In Nigeria, women who are in their child bearing ages stand higher risk of developing fibroids. Fibroids are non-cancerous tumours that grow in, on, or within the walls of the womb. Fibroid is made up of muscle fibre. The cause of fibroid is yet unknown, but experts say when fibroid occurs, it may contribute to women experiencing painful sex, abdominal swelling, frequent urination and heavy menstruation. Some medical experts say that fibroids are common among black women. It has no symptoms and may grow one at a time or in clusters. Fibroids usually develop in women aged between 30 and 50 years and seem more regular in women who weigh over 70 kg.
Fibroids are widespread in Nigeria. According to medical experts, at least 1 in 4 women develops one or more fibroids in her lifetime. Fibroid contributes to the increase of unnecessary deaths and increased life expectancy in Nigeria. A good number of Nigerian women, including well-known artists, have lost their lives through complications of fibroid.
In Nigeria, provision of health care is never treated as a human rights issue. Individuals pay for any form of medication they may receive from medical outfits, even when health care provision is a concurrent responsibility of the three tiers of government in the country. In ‘Financing Health Care in Sub-Saharan Africa,’ Ronald J. Vogel states that the total expenditure on health care as percentage of GDP is 4.6, while the percentage of federal government expenditure on health care is about 1.5%. The mission of the Federal Ministry of Health is to develop and implement policies and programs as well as undertake other actions to deliver health services. According to the World Health Statistics of 2011, Nigeria’s overall life expectancy at birth is 54 years; infant mortality rate is 86 per 1000 live births, while maternal mortality ratio is 840 per 100,000 live births.
Currently, there is no program designed to tackle public health issues holistically. There is also lack of coordinated efforts among the various government ministries and organizations that are assigned various responsibilities to design programs to address health-related issues. Aside from the lack of coordination, the programs designed by federal government to address the numerous health problems in Nigeria are inadequate, and have led to the little improvement in the health status of Nigerians. As a result, there is no health policy addressing and countering the threats of fibroids on women’s health.
The continued negligence by the government to address public health issues in Nigeria make matters worse for poor women who are always at the receiving end. The first WHO Global Status Report on non-communicable disease listed Nigeria and other developing countries as the worst hit, with deaths from non-communicable diseases. However, my years of experience working with a leading women’s organization exposed me to the threats of fibroids on the lives of women:
Sister Roseline was about 37 years old. She usually looked anaemic, sickly and found it hard going out when she was menstruating. My attention was called on a day she fainted in the bathroom. On getting into her room, she said to me, “please assist me, I need to survive. I have been living with this fibroid for some years. Each month I am in my period, my blood gushes as if a tap is opened. My level of bleeding is unbearable. A doctor once recommended surgery to me but I could not afford the cost.” I assured Sister Roseline of my assistance, even without knowing what to do to assist her.
The next day I took her to a private medical doctor. On examination, the doctor confirmed that Roseline had low iron level and was anaemic, and said the fibroid had developed inside her uterus and the best option for her was an operation. The operation was carried out on her the following week and it was very successful. The doctor saved the life of Roseline at no cost. He did the surgery free of charge, but Roseline is unlikely to have a baby after the operation. The doctor said that treatment of fibroid with medication or surgery for fibroids patients is options, but could be complicated too.
Nnenna-- a 40-year old woman was diagnosed of fibroid in 2010. In the words of Nnenna, “I started noticing heavier menstrual flow some five months back. Gradually, I found out that I easily get very tired. I had no symptoms of any sort; I only notice that I feel full without taking much food. I am bothered, sick and emaciated. My sister who was assisting me financially was also diagnosed of fibroid during her pregnancy. She had the baby through caesarean. The baby died, even though the fibroid was removed. My sister became depressed having spent so much money and still lost her only baby. She can no longer support me financially. I am scared of going for medical surgery. Somebody I knew died at the course of fibroid operation, I am afraid I may also die. I am rather taking herbal treatment.” Nnenna lives in a rural area of Imo state.
Sister Cathy, a 34 year old woman was diagnosed of fibroid in 2002. She was still a virgin. She went to a Catholic rural hospital where she was operated. The operation was said to be faulty, and she went for another one. Months after removing the fibroid, she realized her uterus was gradually pushing out from her private part. She said she is more confused by her complicated case because her friends linked the development of the fibroids to her virginity. There were myths surrounding development of fibroids in women.
In June 2015, Cousin Jack lost her wife aged 43 years. Cousin Jack’s wife died in a private hospital in Lagos a week after she was operated of Fibroid. She was working in one of the leading oil companies in Lagos She was married to cousin Jack for up to 10 years but no babies. In a bid to have babies, she was advised to go for a fibroid operation since the fibroid was responsible for her inability to conceive a baby. She died a week after the operation.
So many women do not have access to medical facilities and most of them do not have money to pay for treatment. In Nigeria, the current national health policy have concise statements on policies of health programs such as HIV/AIDS, Malaria, Immunization, Population, Tuberculosis and Leprosy, Blood Transfusion, Elimination of Female Genital Mutilation, Adolescent health, Child Health, Drug & Food hygiene and safety but none on fibroid, which constitutes a rising burden on the health of women.
Women who live in the rural areas are more likely to die of complications, which arise from the severe symptoms of fibroid. Majority women who are in the rural areas use traditional medicines. In Nigeria, traditional medicines are yet to be integrated into the Nigerian health system.
Couple months back I came across a fibroid clinic in Lagos which claims they treat fibroids with natural medicine that are curative in nature The principal consultant of the clinic says that they can get rid of fibroids naturally without surgery or drugs that expose one to negative side effects. The cost of their treatment is equally high and unaffordable to poor women. I have not been able to speak to anyone who has patronised the clinic. But one striking thing about the clinic is that it emphasises on food and nutrition issues that have link with growth of fibroids in women.
I think the link between food and growth of fibroids in women should be another topic of our discussion here soon. But until then the Nigerian women are expectant. They are expecting setting up of policies that will guarantee free and accessible medical attention as well as sensitization and awareness of health facilities especially in the rural communities. It is women’s inalienable rights not to suffer and die of health complications or out of lack of policy, political will and weak health systems, poverty, ignorance, illiteracy and carelessness. The government has indivisible roles to protect the lives of the citizens and save the nation from extinction.