UNFPA Urges Government to implement the Obstetric Fistula Strategic Plan

By Umar Weswala

Mr. Dan Alemu from UNFPA 

The United Nations Population Fund Country Representative Dr. Mary Otieno has urged the government of Uganda to fully fund the National Obstetric Fistula Strategic Plan in order to achieve the strategic goal of eliminating fistula.

This was contained in a speech read for her by the UNFPA Deputy Country Representative Mr. Daniel Alemu during the national commemoration of this year’s Fistula day yesterday in Hoima City.

The National Obstetric Fistula Strategic Plan 2020/2021 - 2024/2025 was launched during last year’s commemoration of the Fistula Day in Zombo District by the State Minister for Health in Charge of General Duties Hon. Anifa Kawooya.

In her remarks, Dr. Mary Otieno stated that much as significant progress has been made by government and partners, more needs to be done to eliminate Fistula by 2030.

According to the UDHS 2016, at least 1 in every 100 women has obstetric fistula in Uganda.

Women who suffer complications of fistula are likely to lose not only their babies during child birth but also their livelihoods and sometimes their lives.

According to Dr. Mary, ending obstetric fistula is a high priority for UNFPA and a must achieve target of the Sustainable Development Goals (SDGs).

“As UNFPA, we have invested in improving the quality of maternal care to make every child birth safe. We have also invested in reducing unmet need for modern contraception. Going forward, we must accelerate our progress toward ending this preventable condition” she noted.

As the leader of the global campaign to end Fistula, Dr. Mary said UNFPA remains committed to support the government of Uganda to end Fistula by 2030.

Minister Kawooya greets UNFPA's Dan Alemu

The national theme for this year’s Fistula Day is: 20 years of progress but not enough, end Fistula by 2030.

Speaking on behalf of the Prime Minister Robinah Nabbanja, the State Minister for Health in charge of general duties Anifa Kawooya commended UNFPA for the partnership and cooperation with the government as well as its lead role in the campaign to end Fistula by 2030 in Uganda.

She noted that fighting fistula should start with a fight against harmful practices like child marriage, teenage pregnancies and school drop outs. These she said push girls into early child bearing which puts them at a high risk of developing the debilitating condition of obstetric fistula during child birth.

Anifa Kawooya represented the Prime Minister Nabbanja

“Such birth complications disempower young girls, their families and the community at large.

As a champion advocating for the prevention of teenage pregnancies in the country, I urge the young girls here to focus on their education, stay in school and acquire skills because it is the surest path to empowerment and the realization of your full potential” Nabbanja stated in her speech that was read by Minister Kawooya.

The Prime Minister also cautioned men against abandoning their partners who are battling with fistula.

“I appeal to the men here. You know that you are involved in the cycle of life. Please support your wives not just during conception. The women have testified how you run away from them. When she came, she was with you and she did the right thing with you, now remain together until death separates you” Nabbanja noted.

In 2022, about 1700 fistula repair surgeries were done across the country, but according to UNFPA, much more needs to be done to clear the backlog and prevent more cases from happening.

At the moment, Uganda still has an unmet need for prevention and holistic fistula treatment which includes surgical repair, social re-integration and rehabilitation.

Shakillah speaking to a UNFPA staff

This year’s fistula surgical camp was conducted at Kagadi hospital where over 50 women and girls were screened and 13 were successfully repaired and will be discharged shortly.

According to Namono Shakillah a Clinical Officer at Kagadi Hospital and the head of the fistula camp, most of the women who were diagnosed with fistula are young mothers whose bodies are not ready for child birth.

Some of the women who were repaired have lived with the condition for decades.

Mawazo Jackline, a 49 year Congolese Refugee from Kyangwali Refugee Settlement can now afford a smile after 26 years of suffering with the debilitating fistula condition. She is one of the 13 women who were successfully repaired at Kagadi Hospital and will soon be discharged.

Jacline can't wait to return to her garden

Girls and women like Jackline suffer life-shattering consequences including chronic incontinence, stigma, poverty as well as physical, mental and emotional health problems.

For Jakeline, the long and uncomfortable wait before accessing fistula care was indeed a wait of pain.

“I have endured a lot of stigma and rejection but I thank the doctors for treating me. I can’t wait to get back to my garden” Jackline said.

Jackline’s story shows that fistula can be eliminated if those with the condition can access timely and quality medical care. Her long and painful wait however, is a pointer to the existing gaps in the provision of quality care in the health system and indeed another reason why government and partners should invest in the implementation of the National Obstetric Fistula Strategic Plan.