→ only partially-correct information
→ only half-correct information
→ in-complete information
→ in-correct information
→ in-accurate information
which circulates? in Nigeria? concerning vesico-vaginal fistula also says that
●●● and still further-more, it is not every female who suffers vesico-vaginal fistula.
●●● and that it is only the very young females of maybe 10??? years to 12??,13??.14 years who suffer it when/while delivering their babies because at that very young and very tender age their bodies are not fully developed enough, in real terms, to go through the rigours of delivering babies and this physical reality and physical truth about their bodies shows clearly when their membranes tear during child-birth and they now have vesico-vaginal fistula.
●●● and that it is because of this reality that vesico-vaginal fistula is not seen in every country and every area of the world unlike fibroids which can occur in women in any part of any country any where in the world or like hernia which can occur in both males and females in any part of any country any where in the world.
●●● and so for example a country like U.K ( the United Kingdom ) may not register or record high incidences or any incidence at all of vesico-vaginal fistula (vvf ) illness because, by and large, females in the UK tend to more or less marry from 18 years old up .. probably mostly in their 20s and 30s .. by which ages ( i.e from 18 years upwards ) their bodies are physically developed enough to withstand and handle the rigours of the child-birth process.
●●● and that it is also for this same reasons that for instance in a country like Nigeria, vesico-vaginal fistula (vvf ) is not a commonly occurring incidence in Southern Nigeria i.e among
● the Igbo ( Ibo )
● the Yoruba
● the Bini
● the Isthekiri
● the Urhobo
● the Kalabari
● the Ijaw ( Izon )
● the Ibibio
● the Efik
● and all other tribes historically native to the Southern Nigeria area
as the females in these areas culturally, traditionally and historically go into marriage and/or child-bearing when their bodies are visibly physically developed enough to handle the stresses, strains and rigours of child-birth .. probably from 16 years up on the average.
●●● it is also for this reason that there is a notable observation of the occurrence of vesico-vaginal fistula (vvf ) in Northern Nigeria as in the Northern Nigeria area the cultures, traditions and history of some? of? the tribes there allow(s) females to go into marriage and child-bearing at very young and very tender ages ( e.g 12 years ) by which time their bodies are usually not physically well developed enough to handle the stresses, strains and rigours of child-birth thus resulting in vesico-vaginal fistula (vvf ) in these young, innocent girls.
the study on vesico-vaginal fistula in Eastern Nigeria says
Our objective was to examine the epidemiological determinants of vesico-vaginal fistula in Eastern Nigeria, and maternal characteristics and sociocultural factors predisposing to vesico-vaginal fistula. The case-records of 74 patients with vesico-vaginal fistula were reviewed. The mean age of the patients was 34.1 years and the mean age at occurrence of fistula was 30.1 years. A total of 24 women (32.4%) presented within 6 months of fistula formation. They were mainly multipara, housewives, subsistence farmers and still living with their husbands. A total of 68 (91.9%) developed a fistula following prolonged obstructed labour. Juxta-cervical fistula was the most common, 33 (44.6%) followed by juxta-urethral 11 (14.9%). The other associated morbidity included chronic vulval excoriation, cervical damage and amenorrhoea. Fetal wastage was high with 53 (77.9%) stillbirths and four (5.9%) early neonatal deaths. Vesico-vaginal fistula is still a major problem in the developing countries and a reflection of standard of obstetric care currently available to our women.
[ link address : https://pubmed.ncbi.nlm.nih.gov/16234147/ ]
and we can see from this that
→→ vesico-vaginal fistula also occurs in Eastern Nigeria i.e South-Eastern Nigeria and not only? in Northern Nigeria
→→ the average/mean age of the patients studied was 34.1 years which is older than the 10? years to 14? years mentioned in the only-partially correct information circulating about vvf.
→→ the average/mean age of the patients studied at occurrence of fistula was 30.1 years which is older than the 10? years to 14? years mentioned in the only-partially correct information circulating about vvf.
be that as it may be
the INDIAN JOURNAL OF SURGERY ? ( Indian J Surg ? ) says in the paper titled Vesicovaginal Fistula: Diagnosis and Management
Although the incidence of VVFs has become rare in the industrialized world, they still commonly occur in developing countries . Estimates suggest that at least three million women in poor countries have unrepaired VVFs, and that 30,000–130,000 new cases develop each year in Africa alone . The general public and the world medical community remain largely unaware of this problem. Ibrahim et al.  emphasized, as have others working in the largely Muslim culture of northern Nigeria, the high prevalence of early marriage and childbearing, the low literacy rate, and the poor uptake of conventional antenatal care among the fistula patients. Probably the most important factors contributing to the high incidence and prevalence of obstetric fistulas in Africa are socioeconomic . Early marriage, low social status for women, malnutrition, and inadequately developed social and economic infrastructures are all more common in the poor areas. Most importantly, lack of access to emergency obstetric services is ubiquitous in the poor regions. In parts of the world where obstructed labor is a major contributor to maternal mortality, the rate of VVF might even approach the maternal death rate .
[ link address : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039689/ ]
so the thing to do really is to ask experts and knowledge-able folks in this area what exactly is the truth and the reality regarding vvf.
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