What we do

There are four key components of TERREWODE’s obstetric Fistula program and they are; awareness and advocacy, treatment, Reintegration of survivors and prevention campaigns.

Awareness and Advocacy

TERREWODE’s Obstetric Fistula Awareness and Advocacy Network (OFAAN) is a vibrant grassroots structure of trained outreach volunteers working in community settings to identify fistula patients and refer them to TERREWODE for treatment. The volunteers also support fistula survivors as they reintegrate them back in their communities and spread awareness about the causes and risk factors of obstetric fistula.

The OFAAN comprises three distinct groups of volunteers that is: Leaders of local Women‘s Groups, retired Community professionals known as Dignity Watch Leaders and finally survivors who have received treatment, counseling and reintegration assistance. They are given training on obstetric fistula awareness and advocacy along with safe motherhood preparation and legal rights advocacy. The model is sustainable due to the fact that the work is carried on by diverse group of volunteers. This not only preserves valuable resources for treatment and counseling for the victim but also continues to work to end fistula long after the initial resource input.

In addition to our three groups of volunteers, TERREWODE also provides OFAAN training to Law enforcement officers, medical professionals, schools, community clubs, traditional birth attendants, and members of the media. In this way, fistula awareness and advocacy, the core message of OFAAN, is widely disseminated throughout the community.

Treatment

TERREWODE ensures that women who are identified as suffering from obstetric fistula are able to access treatment. TERREWODE has built partnerships with the Ministry of Health, hospitals and health centers, local and international doctors and nurses to provide quality treatment.  TERREWODE has sought grant funding to cover the cost of treatment when needed and to provide additional training and incentives to surgical and nursing staff. In addition to supporting continuous treatment at different referral hospitals, TERREWODE also participates in organizing fistula camps with leadership from Ministry of Health.

Re-Integration

TERREWODE realizes that surgery alone is not enough to heal from the trauma of an obstetric fistula and thus we are committed to improving post-surgical care and social rehabilitation. In June 2013, TERREWODE launched a new reintegration centre thanks to our partnership with World Wide Fistula Fund. The Centre provides vastly improved post-surgical care for women along with nutritional support, counseling, income generating skills training and social reintegration services. The Centre’s program includes life skills, health education and entrepreneurship training with five different modules; TERREWODE staff facilitate the formation of Solidarity Groups for Fistula Survivors which provide critical on-going support, counseling and self-reliance as they are reintegrated back in their communities.

Prevention

In addition to the estimated 200,000 of current fistula cases in Uganda, there are approximately 1,900 new cases of fistula each year. In order to eradicate fistula, prevention efforts are critical. Obstetric fistula prevention is built in many of our on-going programs such as OFAAN’s awareness and education about the risk factors for fistula and importance of facility based birth with skilled birth attendants. In addition, TERREWODE recently developed the safe motherhood kit project, which encourages antenatal care and birth at health facilities. Long term, TERREWODE plans to explore the creation of a mid-wives training centre where upon graduation, mid-wives would be dispatched to rural areas that are in most need of quality maternity care providers. At another level, TERREWODE has penetrated secondary schools as part of the prevention campaign.  School visits have been used as a platform to air out risk factors that contribute to fistula like teenage pregnancies. Partnership with Ashoka Innovators for the Public through their Youth Venture program has seen recruitment of young girls as change makers who are passionate about creating solutions to problems in their communities. Many of the girls have concentrated on improving sexual, reproductive and maternal health rights.

TERREWODE’s program has proven itself to be both effective and sustainable. To date, TERREWODE has helped more than 10,000 women suffering from obstetric fistula in Uganda and over 1,000 received social reintegration services which include economic empowerment initiatives. In addition, TERREWODE’s program has been instrumental in highlighting the urgent need for health professionals to work closely with women and human rights activists to address not only the primary causes of obstetric fistula but also the root causes such as wide spread poverty, Gender Based Violence and the lack of land rights of women.