Helping USAID in its effort is an NGO called ACQUIRE – or Access, Quality and Use in Reproductive Health. Together, they are working to prevent and repair fistula, or V.V.F. It’s an abnormal opening or passageway between the birth canal and one of the internal organs, including the bladder. Fistula can occur during obstructed labor or by tears in the birth canal inflicted during female circumcision, or Yankan gishiri’, in Hausa. Waste material seeps through the passage, often leading an unpleasant – and embarrassing – odor. But with surgery, the passageway can be sealed.

So far, the two groups have helped treat over 1,300 women in Zamfara state.

USAID’s mission director for Nigeria, Sharon Cromer, recently attended the commemoration ceremony at the Farida V.V.F. Center at Gusau General Hospital in Zamfara State.

It was part of a project that included buying an operating table, medicine and other instruments for the hospital and rehabilitation facilities. It also refurbished two fistula hospitals including the one in Gusau.

"This support provided from USAID," says Cromer, "is to benefit women who are among the thousands that suffer from V.V.F. in Nigeria. The story of these women is typical of many in Africa and in Nigeria: young mothers, who sometimes after the delivery of their children realize that they have an obstetric fistula, often wait with many others for months at a time in hospitals [or in their] communities, silently suffering and at times ostracized because of this affliction. Many of these women often do not receive treatment and may live a life of shame and embarrassment."

In addition to working in Zamfara state, the ACQUIRE project has also helped refurbish two rehabilitation centers and provide five operating tables at five V.V.F. facilities in other states in northern Nigeria.

Iyeme Efem is a spokesman for the project.

He says ACQUIRE is working with a Dutch doctor, Kees Waaldijk, to train local – and even family -- doctors on fistula repairs in the states of Kano, Katsina, Kebbi, Sokoto, and Zamfara.

Currently, Waaldijk is training six doctors.

He’s already trained 12 doctors who are now performing operations in clinics, two of whom are now training others in fistula surgery.

Also trained are 2 theater nurses and 4 VVF ward nurses.

ACQUIRE is also working at the grass roots level to convince women to go to pre-natal clinics for examination and delivery.

Efem says, "We are utilizing religious leaders because they play a major role in the community, the traditional leaders who are more custodians of the tradition of the people, so we are utilizing these people as advocacy champions."

ACQUIRE is a USAID/Nigeria funded project being implemented by a consortium of partners lead by Engenderhealth, an international ngo working in the health sector of Nigeria.

It aims at improving access and utilization of fistula prevention, repair, and reintegration services.