration considered healthcare, especially the wellbeing of women and children, a priority.
She said successful surgical repair should be followed by measures to restore the confidence, dignity, social acceptance and economic independence of women affected by fistula.
“As a medical doctor myself, I understand the profound physical, emotional and social challenges women living with obstetric fistula may experience,” she said.
The deputy governor said the skills acquisition component had equipped the beneficiaries with practical skills and starter packs to support their reintegration into society.
She appreciated the Ministry of Women Affairs, Fistula Foundation Nigeria, UNFPA, medical professionals, counsellors, trainers and other partners involved in the intervention.
Balarabe, therefore, urged stakeholders to strengthen awareness on fistula, improve access to quality maternal healthcare and promote skilled attendance during pregnancy and childbirth.
She also called for greater access to treatment without stigma or discrimination, urging families and communities to receive women who had undergone treatment with dignity and respect.
In addition, the deputy governor encouraged the beneficiaries to use their skills and starter packs to establish sustainable livelihoods and support their families.
She also urged them to share their experiences and encourage other women to seek help, stressing that fistula was preventable and treatable.
Earlier, the Commissioner for Women Affairs and Social Development, Hajiya Rabi Salisu, said the graduation marked another step in the women’s recovery and economic empowerment.
Salisu said the 58 beneficiaries had undergone successful VVF repairs before participating in skills acquisition programmes across the state.
She stressed that surgery alone could not guarantee sustainable recovery, saying rehabilitation and economic empowerment were necessary to help survivors rebuild their lives.
“The starter packs are not just materials; they are investments in your future,” she said.
The commissioner urged the beneficiaries to see themselves as survivors, entrepreneurs, leaders and advocates rather than allowing their experiences to define them.
She also disclosed that the beneficiaries would form a cooperative society under the ministry to promote mutual support and economic development.
Meanwhile, the Executive Director of Fistula Foundation Nigeria, Mr Musa Isa, who represented UNFPA, said progress had been recorded in the prevention, treatment and rehabilitation of women affected by fistula.
Isa said quarterly fistula repair campaigns had enabled more than 400 women and girls to receive free treatment, including surgery, medication, feeding and transportation.
He said health workers had also received specialised training in fistula management, while survivors were being trained as advocates and community mobilisers.
According to him, community identification, referrals, savings associations and community dialogues were among the strategies being used to support affected women.
Isa said the 58 beneficiaries completed rehabilitation and skills acquisition after successful repairs at the Yusuf Dantsoho Fistula Centre.
He urged the women to use the skills and empowerment packages provided to them and remain united in supporting one another.
He also advised them to follow medical advice after treatment, including appropriate family planning and safe management of subsequent pregnancies and deliveries.
Representing the Federal Ministry of Health, Mallam Faruk Usman commended the Kaduna Government for supporting health partners and non-governmental organisations working on fistula intervention.
Usman said the establishment of the Yusuf Dantsoho intervention centre had brought specialised fistula services closer to communities.
According to him, more than 300 patients had undergone fistula repairs at the centre within two years through collaboration between the state government and Fistula Foundation Nigeria.
He said three doctors and six nurses had also been trained to manage fistula cases, stressing that treatment required specialised medical expertise.
Usman also urged stakeholders to strengthen advocacy and community-level identification and referral of women living with the condition.
He said many affected women were still unaware that fistula could be prevented and treated, including through available free treatment.
For the 58 women, the intervention has marked a shift from medical treatment to rebuilding their livelihoods and returning to family and community life.
More broadly, their experience highlights the need to prevent new cases through access to quality maternal healthcare, skilled birth attendants and timely emergency obstetric services.
At the same time, women already affected need early identification, treatment, rehabilitation and social acceptance to support their recovery.
As the beneficiaries leave with new skills and starter packages, their stories underline that fistula does not have to result in a lifetime of isolation.
Ultimately, with timely care and sustained support, recovery can extend beyond surgical repair to restoring confidence, dignity and livelihoods.
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