Her Excellency Josephine Elechi

The first lady of Ebonyi State, Chief Josephine N. Elechi, knew women who had died in childbirth and understood the grief of maternal mortality. But Her Excellency Mrs. Elechi had not heard about the injuries that can befall women who narrowly escape maternal death until a friend told her about obstetric fistula. The first lady was moved by the stories of women with fistula, who in her words were “performing their God-given role. What happened was not their fault; it was our fault. We allowed it to happen.”

Filled with compassion toward the incontinent and shunned sufferers of fistula, Mrs. Elechi set out to ensure that surgical repair was made available in her state. She brought together members from the state teaching hospital and the ministries of Health, Women’s Affairs, Planning, and Education to form the Mother and Child Care Initiative, or MCCI. The MCCI developed a conceptual document outlining its aims, which included the construction of a standalone center dedicated to providing surgical fistula repair services in Abakaliki.

The first lady spent a great deal of time attempting to establish partnerships and draw attention to the project. She traversed the country, meeting with the Federal Ministry of Health, USAID, UNFPA, UNICEF, and the nation’s first lady. Although at times she was brushed aside, her persistence paid off. Following the construction of its fistula repair center, the MCCI began to welcome visitors, including an impressed representative of the ACQUIRE/Fistula Care project, who lobbied for USAID to expand the project’s coverage to include Ebonyi State.

Advocacy was also necessary closer to home. At first, the leaders and population of Ebonyi State did not consider fistula to be a local problem. The MCCI chairman and fistula surgeon Dr. Sunday Adeoye carried out screening campaigns around the state and, to the shock of many leaders, identified 400 women living with fistula in seven of the state’s 13 local government areas. Despite the first lady’s community awareness-raising activities, many women living with fistula did not believe that they could be cured. Once the first repaired women began to return to their communities, transformed, younger women living with fistula emerged to present themselves for surgical repair at the center.

The MCCI’s fistula repair center represents a unique collaboration between numerous partners, including the state government, local government areas, ACQUIRE/Fistula Care, UNFPA and others. In the long term, Mrs. Elechi would like the federal Ministry of Health to take the reins of the center, which is located on the grounds of a state teaching hospital. The first lady hopes that a cost-sharing agreement could be arranged that would ensure the continued provision of quality repair services at no cost to fistula patients. Mrs. Elechi continues to invite people to come together, using her political influence and dedication to maternal health to advocate for quality fistula services that do not depend on her for their continued success.