From Chuks Moses, Awka

An Obstetrician, Gynaecologist, and university don, Dr Joseph Ugbaja has described heavy and increased menstrual flow as the commonest symptom of uterine fibroid.

Dr Ugbaja, the Chairman, Medical Advisory Committee (CMAC) of the Nnamdi Azikiwe University Teaching Hospital (NAUTH) Nnewi, who made this disclosure at a health seminar at the weekend on Women’s Health, also pointed out that leiomyomas otherwise known as uterine fibroids were benign growths of the smooth muscles of the uterus.

He added that, “the primary function of the uterus is to receive, house and nourish the developing baby (foetus) and to successfully give up the baby when the baby is matured through the processes of labour and delivery.

“In the absence of pregnancy, the prepared inner lining of the uterus referred to as the endometrium is shed every month in the form of menstruation”, he noted.

The health expert however noted also that the cause or aetiological factors of fibroid is still largely unknown but that what is known is that, just as in other growths in the human body, it results from dysregulation in cellular growth.

“It is also known to be common among the blacks and older women who have not or will not conceive.

“The commonest symptom of uterine fibroids is increased menstrual flow otherwise called menorrhagia. For instance, if you have a normal four day menstrual duration and suddenly noticed an increase in the number of days as well as in the volume of menstrual flow as evidenced by use of increased number of pads, then uterine fibroids should be suspected.

“This finding may be associated with passage of blood clots during menses and feeling of faintness following each period.
A woman with uterine fibroids can also notice an abdominal mass which gradually increases in size with some form of mass effect on the bladder and rectum leading to some difficulties and issues with urination and defeacation.

“There may also be dysmenorrhea which is commonly known as painful menstruation. Sometimes, the only manifestation of fibroids will be repeated pregnancy losses.”

Ugbaja admitted that in a vast majority of cases, the fibroids are asymptomatic (ie no symptoms) and only discovered on routine ultrasound scan for other gynaecological problems.

An obscene video of the raping of a woman, allegedly by Fulani herdsmen, who filmed and circulated the dastardly act, is drawing condemnation, just as another gang-raped woman in Anambra has died in her home state of Ebonyi.

Rape, a weapon of choice by herdsmen against women, has become widespread across the country, from the North to the South. Many women have been raped in recent months, leading to death after the women were subsequently attacked with . nearby objects. The case of a University of Benin undergraduate and another young lady in Ibadan are under investigation.

But the rate of rape by women by herdsmen is assuming frightening proportions.

Worse, many of the women do not step forward because of the stigma attached to it. In the north of the country, an unwritten code of silence prevails as the women suffer psychological pains in silence. Some are quietly divorced, while many bear their pain with forced equanimity.

“Others don’t dare mention their rape on the farms, bush paths, and streams littered over here where we do not have water supply near our homes,” a source said in Niger State years ago.

Another said: “When you hear of banditry and kidnappings, be sure you did not hear the full story. In the South, they are a little more open; in the north, use your imagination, but the situation is terrible, it has been with us for decades and we pretend about it all. The herdsmen is considered a dangerous specie here”.

The source, who insists on anonymity, added curiously, “but you will be shocked it is not only herdsmen. Do you remember the son of a prominent Nigerian and Governor advocating gang-raping someone’s mother? What happened? Didn’t that state government weeks after begin to advocate against rape? That is the world we live in”.

He adds, “do you recall insurgents impregnating those they abducted, including peoples’ wives? What do you think is responsible? Minds are sick and barbaric, and only God can save and deliver all up here and down there where people are more open about these things”.

Meanwhile, a middle-aged woman who was allegedly raped to coma in a farmland at Ebenebe in Awka North local government area of Anambra State by suspected  herdsmen has reportedly died in her home state of Ebonyi.

The woman, whose name was given as Agnes Okekpe from Abakaliki local government area was said to be working on a farmland in the community as a labourer late last year when suspected   herdsmen who went into the farm with herd of cattle allegedly gang-raped her until she lost consciousness. She was later taken to her state by her relations for treatment where she recently died.

