What we do

Campaign against Fistula Over 200,000 women in Uganda live with obstetric fistula.1 However, only 4000 out of this number have sought health care. In Uganda on average, fistula patients have lived with the condition for 10 years. An estimated 4,300 fistula cases have cumulatively been reported to health facilities countrywide and are awaiting repair. Understaffing, insufficient supplies and ill equipment of hospitals in general, limit the annual number of obstetric fistula repairs or treatment. The cost of one operation and adjunct care is estimated at US$ 300.

This cost prohibits utilization of treatment and social reintegration services on wide scale. Further, four of the ten resident fistula surgeons that have been trained to repair fistulas in regional referral hospitals still offer routine obstetric treatment services. The majority of patients are treated in obstetric fistula surgical camps by visiting fistula surgeons. The success rate in these camps has been reported to be above 80 per cent. Despite this success, the capacity to repair and reintegrate women who have suffered obstetric fistula back in society remains low in Uganda. Effective fistula treatment includes: provision of post treatment psycho-social counseling services; regular follow up of the survivors to ensure they adhere to prescribed treatment and required care for full recovery; reconnection with family members and community through literacy education on fistula causes, human rights, gender inequality; and economic empowerment. All these empowerment interventions have to be followed by preaching and exercising reconciliation for the individual to successfully regain their former social networks.

TERREWODE works with community volunteers and social workers to raise awareness, lobby and advocate for women’s health rights through a holistic obstetric fistula program. The program includes prevention, treatment and social reintegration of patients. It works in six districts in Teso region. TERREWODE uses obstetric fistula to mirror the broader reproductive health concerns of women and children. Emphasis is put on capacity building of women’s and sub county groups in grassroots advocacy to promote and protect young women and girls’ rights and at high risk pregnant women as a long-term strategy for the fistula prevention campaign. Train-the-trainer models are used to advance activities that promote women’s health rights. School clubs are created and or strengthened to engage in reproductive health campaigns and act as an entry point to the school community. In addition, community mobilization ensures active participation in reproductive health rights campaigns.

It has successfully targeted different stakeholders in creating awareness activities that emphasize provision of information and education on reproductive health and rights, especially obstetric fistula. TERREWODE’s reintegration program for survivors of obstetric fistula has been piloted in the eight districts of Teso for the last ten years. It has been successful in these districts but it is yet to be scaled up to a national scale.