Female genital schistosomiasis is a devastating disease that is estimated to affect millions of women and girls across Africa. As a researcher at Sightsavers, I’m working to understand how we can provide better care to these women.
Female genital schistosomiasis (FGS) is caused by water-borne parasitic worms that infect people as they fetch water, bathe and wash clothes. The parasites burrow through the skin to live in the blood. As they reproduce, their eggs migrate into organs including the uterus, vagina and fallopian tubes, causing inflammation and bleeding.
Women with FGS are three times more likely to get HIV, and may also be more susceptible to cervical cancer. The disease has also been linked to an increased risk of low fertility and life-threatening ectopic pregnancies. The problem is compounded by a lack of knowledge among health workers in many low-income countries. The disease is often misdiagnosed as a sexually transmitted infection, meaning that women can be subjected to isolation and even gender-based violence.
FGS is a huge problem, but it’s one that can be solved. My colleagues and I at Sightsavers are working on an exciting research project in Nigeria that could help to tackle this disease. We’re speaking to women living with the condition, as well as health workers and gynaecologists who are based in affected communities. We’re hoping to build up an understanding of why women are not receiving adequate treatment, and how countries can integrate the management of FGS into their health systems.
We will then be able to recommend key improvements that governments can make at every step of the way. For instance, this could include increasing awareness of FGS, using the diagnostic tool found within our health worker training guide to identify women with the disease, or making sure treatment for FGS – praziquantel – is always available in local clinics.
Although our current research project is still in progress, we know from previous studies that the three actions below can help to address the issue of FGS. We will need the support of government officials, health workers – and even you as the reader of this blog.
You can play a role in raising awareness by using the #FGSchisto hashtag on social media, and by speaking about the condition with family, friends and colleagues.
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Training health workers to diagnose FGS
According to Olubunmi Babatola, a gynaecologist who was involved in our research in Nigeria, it’s important to provide training so that health workers at all levels can recognise the signs of the disease.
“There are features that are overt, and that can easily be seen without a colposcope,” Olubunmi says. “Even the least skilled people in the healthcare system can recognise them, and then these women can be given treatment.”
Integrating testing into other health programmes
We need to increase the number of women and girls who are being tested for FGS. One of the best ways to do this is by including FGS testing alongside other forms of treatment.
Adesugba Abigeal, a health worker in Nigeria, told us: “it’s important to integrate FGS screening when treating other diseases such as HIV, and the human papilloma virus (HPV).”
“It’s also important to combine FGS with other programmes going on in the health centres, such as family planning and health education. […] When women take their children to the hospital, we can test them and know whether they have the disease.”
Improving water, sanitation and hygiene
Women and girls typically contract the parasite that causes FGS after washing with contaminated water. The disease can be fatal if left untreated for a prolonged period of time. We need governments and international NGOs to work together to provide clean water and sanitation facilities for communities affected by the disease.
We also need to educate people in these communities about why they shouldn’t drink from, bathe in, or wash clothes in certain risky water sources.
Omosefe Osinoiki is a research associate at Sightsavers, based in our Nigeria office.