With sunken eyes that appeared to be retreating into her skull, Hauwa Yusuf’s lanky body unveiled not only her medical struggle but also her internal despair after she was betrayed by her lover. She married two years ago when she was 17, and it was all a bed of roses until she gave birth to their first child. 

“The pregnancy came with complications,” she said. “It was a terrible experience.” A local midwife tried to take care of her, but the baby only came out halfway. She was then taken to a local maternity clinic, where she eventually gave birth. That was the beginning of her ordeal. 

Although the baby didn’t survive, the labour left her with a condition that devastated her marriage.

Her complications worsened after birth, and her mother would always come to her house to take care of her until they realised she had a vesicovaginal fistula (VVF). 

VVF is a type of obstetric fistula where a hole appears between the vagina and the bladder, causing the involuntary and continuous discharge of urine. The common causes are obstructed or prolonged labour, early marriage, infections, and lack of reproductive healthcare. The symptoms include abdominal pain, diarrhoea, fever, nausea, and weight loss. There are millions of people with the condition globally, but women in less developed countries are most affected. Oftentimes, they also have to live with the accompanying emotional trauma.

After Hauwa’s diagnosis, she was taken back to her family home. Her husband initially visited her from time to time, then he stopped. He started by complaining that it was taking too long for her to recover. Then, he stopped taking care of her. Hauwa later learned he was taking another wife.

“He left me with no care, but he was busy spending money on his girlfriend,” she said. Tears gushed out of her eyes as her mother, who also sat on the hospital bed, comforted her.

In her village, the superstition that a person with VVF was possessed by a spirit was common. So, they started with spiritual remedies and herbal medicine. They were finally left with no option but to go to the hospital.

At the hospital, Hauwa waited to see her husband. But when he didn’t show up after several weeks, they sought support from the Hidaya Foundation, which is now paying her bills. Today, all she expects from her spouse is a letter of divorce. 

“I’m tired,” she said. “I need my papers. He doesn’t act or behave like a husband. I’ve been here for months, but he hasn’t felt it necessary to follow or visit me. He doesn’t like me, and I don’t like him either.”

In another part of the Murtala Muhammad General Hospital in Kano, a group of women gather under the shade of trees. Their expressions hide the cruelty they have endured—stigmatisation and neglect by those who once vowed to stand by them. They are all battling vesicovaginal fistula.

They initially left their homes in search of healing, but some of them decided to stay in the hospital because there they could get the medical attention they needed and stay away from the stigma back at home. 

Their husbands have abandoned them in their time of greatest need. They gather here looking for not only what to eat but also money to buy detergent to wash their faintly smelly, worn, and faded fabrics. “This is a condition in which cleanliness is not only required but necessary,” said Hidaya Abubakar, co-founder of Hidaya Foundation, a non-profit supporting them in paying their bills. 

“Every day you come here, you’ll find them washing their clothes. It’s like every day on duty, but you could still smell a faint scent of urine.”

These women, some of whom are young and in their early twenties, are caught between the hard grip of their suffering and the glimmer of charity. They wait, with a patience born of necessity, for the meagre sustenance that comes their way every day, in the shape of food donations or through begging in the streets. They had come to the hospital for healing, but it has become their shelter and last hope. 

Most of the women are from villages around Kano, from Rano to Sumaila, where their conditions are wrapped in superstitions and misinformation. 

“If you find yourself in this condition, many people believe you’re possessed by a spirit and you’ll never heal,” explained Binta Mansur, who has had VVF for almost twenty years. She said she had been depressed for many years, not because of the disability but the stigma that came after it. 

Binta, who is in her late 30s, has married four times. None of them spent more than a year, except the fourth, who stayed for five years and then divorced her.

“They’ve all left because they couldn’t support me,” she said. In fact, her first husband divorced her immediately after she became a VVF patient. 

“Life in the village as a VVF patient is difficult because of the stigmatisation,” she said. There, she was never allowed to be with a large number of people, and she was forced to stay in her room. 

“I became a VVF patient when I was less than 15 years old. It has been an emotional rollercoaster of depression, divorces, and breakups.”

In the Kano metropolis, she has found a new family. Here, especially in the hospital, there’s no stigma because everyone close has the same condition and the health workers have become friends. 

“It has been more than a decade since I started receiving treatments here. I was operated on twice, but because my condition has become chronic, I always go back. This hospital is like a home,” she said.

For Fiddausi Haruna, the story is almost the same. She was married when she was 16, and she became a patient when she gave birth to her first son. She was taken to the hospital and had a successful surgery.

The doctors told her to always come back to the hospital whenever she was to give birth. She returned for the second childbirth, but for the third one, her husband said she could give birth at home. A quack doctor operated on her and, in the process, injured her and the baby, who didn’t survive.

“The [quack] doctor came with one lady, and they both operated on me with a razor blade. It was in the process that he even cut the baby,” she said. And that was how she fell back into the VVF problem. 

Fiddausi now puts all the blame on her husband, who she said visited her only twice in two months and gave her a meagre amount for her upkeep. She said her parents are the ones taking care of her. Because she belongs to a polygamous family, she believes her husband is now going to her co-wives and, therefore, feels unwanted. 

“He doesn’t care anymore, even though he was the one who insisted that we shouldn’t go to the hospital.”