We are taking on comprehensive treatment of women with obstetric fistula; the main goal of this program is to provide treatment and care to women suffering from obstetric fistula whose rights have been violated rejected, isolated, stigmatized and denied access to social services. As a result, we have facilitated the identification of 400 fistula patients and referred them to Soroti referral hospital, Moroto Hospital for the eastern region and Mulago national referral hospital for the central region under our treatment camps organized in collaboration with Ministry of health and UNFPA. We have recently provided treatment to 167 women with fistula. Their dignity has been restored and they have been re-integrated back into their communities.

TERREWODE is successfully mainstreaming a Rights Based Approach (RBA) alongside Needs Based Approach and Empowerment Approach in all her programs and policy documents to effectively tackle the root causes of abuse and violation of the rights of women and girls. Our new strategy is systematically and strategically tackling the sensitive issue of lack of ownership and control over key factors of production especially land. The immediate impact is empowerment of rural small-scale farmers (women groups and the fistula survivors) through leading the advocacy for land ownership rights either through inheritance from their paternal homes, co owning with their spouses and purchasing in their own rights. This move will transform rural communities that are recovering from post war development challenges into factors of productivity that will transform the country into a middle class economy.

We are actively engaged in producing and disseminating Information, Education and Communication (IEC) materials to promote awareness. We have distributed over 500 t-shirts, calendars and booklets bearing information about fistula and its linkages to rights violations while emphasizing lack of land rights linked poverty as a root cause of the current high maternal and infant mortalities and morbidities in Uganda. The IEC materials have a multiplier effect in rural areas considering the fact that information is power and yet these areas are under served. We are still disseminating some of the IEC materials and thus, we can confidently comment on their impact in the community as having created a platform for women to stand up to report cases of violence to the police and local councils.

TERREWODE carries out media campaign activities; we sponsor Radio Talk shows on sexual violence and its implications on health and poverty situation of women and girls /announcements on availability of fistula treatment. Radio talk shows are conducted in 4 local languages that is; Ateso, Kumam, Luganda and Ngakarimojong. The media interventions continue to increase levels of awareness among the different members of the public while also providing a platform for getting issues of marginalized and vulnerable women into strategic spaces for the public.

Through training community-based volunteers/counselors, TERREWODE has recorded increased number of fistula patients identification and referral for treatment (Our volunteers mobilize, counsel and encourage fistula patients to seek treatment), increased number of fistula patients who have received treatment and increased number of patients who have received pre and post operative counseling services. TERREWODE’s squad of volunteers comprises of Home Based Maternal Health Care (HBMHC) volunteers, Dignity Watch Society Forum members, Village Health teams, Women groups and Leaders. We equip them with additional knowledge and skills in basic counseling particularly on how to handle fistula patients as well as some aspects of fistula prevention and patient re integration. Our impact in communities is persistently felt because volunteers make follow up visits to ensure that patients adhere to the treatment rules.

As a way of socially integrating fistula survivors, TERREWODE is centering her energies on economic empowerment. In 2007 – 2008, TERREWODE initiated a pilot microcredit scheme with fistula survivors and it was very successful. In December 2011 – January 2012, a needs assessment was conducted with fistula survivors; when asked to identify barriers to self-reliance and social reintegration within their community, survivors overwhelmingly responded that poverty was their biggest challenge. The women had a strong desire to work, achieve self-sufficiency, and maintain a life-style that reduces their risk of fistula re-occurrence. The survivors identified income-generating skills and small business loans as their number one need. We are responding to this need to create a tangible impact by strengthening our microfinance department.

TERREWODE persistently carries out capacity building among community members in its areas of operation. Building the capacity of communities facilitates them to take self-owned actions and gives them the ability to utilize and sustain community institutional actors in strengthening effective implementation and support for all programs.

In the Teso region, TERREWODE has created a vibrant community movement consisting of 32 women’s groups, each with an average of thirty members, and through these groups increased awareness and advocacy for improving women’s human rights, with a focus on maternal health, elimination of obstetric fistula, and poverty eradication. The leaders of the women’s groups have received leadership, advocacy, monitoring and evaluation, and documentation training. In addition, in locations where several fistula survivors are in close proximity to one another, TERREWODE has assisted them in forming solidarity groups. It is these groups that support the micro credit project, hosting the training courses, providing support, encouragement and cooperation for business ventures, and serving as a group guarantee- a proven risk mitigation factor in loan repayment.

TERREWODE has impacted on local education policies in the Teso region. The organization has been very instrumental in getting four districts to enact and operationalize district ordinances to strengthen the enforcement of the existing national legislations that attempt to protect rights of girl children to education. Schoolgirls are vulnerable to drop out of school as a result of child marriages, defilement and rape resulting into pregnancies; therefore at the request of communities TERREWODE engages school communities in their campaigns against obstetric fistula. Over 10 schools in eight districts of Teso have been reached with information about fistula with an aim to prevent it. The organization equips the girl children with the skills and knowledge to prioritize their education against all the odds by highlighting fistula as one of the barriers to their education.

TERREWODE carries out advocacy and raises community awareness and education at all levels on various issues as well as supporting effective and participatory Advocacy pertaining to all its program areas for increasing general knowledge and demand for services. TERREWODE’s purpose is awareness raising on obstetric fistula for renewed commitment to improve livelihoods and status of vulnerable women and girls in relation to maternal and child health.

Through our Research programs, we have successfully carried out a survey on the Interplay between poverty, lack of land rights and poor maternal and neonatal health; a case study of Teso sub-region. The overall goal of the survey is to inform our awareness and advocacy work seeking to secure property rights for females, especially their land rights. The impact is that it has increased level of awareness about women’s lack of land rights impacts on their maternal health and poverty situations and thus, making them more vulnerable to rights violations yet unable to speak out against the injustices. There are also growing discussions currently about the need for stakeholders to use holistic approaches to addressing human rights simultaneously for greater impact. Overall, we are using the findings to mobilize funds to implement planned activities. In addition, we have also started disseminating the findings to selected members of the community for instance, we have so far conducted three separate information sharing sessions with the women leaders (30 members), victims of human rights violations including fistula survivors (45) and community volunteers (32) for the awareness creation purpose.