Friday, August 7, 2009

UVP Transports Women with Fistula for Repair

On Sunday, Uganda Village Project transported nine women from Namungalwe Health Center III to Kamuli Mission Hospital, a private hospital in Kamuli District about an hour’s drive from Iganga.  Five of these women suffer from obstetric fistula, a painful and isolating condition characterized by an abnormal passageway between the vagina or uterus and internal organs such as the bladder or rectum, which leads to persistent leakage of urine and/or feces through the vagina. 

Virtually unheard of in wealthier nations, obstetric fistula (Latin for hole) is an affliction of the very poor, and is predominantly caused by neglected, obstructed labour.  If the obstruction is unrelieved, the baby usually dies, the prolonged impaction of its head against the mother’s internal tissue resulting in a fistula.  The loss of the baby, the persistent incontinence and rank odor that follows, along with many other possible complications such as infertility and chronic infection, may all conspire to isolate the woman from family, society, and employment.  Though a simple surgical repair can mend most cases of obstetric fistula, most women go untreated, afraid to admit to the condition or too poor to afford the repair.

Obstetric fistula is particularly prevalent in Sub-Saharan Africa, and Uganda has been reported to have the third-highest rate of fistula in the world. 

We arrived on a hired mini-bus at Namungalwe Health Center at noon to pick up the women with fistula, and the women who have volunteered to be their care-takers while at Kamuli Mission Hospital.  It can take up to two weeks to be seen by the British doctors who are operating at this ‘fistula repair camp,’ and so these care-takers are friends indeed, to give so much of their time.  They will cook for the women undergoing the operation, clean and nurse them if necessary, and generally support them through the operation.  In Ugandan hospitals, where nurses are scarce, all patients must arrive with a care-taker if they intend to stay for any length of time.

Julius Ntalo, a tall, thin Ugandan graduate student who has volunteered with UVP for years now, working particularly around obstetric fistula, has organized the women who are attending this year’s camp.  He had arrived at 10am and stands waiting for us as we drive up, women and colorful bundles of food and supplies all around him.  One woman with fistula was not able to bring a care-taker, he informs us, but another care-taker volunteered to take charge of this woman as well as her own friend, so all is well.

We walk out to greet the women, and to greet the Namungalwe Health Center In-Charge (the man who oversees the Health Center), and the Namungalwe Senior Nurse, who is coming with us to drop off the women.  After a few minutes we parade back into the mini-bus – women, supplies and all – and begin to drive down the long, red, dirt road that leads to Kamuli.  The women are quiet in the bus, barely chatting amongst themselves.  A few are from the same village, Bulumwaki, one of UVP’s Healthy Villages.  Julius himself stayed in Bulumwaki with one of our five Healthy Village volunteer teams this summer, and conducted sensitizations about obstetric fistula while there.  In the days prior to this camp Julius also appeared on two local radio stations, talking about obstetric fistula and letting women listeners know that UVP would transport them from Namungalwe Health Center, as well as provide them with a small sum of money for the two weeks, if they wished to undergo the operation for repair.

When we arrive at Kamuli Mission Hospital we first meet with a head administrative official and then a nurse shows us the room for our women – the British doctors had reserved particular spots for women transported by UVP, as we have brought so many women in years past.  The room is mostly empty, but clean, with mattresses provided and an area to cook and fetch water nearby.  For a hospital in Uganda, it’s nicely outfitted.  We hang back as the women inspect the room, obviously satisfied, and then check to make sure they need nothing, are comfortable, have our phone numbers, and will contact us if anything goes awry.  Eventually the four of us – Mariam, Julius, Kevin the Head Nurse from Namungalwe, and myself – leave to begin our journey back to Iganga.  We plan to return next Sunday, to meet the British doctors who are not currently present at the camp.

An Update

On Thursday, we were contacted by Kamuli Mission Hospital, and told that each of the five women we brought had undergone surgery already, and are repaired!  It will be exciting to return on Sunday to visit the women at Kamuli – only one week later, and yet their lives so dramatically changed for the better! 

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