Physician caution parents to prevent early marriage

Dr. Patrick Okolie, an Abuja-based general medical practitioner, has advised parents to stop giving out their daughters in marriage early, as it could endanger the child’s whole life.

Okolie told the News Agency of Nigeria in Abuja on Tuesday that early marriage exposed young girls to Vesico Vagina Fistula.

According to the doctor, VVF is an abnormal fistulous tract extending between the bladder and the vagina that allows the continuous involuntary discharge of urine into the vaginal vault.
He said the condition was one of the two common obstetric fistulas that were found in the
developing world like Nigeria.

“It is generally associated with early age of childbirth and marriage, which is more common in the some states.
“The average age of occurrence of VVF in Nigeria, especially in the Northern part of the country, is about 11 years to 15 years of age,” he said.

According to the doctor, it is associated with early pregnancy and unskilled or unattended childbirth.
He said, “So when unskilled birth attendants take delivery or the delivery is unattended, it usually leads to prolonged labour and other complications, which ultimately results in the development of the fistula.

“During prolonged labour, the vessels and the tissues that lie in the birth canal would be compressed, they lose their blood supply and develop holes,” he said.
He said basically, a simple definition of fistula is a hole connecting two cavities or two vessels in the body.

“So the vesico vagina fistula is the communication between the bladder and urethra in front and the vaginal behind.
“When a fistula forms between these two organs or tissues that is when you have vesico vaginal fistula and the common presentation is that the person will be leaking urine through the vaginal,” he said.

Okolie said that the other type of fistula was recto vagina fistula, which is the opening between the rectum and vagina that allow both flatulence (causing excessive gas faitus to be created in the stomach and intestines) faeces to escape through the vagina.

“The vesico vagina fistula accounts for high percentage of maternal mortality in Nigeria.
“It also accounts for over 75 per cent of baby lose and has complications which may be present after delivery, as the husband may not want to associate with the wife,” he said.
He also said it was responsible for the high rate of divorce in some of these places where young women suffering from vesico vagina fistula were victimised.

“Rape and female genital mutilation were also associated with vesico vagina fistula.
“So these are some of the effects of vesico vagina fistula,” he said.

According to the doctor, the treatment is surgical, there will have to be a surgical repair of the fistula, opening has to be closed.
He said, “This is usually done by a qualified obstetricians and Gynaecologists (O and G) doctors.
“So when a woman develops fistula, she will have to see a gynaecologist, who will determine the extent of the damage and what kind of surgical repair needed.”

He, however, said that analysing the causes could determine how best such patient would be treated.
Okolie also explained that the major cause was early age of child birth, and that if a woman was not fully developed and the pelvic not fully matured.

“It will mean that the birth canal is not big and then a normal weight for a child passing through this birth canal is what will compress these organs or vessels,’’ he said.
He explained that preventing or allowing our female children to reach age of maturity before going into marriage and child birth was one major means of prevention.

“Another means of prevention is also about unskilled birth attendants in all deliveries. When a woman is pregnant, she should attend antenatal care with qualified practitioner or medical personnel.
“She should also make sure that the deliveries are taken by either skilled birth attendants or qualified medical professionals,” he added.

He advised that any complications noticed either during the period of pregnancy or at deliveries, should also be managed by qualified medical professionals.
“This way vesico fistula and other complications can be prevented.
“Health care is important and not just for fistula alone, but for other conditions, many complications can be prevented,” he said.

He said that through knowledge and information, the disease could also be prevented, adding that attending or receiving medical care is not as expensive as it used to be.
“There are many interventions now like the National Health Insurance Scheme that makes health care relatively affordable for everybody,’’ he said.

Okolie advised people to make use of this intervention by visiting hospitals when they have health challenges so that they don’t wait until complications set in.
“People should make use of the available health resources and go to hospitals on time to prevent complications and also in cases of VVF, most of the cases result from prolonged labour.

“So if a woman with such condition is having difficulty in delivery, she should be referred quickly to qualified professional or obstetricians and gynaecologist,” he said.
He said that doing that could guarantee that such patients would be managed on time to avoid more complications.

“We all know that the level of poverty is a problem in Nigeria, it does not benefit any one, if your ward or your daughter gets married at early.
“And then develops a complication that may affect her for the rest of her life,” he said.

He said it was better to allow our young ones to be fully matured so that they could endure both the physical and psychological challenges of both marriage and child birth.