Problems medicine cannot solve

This evening I attended UCL’s Annual Lancet Lecture. This year’s theme was; Climate Change – The biggest global health threat of the 21st century? ….But no, climate change is not my topic for today. In making a point this years lecturer and one of Britain’s most senior scientists; Lord May, a former President of the Royal Society and Government chief scientist mad an astonishing empirical fact – that on average, girls that have had a primary education – have 1.5 children less than those that do not. Girls that have a secondary education have on average 3 children less!

Now…what does this have to do with anything?

Vesico vaginal fistulas (VVF) is one of those things very few of us talk about, even in the profession. I have hardly thought of this since leaving university. It is just not on the health agenda……What are VVFs some might wonder, especially if you have not worked in our neigbourhood. In simplest terms these are abnormal anatomical passages between the bladder and the vagina most often cause by obstructed labour in young (often very young) mothers. Another reason obviously is more access to appropriate antenatal care. It is a devastating condition as women become incontinent of urine.

Recently the Minister of Health announced during the foundation laying ceremony of National Vagina Fistula (VVF) Centre in Kwali area council, Abuja that Nigeria had the higest number of VVF cases in the world. Its is hardy a surprising statistic – although the source of any health data in Nigeria is always a worry.

Apparently there are five major centers in the northern part of the country where those with the condition are looked after. These include Katsina as the headquarters, Kano, Zaria, Sokoto and Kebbi. The National VVF Project  in these five centers in the north are managed by Dutch surgeon known as Dr Kees, who is the head of the whole project. He added that Krees trained all of them in these centers.