President-general of Ebenebe, Mr. Paul Nnatuanya, while narrating the emotion –laden story, said the woman’s ordeal was the common thing his people have been experiencing, in addition to the destruction of farmlands by suspected herdsmen.

He said: “The information we got from Ebonyi State was that Agnes has died. After she was raped to coma, our people took her to the hospital where she was revived. She died as a result of the trauma she suffered.

“After she was discharged from the hospital, she travelled back to her place in Ebonyi State; perhaps, to continue treatment there.” She didn’t continue with the business she came for.” “Her colleague who was able to escape said that before the rape, the herdsmen hit the woman with a log of wood, which made her weak and unable to raise the alarm..

“The herdsmen also took the money the woman tied on the her wrapper and it was the victim’s colleague that ran back to the town to alert the residents, who found her lying helplessly on the farm. When the villagers stormed the scene, she was already lying unconscious on the ground.”

▪︎ Additional reports by Vanguard

By Adesida Adewumi, MD

I was inside my consulting room that afternoon when a gentleman and a lady walked in. I later knew Akin (not the real name) to be 38 years old and Juliet (not the real name) to be 30 years old. They were both planning to get married. “So what can I do for you both?”.

“Doctor, I brought my fiancée here for you to help me check her comprehensively and tell me everything about her health and I will like to know all your findings,” Akin said.

I asked Juliet, “did you hear what your fiancé said and do you give your consent to that?”

“Yes,” she emphatically said.

I documented this and asked her to sign the consent form. She did. Then I asked Akin to excuse us. I called in an hospital female assistant to stay with me as my witness.

There are three steps we use in medical profession to comprehensively check our patients. The first one is called history taking or interviewing. The second one is called examination which means checking the body. We do this in two ways. First, we check generally from head to toe, and secondly we focus on the important systems. Then the last step is for us to order for relevant tests.

There is something unusual about this premarital medical check-up requested by Akin and that was him asking for complete check-up. Many couples to be I have met usually come for genotype, blood group, HIV and Hepatitis viruses tests and once they are okay, they are good but requesting for a comprehensive premarital check up is not common.

So I proceeded into step one. I interviewed Juliet asking all our barrage of questions about the past and the present, the ones that concerned her and her family, work and social life and past relationships and abortions and so on. Juliet told me all was well. No single problem.

Then I proceeded to step two of the medical examination. I checked her generally first, all was fine.Then I focused on the important systems one by one.The major findings were found at the tummy. I saw wrinkles and lines that showed Miss Juliet was once pregnant or most likely had a child which she denied throughout the interview. Then I confronted her with the clinical evidence which she could not deny. Then she burst into tears begging me to help her lie to her fiance that she had never been pregnant before. I told her I would not be able to do that. Apart from betraying my oath, I would be putting my integrity on the line which is the major thing in my job as somebody dealing with human lives, as somebody that whatever I say today or I do not say, can make or mar people’s destinies. I told her I wouldn’t join her to lie to her fiance. She cried and begged me with her life. I stood my ground. I went ahead to counsel her to tell Akin herself when I called him in, but if she failed to do so, I would have no choice than to tell Mr Akin myself the whole truth about my findings. After a while she agreed to confess to him herself . That was better for me because the truth would be coming from her.

I called in Akin. I told Mr Akin every other thing I found and told him, his fiancee would tell him the major finding. So I waited and waited, but Juliet remained mute. She kept foot dragging. She couldn’t say it. I excused Akin for the second time. I counseled her again to tell him herself. She concurred but when Mr Akin came in, the same silent treatment took place.

I excused Akin the third time and appealed greatly to Miss Juliet to do the needful. She agreed but when Mr Akin came in same thing happened. Then I opened up to Akin about the past pregnancy issue I discovered.

Juliet rushed to her knees, held Akin’s feet and started weeping and wailing. Begging to tell him the whole truth. Akin told her to go ahead and tell him the whole truth.

