From Despair to a Smile for a Nigerian Woman: A Transformation Long Desired

This blog was originally published on the USAID MOMENTUM website. It has been republished here with permission.

By Olumide Adefioye, Senior SBCC Specialist, MOMENTUM Safe Surgery in Family Planning and Obstetrics Nigeria

Woman sitting on a hospital bed in Nigeria

Mrs. Josephine Agada, a farmer from Benue State in Nigeria, is sitting on the hospital bed with a bright smile etched on her face. It is a sunny afternoon at the gynecological ward of the University of Abuja Teaching Hospital where the 61-year-old woman is recuperating after a fistula surgery.

Photo: Mrs. Josephine Agada post-surgery. Photo Credit: Mrs. Mumuni Tolulope.

The mother of seven and grandmother of many grandchildren earns her living by farming yams and other food crops in Benue State.

She can afford to smile now due to a big change in her life. She eagerly shares the story of how she became free of the dehumanizing condition of leaking urine – a condition known as obstetric fistula.

‘’I have been leaking urine for the past 34 years. It all started during the birth of my last born in 1989 when I was in labor at home for two full days,” she explains. By the third day after Mrs. Agada’s baby was delivered by cesarean section, the damage had already been done. She realized days later that she was constantly leaking urine. The uncontrollable leakage of urine following childbirth is a condition caused by prolonged obstructed labor. About 150,000 women live with fistula in Nigeria, an estimated 7.5% of the global burden.

Since then, she has been seeking different remedies, most of which depleted her meager resources from working as a farmer. In her words, “I was thinking the thing would stop and even sought medical help and had to buy expensive drugs. The thing did not stop.’’ Mrs. Agada added that the condition made her depressed, sapped her income, and significantly limited her mobility. She had resigned herself to living with the condition and the stigma that comes with it. Treatment of fistula is mostly by surgical repair, which is costly and can only be performed by specialist doctors available in few tertiary hospitals in Nigeria.

That was Mrs. Agada’s everyday experience until her son heard an announcement for free fistula repairs intervention by MOMENTUM Safe Surgery in Family Planning and Obstetrics to strengthen competencies of the health workforce to treat obstetric fistula.  This information brought her on the five-hour journey from Benue State to the University of Abuja Teaching Hospital, Gwagwalada, where the repair surgery was successfully performed on her.

Beaming with an infectious smile, she says, “Now I am very happy. If I go back home, anyone I see with the condition, I will tell them about this hospital so they can also come. I also thank the organization that funded my surgery.” Mrs. Agada is one of the many women who have benefitted from the obstetric fistula repairs, one of the interventions implemented by MOMENTUM to address the obstetric fistula burden in Nigeria.

A total of 21 doctors and 23 nurses were trained to perform the surgery, which is provided at no cost to patients. In addition, MOMENTUM supported 1,238 fistula surgeries between January 2022 to September 2023 at supported Fistula Centres.