by Christiana Gokyo, Jos
The Federal Government has been called upon to review National Health Management System to mainstream Pelvic Floor Dug (PFD), develop and standardize the tool to capture data, establish computerized national database with ICT as PFD data Bankat Federal, State and Local Government levels.
This was disclosed during the 108th Inaugural Lecture held recently at the University of Jos, by Prof. Jonathan Abina Karshima, a Professor of Obstetrics and Gynaecology/Urogynaecology, Department of Obstetrics and Gynaecology in Faculty of Clinical Sciences, College of Health Science University of Jos, and Consultant Obstetrics and Gynaecologist of Jos University Teaching Hospital.
According to him, the purpose of the Inaugural Lecture was to raise public awareness on women heath issues, particularly women with Pelvic Floor Dug, with the theme, ‘Pelvic Floor Dug, The Silent Tormentor of Woman the Lax and Bulges, Holes and Leaks, Seals and Pains.’
He said Pelvic Floor dysfunctions (bugs) are very worrisome conditions and cause profound discomfort for the patient, and are major causes of women health challenges worldwide.
Prof. Karshima described the human pelvis as base-shape complex of bones that connect the trunk and the legs, support balance the trunk, and contain and support the intestines, the urinary bladder, and the internal sex organs.
He stressed that, the pelvis consists of paired hipbones, connected in front at the public symphysis and behind by the sacrum; each is made up of three bones, the blade-shaped ilium, above and to either side, which accounts for the width of the hips, the ischium, behind and below, on which weight falls in sitting, and the pubis, the front.
He explained further that, the ring made by the pelvis is higher behind and by the side than in the front, and by this forming what is described as the “false and true pelvis,” adding that the true pelvis functions as the brith canal in females; it provides attachments for muscles that balance and support the trunk and move the legs, the hips, and the trunk.
According to him, the Lecture also include the Perineum in the floor, which is anatomical region below the pelvis, and is described as part of the pelvis; it’s located between the thighs and represents the most inferior part of the pelvic outlet.
“The Perineum is separated from the pelvic cavity superiorly by the pelvic floor. It contains structures that support the urogenital and gastrointestinal system, and it plays an important role in functions as such micturition, defecation, sexual intercourse and childbirth,” he stated.
Prof. Karshima urged that, “The silent torment in women should not be allowed to suffer in silence, because, if you have problem in sexual intercourse, seek help and open up, because many of the women are under siege, silently being tormented by Pelvic floor disorder.”
He revealed that, “Pelvic Floor Dug are common pelvic floor disorders, and they challenge even the gynaecologists; but can help the women to break the silence through respectful communication with her family, and the health care provider is essential for optimal understanding informed consent and management; rescuing her from the bug will cause her to think right.
He said, for the past 55 years, that has been his mission, which he started when he was 17 years, because he came about women since 1971.
Prof Jonathan Karshima noted that, with the increase in life-expectancy of the over 2 million out-of-school children, larger numbers of not literate and literate will be presented in no distant future.
“There is the need to improve on a higher level. Caring and preventing PFD involves the skill for identification and prevention of PFD in labour or early after-birth period, monitoring every labour by use of a pantograph and quick attention to clues of impending fistula; for example, by resting the bladder with use of indwelling catheter for 7 to 14 days or longer for all women, who had obstructed labour.
He added that, “There is need for government to help in reducing the PFD by covering the cost of care, because there are many women with PFD out there, but the cost of care has a very wide range, from use of Foley catheter that costs a few naira to use of energy therapy or surgery that costs hundreds or thousands of naira.
“Government should promote universal health coverage with Health Insurance for the low-income women, and build a capacity of doctors and other health workers towards care of patients with PFD,” he said.
While calling on government to mobilise resources and strengthen strategic partnership for PFD research, Prof Karshima emphasized that, “Government should also promote multi-disciplinary, multi-center national and international PFD research and promote use of evidence to inform policy and action.”
He also urged community leaders, gatekeepers, faith leaders – especially women leaders and stakeholders – to work to create an enabling environment and promote behavioral changes for PFD prevention control.
He buttressed that, “Nigeria must invest in education, especially girl-child education, improve health awareness and knowledge, and effect positive behavioral changes.
“An educated person is empowered to take control of his destiny and advocate for his or her well-being. It empowers one to make informed choice, communicate better with care provider and motivate towards self-concept,” he stated.