Sister Sylvia Ndubuaku draws a blood sample from a patient for a free test at the Family Life Centre. (Photo: Kelechukwu Iruoma/Global Sisters Report)
It took some time, but Esther Edet finally received the health care she needed.
She credits the Medical Missionaries of Mary who run the Family Life Center in Mbribit Itam, where women experiencing a variety of health issues, including fistula, are able to receive treatment and care. Edet, who asked that her real name not be used, now is 17 and continues to recover.
Edet's ordeal began when her stepmother forced her out of the house, accusing her of being responsible for her half-brother's unfortunate death. She was 15.
Moving in with a friend, Edet got involved in a romantic relationship at her friend's behest and soon became pregnant.
"He started sleeping with me because I didn't have money to feed," she told Catholic News Service. "He buys me food and some few other things I needed so I couldn't stop him. But he ran away when he got to know that I was (pregnant)."
That's when Edet's health began to deteriorate. The doctor Edet saw didn't help, leading her to contract vesicovaginal fistula, known as VVF.
Obstetric fistula is an abnormal connection between the vagina and bladder or rectum through which urine and/or feces continually leak.
Edet was taken to a traditional birthing home when it came time for her child to be born. But she experienced a prolonged and difficult labor and couldn't give birth.
"The baby was forced out, but it couldn't make it. When I started having problem, they directed us to this place (the Family Life Center)," Edet told Catholic News Service.
Edet underwent fistula repair surgery at the center, but still battled complications that included endometriosis, uterine fibroids and foot drop, also known as drop foot, in which a person cannot lift the front part of one or both feet because of muscle weakness or paralysis.
The center provides no-cost surgery and other health care to the less privileged in Akwa Ibom, Nigeria's oil rich state in the Niger Delta region.
Medical Missionary Sister Sylvia Ndubuaku, who oversees the hospital, said the congregation focuses "much more on maternal health needs of the people in far-to-reach communities where access to medical doctors is limited."
The sisters provide medical, physical and spiritual care for women and girls, treating about 200 patients annually. Care this year, however, has been complicated by the coronavirus pandemic.
Around the world, 50,000 to 100,000 women develop obstetric fistula annually, with upward of 60% of the cases in Africa. The World Health Organization estimated that more than 2 million women in sub-Saharan Africa, Asia, the Middle East, Latin America, and the Caribbean are living with VVF. The WHO said the illness can develop after prolonged and obstructed labor and may result from common African practices of child marriage and female genital mutilation.
Health experts say 200,000 women live with fistula in Nigeria. No data is kept on the number of women who have died from the condition. The disease is prevalent in Nigeria because of sociological and cultural beliefs and practices, poverty and poor health care.
In response, the sisters and center staff engage visit villages to look for women with VVF. They distribute fliers to help raise awareness; they also have quarterly radio and television programs and catchy public service announcements which are broadcast to reach a wider audience.
Sister Sylvia said fistula is a preventable condition that requires a match between a fetus and a mother's pelvis. A mismatch can lead to a difficult delivery, she explained, "and may require a cesarean section to get the baby out."
"But when a girl is given out in marriage at a very early stage when her pelvis is still maturing, it pushes her into hard labor, which may not turn out well in the end," Sister Sylvia said.
The nuns also provide rehabilitation, mental health counseling and skill development in soap making, hair dressing, sewing and baking to women and girls who have lost their self-esteem and means of livelihood.
"We speak with them with soothing words to encourage them, and that early approach loosens them up for treatment and expedites their recovery process because they have been traumatized," Sister Sylvia said.
Iyang Joy, who was part of the skills development program, told CNS the love and care of the sisters is evident daily. "My mum was brought here for a surgery in November 2019, while staying with her in the hospital; I decided to join the girls in the rehabilitation center to perfect my hair styling craft and the sisters approved of it," she explained.
"When it was time the girls whom the rehabilitation center was actually set up for to graduate and become independent, I was surprised to be part of them because I am not a patient," Joy said.
Joy was settled with about $300 to buy hair dressing equipment and a power generation system to set up her own salon, allowing her to earn money to continue her education and support her family.
The sisters also have a natural family planning unit which teaches couples about relationships and natural family planning derived from the Billings ovulation method. Sister Cornelia Udoka, who runs the unit, said she and the staff help couples understand the method so they can plan when it is best to have a child.
To reach more women with the disease, Sister Ngozi Ahunaya, who heads the center's Safe Motherhood team, and her colleagues travel into communities with a mobile clinic. They provide temperature and blood pressure tests, diabetes screening and treatment for malaria and typhoid. They also administer immunization services, school health and other treatments for those who cannot regularly visit the hospital.