Now this was what actually happened. This year made it three years they had been dating. They dated for a year before Akin travelled abroad for his two years postgraduate scholarship programme. He was so committed to Juliet that he had introduced her to his family and he kept in touch for the two years he was abroad. At least in a day they would talk for 5 minutes to two hours as time permitted. He assured all the time of his love for her and promised to marry her as soon as he was back to the country.

After he travelled abroad, Juliet met her Ex in shoprite in one of those times she went for shopping. One thing led to another and they started seeing each other again but Juliet, naturally, kept this from Akin. It was in this process she got pregnant for the Ex and the Ex insisted he would not agree to abortion of his baby. In all this she still kept communicating with Mr Akin.

After nine months, she delivered the baby but the baby died few weeks later in the hospital after developing jaundice. This led to the break up with the Ex. Then a year later Akin returned and brought her for this check up before marrying her. After she narrated this story I was overwhelmed and so many lessons started rushing through my mind.

I noticed Akin was calm, unperturbed and unruffled about all these confessions and tears. As I was wondering why, he gave his response.

“I know everything you confessed now because immediately I returned to the country, people had been coming to tell me all sorts of things that happened in my absence. Even over there I perceived something was wrong with you the way you usually turned down my video calls which was not so before. But you know what? Because of the love I have for you I forgive you.”

Then Akin turned to me. “Doctor, thank you for standing by your integrity and the oath you took to tell nothing but the truth at all times no matter the pressure. Keep it up.”

I went ahead to conduct the other relevant tests which later came back to be compatible with one another. They came three days later to collect them and it was as if no offence happened three days ago. Love is a powerful force behind forgiveness, I have no doubt. Three months later they got married. I was invited to the wedding as a VIP which I honoured. I asked for the permission of both of them to share this lesson on my platform for others to learn. It was granted. As I wished them marital bliss and on my way home from the reception the following life lessons started running through my mind:

Lesson number 1: This is to my fellow medical doctors. Always ask for your patients’ consent in all important and seemingly unimportant issues.

Lesson number 2: always document everything you discuss with your patients

Lesson number 3: never collude with any patient to lie to anybody

Lesson number 4: this is to all the young ladies out there in a committed relationship, always avoid Exes. This can put you in big trouble.

Lesson number 5: keep no secret from the person you are planning to spend the rest of your life with or someone that loves you so much. Don’t join others in keeping secrets from them them or lying to them. Even after 20 years into marriage, the truth may find you out and then the consequences will be grave.

Lesson number 6: when you are wrong or caught in your wrong doing, don’t defend your wrongdoings. Dont excuse them. Repent and show true remorse. Who knows, you may be forgiven.

Lesson number 7: Akin taught me a great lesson: LOVE CAN FORGIVE ANY SIN, I MEAN ANY SIN, NO MATTER HOW GREVIOUS IT MAY BE.

(You can equally add other lessons you have personally learnt from the story)

Share this true life story with your family and friends.

▪︎ Dr. Adewumi, works in the Department of Family Medicine, Aminu Kano Teaching Hospital, AKTH, Kano, Nigeria. Follow his page on Facebook: “FROM INSIDE MY CONSULTING ROOM “. Follow his health page on Instagram @doctorhealtheducation and on Twitter @doctorhealthed1 for daily education on your health.

By Adesida Adewumi MD

I have Jaruma and her mother’s consent to share this story with every mother to learn from what happened to them.

It was around 3 a.m. in the morning on that fateful Tuesday. I was on call. The crying of Jaruma’s mother woke us up in the emergency unit. “Please save my daughter’s life” was the repeated statement as she was carrying her daughter, wailing and running inside the emergency unit. We collected her from her hands and laid her on the bed. Jaruma was semi conscious. Almost gasping. She was just 13 years old. I saw her intestine coming out from her vagina with bleeding. In this type of case you must do many things simultaneously to save life and time. As I was setting IV line for Jaruma, I was asking the mother for the summary of what happened.

