based on the only-partially correct information circulating concerning vvf
one would probably surmise that

in Nigeria
the way forward is probably for the federal government and the government of those states where vvf ( vesico-vaginal fistula ) is an observable occurrence to put in place strong, responsive, easily accessible measures of treatment and health management for the females in areas where there is a historical and current manifestation of vvf ( vesico-vaginal fistula).

these measures should also note that many of the young, innocent females who find themselves in this situation tend to be financially poor and to come from financially poor families such that their husbands and/or their biological parents are usually able to afford expensive, high medical bills.

a measure that could be helpful is probably the putting in place of constant, consistent and repeated education and enlightment programmes for peoples from the areas where vvf ( vesico-vaginal fistula ) is an observable occurring incident.

this measure should note that the challenge in these areas is a combination of
● culture challenge,
● tradition(s) challenge,
● way of life challenge,
● way of life challenge,
● historical way of life challenge ,
● possibly also low level of enlightenment challenge,
● possibly also low level of education challenge

and therefore the enlightenment and education programmes targeted at the folks from these areas should take these factors into consideration and necessarily include as an important part of their target groups the male folks in these areas
as the males from these areas are very contributory to the problem because
they are the ones who go about impregnating very tender and very young girls of around about 12 years old and thereabouts whose 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.

this inference / surmisation is not far away from what the
INDIAN  JOURNAL OF SURGERY ? ( Indian J Surg ? ) implies in the paper titled Vesicovaginal Fistula: Diagnosis and Management
when it says that
Although the incidence of VVFs has become rare in the industrialized world, they still commonly occur in developing countries [1]. 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 [2]. The general public and the world medical community remain largely unaware of this problem. Ibrahim et al. [3] 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 [4]. 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 [5].

so at the end of the day,
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.

By sam

Samuel Ojekwe is essentially just your basic everyday fellow that you see in your neighbourhood while you go about doing your stuff and who, like you, wishes and hopes that the world becomes a better place for all of us.

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