Poverty and cultural traditions in Niger lead thousands of young women to give birth without medical supervision which exposes them to often irreparable scars.
”Giving birth is women’s work, and these girls are children,” said Lucien Djangnikpo, a physician and director of a maternity centre in Zinder, a city in southeast Niger.
Some young women are married, or given in marriage at the age of 12, often before they have begun menstruating, said Djangnikpo, who is also president of a non-governmental organisation, Solidarity.
The West African nation, one of the world’s poorest, is currently at the centre of an international effort to bring food to the drought-hit country where tens of thousands of children are suffering from severe malnutrition.
The care of women in a country with one of the world’s highest birth rates — roughly eight children to every woman — poses numerous problems.
Ibrahim Hadizatou, vice-president of the Solidarity group, listed a host of conditions that endanger women’s health, including the young age of a wife during her first sexual experience, the absence of medical care during pregnancy and the distances between villages and the nearest hospitals.
”And the biggest problem is ignorance,” he said, which causes difficulties both during pregnancy and childbirth.
For some women, difficult childbirth causes severe medical conditions.
Djangnikpo said that when a baby remains stuck under the pelvic bone after several days of difficult labour, necrosis of the pelvis can develop.
These so-called obstetric fistula can lead to permanent incontinence and cause a gaping wound that touches the vagina, the bladder and the anus.
”For many of them, the fistula will remain their only remembrance of their first sexual experience. Their lives are destroyed,” said Djangnikpo, who also runs a centre to treat the condition.
Solidarity, established in Zinder in 2001, offers free operations at the centre and follow-up help for the women, the majority of whom are under 18, to help reinstate them in their family or community, which most of the time has rejected them because of their medical condition.
The centre, next to the maternity clinic in the dusty old city of Zinder, is financed by the United Nations Children’s Fund Unicef and the French embassy. About 100 women are treated there each year.
Several small houses made of mud and corrugated metal, clean and fresh, surround a central patio where patients and their companions dressed in long flowing garments known as boubous sit on plastic-covered cushions.
One girl named Fassimou, who is about 14 years old, is so fragile and thin that one can count her ribs. While she still has a baby face, she already possesses the heavy breasts of a mature woman.
”I wanted to die,” she murmured.
”I felt terrible, no one came near me and my new husband no longer even talked to me.”
For Djangnikpo, her work as a physician at the centre involves more than medical care.
”Besides saving the patient, the human being, I have to know how to give these young women back their femininity and their bodies. It’s the essence of my work.” – Sapa-AFP