Medical experts have identified stigma, lack of awareness, and limited access to maternal healthcare as major factors sustaining the burden of vesico vaginal fistula (VVF) in Nigeria, despite ongoing efforts to reduce the condition.
Speaking during a media engagement at the Evangel Vesico Vaginal Fistula Centre, Bingham University Teaching Hospital, Jos, the Project Director of the centre, Professor Sunday Langman, described stigma as a “serious and multi-layered challenge” affecting patients, families, healthcare workers, and communities.
According to him, discrimination against fistula patients remains prevalent, even within hospital settings.
“When we started in the 1990s, fistula patients were kept in general wards, but other patients often refused to stay near them due to stigma. Even among healthcare workers, some doctors avoid attending to fistula patients,” he said.
He stressed that the most damaging stigma occurs within families, where patients require the most support, urging communities to understand that fistula is not contagious and is a treatable medical condition.
“Women living with fistula can be treated, return to normal life, and even have children. We must demystify the condition and encourage families to support affected women,” Langman added.
The professor spoke during a co-creation advocacy workshop themed “Voices for Safe Motherhood,” organised by the University of Nottingham in collaboration with the Evangel VVF Centre.
He explained that the initiative aims to engage journalists and survivors in storytelling to improve public understanding and influence policy.
“For over two decades, journalists have reported our activities, but this approach allows survivors to tell their full stories while healthcare providers add context. This will help drive better engagement with communities and policymakers,” he said.
Langman further highlighted that the Evangel VVF Centre, a mission-based facility, provides free treatment, transportation support, feeding, and rehabilitation services for patients, most of whom come from poor and rural backgrounds.
“Fistula predominantly affects the poorest women with little or no access to healthcare. Without surgery, it can devastate lives indefinitely. This is why we see it as a humanitarian responsibility,” he noted.
He, however, identified barriers such as ignorance, fear of stigma, and poverty as reasons many women fail to seek treatment.
“Some women don’t even come forward because they are ashamed or unaware that treatment is free. Others worry about transport or feeding, not knowing these are also taken care of,” he said.
Providing statistics, Langman revealed that Nigeria’s fistula burden has reduced significantly from about 114,000 cases to 45,000, although approximately 12,000 new cases still occur annually.
He noted that Plateau State has recorded progress due to sustained interventions over the past three decades, with fewer local cases now reported at the centre.
“Currently, most of our patients come from neighbouring states such as Kano, Bauchi, Nasarawa, and Benue. We carry out about 800 surgeries annually, including outreach programmes,” he said.
He expressed optimism that with sustained collaboration, fistula could be eradicated in Plateau State within five years.
Also speaking, Dr. Hannah Degge, Assistant Professor of Health Promotion and Public Health at the University of Nottingham, described fistula as a preventable condition linked to poor maternal healthcare systems.
She explained that the “Voices for Safe Motherhood” project leverages storytelling to raise awareness and promote prevention.
“Fistula is a condition that leaves women physically and emotionally devastated, yet many do not know that treatment is available. Through storytelling, we can inspire hope and drive change,” she said.
Degge emphasized that access to free or subsidized maternal healthcare remains critical to eliminating the condition.
“The biggest challenge is funding and the political will to ensure women have access to quality maternal care. In societies where fistula has been eradicated, maternal healthcare is accessible and affordable,” she noted.
She also called on healthcare providers to uphold professionalism and compassion, citing reports of negligence and abuse during childbirth.
“Every woman deserves dignity and respectful care during childbirth. Delays, poor handling, and lack of skilled care are major contributors to fistula,” she said.
Both experts stressed that prevention remains key, urging pregnant women to attend antenatal care and deliver in equipped health facilities with skilled birth attendants.
They also called on men and families to support affected women rather than abandon them, describing such actions as harmful and unjust. Also stating that patients can access free medical care and support at the Evangel Vesico Vaginal Festula Centre Bingham University Teaching Hospital Jos.
“Fistula is not a death sentence. With awareness, access to care, and community support, we can restore dignity to affected women and ultimately eliminate the condition,” Langman said.