Two Million Tears: Africa’s Silent Epidemic

“I have no friends and my family won’t speak to me. Wherever I go, people run away from me due to the horrible smell that comes out of me because of the condition I have.” – Madeline, a 13-year-old girl from Zaria, Nigeria.

These are the words of a young lady, a teenager – barely – from Nigeria. After 24-hours in labor on the dirt floor of a hut, miles away from the hospital and doctors who could help her, she gave birth. But instead of a healthy baby, she was left with a stillborn son and a large tear that constantly leaked urine and feces.

The hurt of a dead child coupled with her new condition was too much for Madeline’s husband and family to bear. She was thrown out of her home and abandoned by everyone she ever knew.

This year, 130,000 girls and young women in the third world will develop what is known as a “vesico vaginal fistula” – a condition mainly caused by prolonged or unattended birthing labor. This devastating circumstance — known commonly by the acronym VVF — can be prevented with the proper medical care and fixed with a specialized, but relatively routine surgery. Yet sadly, most local surgeons are not trained to treat these young women; thereby they live out the rest of their lives without help, suffering silently; they hesitantly walk through their villages carrying a white, plastic bucket because they have no way to control the constant leakage.

This “leakage?” VVF leaves a woman – typically a very young girl – continually dripping urine and other vaginal fluids from fistulas, abnormal connections or tears formed between the bladder and vagina. Not only are these young women in immense physical pain, they also deal with tragic, emotional damage – in the form of complete rejection from their families, friends and communities; they become social outcasts.

While AIDS, famine, and war grab national attention, the growing VVF epidemic goes virtually unnoticed. Though the exact magnitude of the fistula problem worldwide is unknown, estimates have put the number of women living with the condition at nearly four million; at least two million of those live in Nigeria.

“Two Million Tears: Africa’s Silent Epidemic” tells their story.

To get at the heart of this devastating problem, The KBTV team and I traveled to northern Nigeria, the country hit worst by VVF. At a small hospital in Kaduna, in the southern region where 70 percent of the country’s VVF cases are, we followed a team of American surgeons and health care practitioners on a medical mission to repair dozens of women with VVF. We also delved into the stories of some of their patients, very young women like Madeline, who have known nothing but sorrow. From their journey to the hospital, to the operating table to the recovery room, we have followed their road to recovery and what it means for other women with VVF.

Part of the reason this epidemic has largely been ignored is the culturally sensitive nature of VVF. Some 97 percent of VVF cases are caused by prolonged obstructed labor during childbirth, which often occurs when women have no access to health care. However, a large proportion of these problems are the result of girls having children before they are fully developed. African culture, like many others in the developing world, practice early marriage; UNICEF estimates that 42 percent of girls in Africa are married before age 18.

In some African countries the figure is much higher, such as in Nigeria where there is a 76 percent incidence of child marriage, and in some areas of West Africa and in Ethiopia, girls are sometimes married as early as 7. African governments, such as that of Nigeria, are beginning to address the massive VVF problem, especially with the push of the United Nation’s millennium development goals, help is coming slowly. Africa is severely lacking the medical professionals trained to do these kinds of procedures.

It is organizations such as Physicians for Peace that make a difference by not only embarking on these missions – but raising awareness.

KBTV Productions, through our feature-length documentary “Two Million Tears: Africa’s Silent Epidemic.” We seek to bring light to an issue that has remained in the dark.