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‘In Nigeria, there are 20 fistula surgeons to 120,000 patients’

By Chioma Obinna

A clinical Associate, Fistula Care Plus, Dr.Suleiman Zakariya has  decried acute shortage of Fistula Surgeons in the country, lamenting that with a population of 170 million, Nigeria has only 20 fistula surgeons.

Speaking during a media round table discussion on Fistula intervention with the theme, “Service Availability; Access to service”, in Sokoto, Zakariya expressed worry that the few number of fistula surgeons in the country does not match the over 120,000 Nigerians affected with the disorder every year.

Dr Suleiman Zakariya
Dr Suleiman Zakariya

He said that due to the acute shortage, only 5,000 out of a total of 12,000 new cases diagnosed each year are treated.

“Worldwide over two million women live with untreated obstetric fistula.”

Advocating urgent intervention in fistula treatment, he said: “In Sub Sahara Africa, 1 in 16 women has the chance of dying in pregnancy or childbirth while in developed countries, 1 in 4,000 is at risk.

“In Nigeria, it is estimated that between 120,000 and 150,000 are living with Fistula and about 12,000 new cases are diagnosed per year.  The most vulnerable group is the young, poor illiterate and rural women who are economically disadvantaged.” Noting that although, all doctors know about fistula, he explained that not all surgeons can repair fistula because it is a specialised area of surgery.

Explaining why Nigeria may continue to witness shortage of fistula experts, he said: “Fistula repair is a specialized area of surgery that does not attract financial gains as most of the surgeries are done free of charge.  As a result, many of the doctors are abandoning it to specialized in other lucrative areas.

“Fistula experts are not recognised. The pressure of being a fistula surgeon will drive them alone.  It is difficult to retain doctors in the system.  There is no money because it is done free of charge. Salary does not increase.  There is no recognition, retaining doctors in the system is a problem,” he further explained.

He said Engender Health under the Fistula Care Plus has  trained a pool of doctors and nurses to boost the available pool of doctors and nurses in Nigeria. Further stating that obstetric fistula is a manifestation of sub-optimal healthcare, Zakariya called for the upgrade of emergency obstetric care in the country to prevent obstetric fistula.

The Clinical Associate  stressed the need to increase political commitment to health through creating budget line for fistula. “Government should increase and improve health infrastructure and promote gender equity and reduce violence against women.

Identifying family planning as a factor in the treatment and prevention of Fistula, he said: “We need to improve access to family planning, provide safe and quality caesarian section, client friendly affordable services in the various hospitals as well as apply the use of catheter and partograph to monitor labour.


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