“We did abortion for her”.

“We? You and who?”

She was reluctant to talk. When I roared in my impatience looking at life leaving this small girl’s body on bed. She answered me quickly.

“My husband and I.”

“In other words, you are saying you the mother and her father procured abortion for this small girl that landed her in this?”.

“Her step father actually, my husband.”

“Okay why will you and the step father take her for abortion? Who was responsible for the pregnancy?”.

She was reluctant to talk again. When I looked at her ferociously, she said ” the father, sorry, the step father”.

My brain could not process that but I quickly examined Jaruma. Her intestine was protruding through her vagina. This could only mean one thing. Whosoever did this abortion for her would have passed an instrument through her vagina to her womb then perforated her womb with the instrument and used the instrument to bring her intestine through her perforated womb to her vagina and out. Most likely this was an unsafe abortion. Most likely done by one quack in one remote shop. There was no time to waste if we would not lose her.

I called the senior doctor on call with me and briefed him. He asked me to prepare theatre and got everything and everybody ready for the emergency operation. I asked Jaruma’s mother to get three bags of blood. We got her consent to operate her and we moved to into action immediately. After three hours of rigorous surgery, we were able to save Jaruma’s life but not her womb. Her womb had been torn and turned to ragged pieces. We could not salvage the remains of the little womb left. Part of her intestine too was already dead, the part that was outside her vagina that had been strangulated for lack of blood. We cut the dead part and re-joined the remaining intestine. In all this we were happy Jaruma lived. We gave her two bags of blood inside the theartre on operation table and we gave the third one outside in the ward after wheeling her out. She came around later. After one week on bed she started walking. She could eat and move around well. We removed our ropes we used in tying the tummy. She had healed well. We decided to observe her for one more week before discharge.

I had not been able to keep my mind straight since I heard what Jaruma’s mother told me in emergency unit but I had no time to interview her further since that day. So at the end of one week I was able to invite her inside my consulting room.

“Tell me more about that story you were telling me that day in emergency unit”.

Tears rolled down her cheeks. I told her to go ahead and tell me more. She said she married her first husband 14 years ago and had Jaruma a year later. Her first husband told her not to work. He would provide everything for her. So she was a full house wife for the 11 years the marriage lasted. She went through physical and verbal abuse in the hand of the man before the man finally divorced her three years ago. Her family disowned her, too. She found it difficult to feed herself and her five children from the first marriage. Jaruma was her first child. It was in the midst of this suffering the present husband, Jaruma’s stepfather met her and took her in. He was a divorcee, too. He had been taking care of them for the past three years.

I asked when she got to know he was abusing Jaruma. Long silence. I knew what I was about to hear would likely be shameful for a mother to say. She started crying profusely all over again.

“Doctor, I would not lie to you . It was almost immediately we moved in with him. My daughter told me but I shut her up. She told me several times, but I kept shutting her up for the sake of our survival and shelter. First time I confronted my present husband he threatened me that he would send me and my children out if I dared tell anybody or disturb him again. I have been dying in silence since that day, until three months ago when Jaruma got pregnant.

“We did all to abort the pregnancy for her at home using herbal concoctions, Andrew liver salt, Schweppes, small lime oranges, Sprite etc. There was no abortion,” she said.

I asked who told her all those things she mentioned could abort pregnancy.

“People,” she answered.

I laughed angrily at such level of ignorance.

The story fast forwarded to a nearby village where they went to see the man that helped them get the abortion done in one local pharmacy shop. He assured them that everything was out and well but Jaruma had been wriggling in pains and running temperature from the second day they came back home. Until that night when she saw her intestine protruding through her vagina and she rushed her to the emergency unit.

“Doctor, this was how my 13 years old daughter lost her womb to my husband o”, she said crying profusely.

Since that day she said her husband had disappeared into thin air. I asked her level of education and if she learned any skill? She said she was a secondary school leaver and a tailor but her former husband stopped her from practising the tailoring or doing any work. She had one child for the present husband already. I was lost in utter silence.

Jaruma was very okay after two weeks post-surgery. We discharged her from the hospital bed but she could not go home due to the fact that they had not paid up their hospital bill. So she was still hanging around the hospital environment. Many times I met her in different food shops around the hospital either in people’s company or alone eating. After three weeks in the hospital, they paid up and the mother came to say good bye to me with Jaruma. I collected their contact so that I could follow Jaruma up with the view of referring her for rehabilitation in our mental health department.

Now I am about to tell you what brought tears to my eyes and sank my wounded soul most, in this whole story. It happened one week after Jaruma and her mother left the hospital environment. I went to eat in one of the food restaurants inside hospital. I sat alone on my table. Next to me was another table surrounded by four men eating and gisting. From their discussion, it seemed they were patients’ relatives that had been in the hospital environment for a while. I heard Jaruma’s name from their discussion. This aroused my curiosity and made me pretend as if I was eating but paying cat ears to their discussion. The things I heard overwhelmed my soul. One of the four men started by saying, “do you know Jaruma finally left the hospital a week ago?”.

The second man said “Wow! I missed that girl. I enjoyed her so much, small but mighty girl.” The third one said “that girl was very sweet in bed.” The fourth man said “I was not able to enjoy her so much like you people.” My soul became paralysed on the spot. I had to fight back my teary eyes.

Apparently, Jaruma had become a sex addict already, perhaps as a result of her stepfather’s three years continuous abuse and her mother’s cover up. Now what do I do to these useless four men who had been busy raping this helpless minor who just had surgery and taking advantage of her fragile and damaged childhood.

I informed the Chief Medical Director who ordered their arrest to face the consequences of their abominable acts. If at all I might not be able to deal with the beast of a stepfather that started this, I was consoled that I was able to get justice for Jaruma in a little way.

I was able to stop this sex addiction of Jaruma through rehabilitation. I called her and her mother back to the hospital that very day, and referred them to the psychiatry unit. I was able to inform an NGO that helped them financially. She did well in rehabilitation and moved on with her life.

I kept close contact with the family. Occasionally I called to know how Jaruma was doing. The last time I heard about Jaruma from the mother was that she was in 300 Level Medicine in the university. The mother had got government job and at the same time doing her sewing work part-time. The stepfather died of diabetes few years after that incident.

This story happened 12 years ago but till now I am still in contact with Jaruma and her mother. It was recently I was able to get consent from both of them to share this story.

Recently Jaruma asked me the big question about which option was left for her as per child bearing in view of her womb loss. I counselled her to plan for adoption of as many children as she wanted and she had to let her future husband know her harrowing childhood experience and absence of her womb

Many lessons have been running through my mind from this story which I will like to share with you:

Lesson one: As a woman never ever allow any man to tell you not to work and earn a living. I am not in any way saying you should not be submissive to your husband but work I plead with you. This is my opinion and I am entitled to it. Women empowerment is key to so many things in marriage and our society.

Lesson two: Never for any reason cover anybody, even a family member of a crime as terrible as rape. The consequences on the victim are unimaginable. Help them get justice no matter what and who is involved.

Lesson three: If you are a victim of rape, know that this is not the end of the road for you in life. You can still move on in life to have a great career and future you rightly deserve. Do not harm yourself and do not commit suicide. Rather seek help physically, mentally, spiritually and socially. Whatever you have lost, God can replace!

(Please feel free to add your own lessons learnt from the true life story. Thank you.)

▪︎ Adewumi works in the Department of Family Medicine, Aminu Kano Teaching Hospital, AKTH, Kano, Nigeria. Follow his page on Facebook “FROM INSIDE MY CONSULTING ROOM “; his health page on YOUTUBE and INSTAGRAM @doctorhealtheducation
On TWITTER @doctorhealthed1
On WhatsApp:+2348068649694