Tuesday, September 6, 2016

Uganda's First Ever National Fistula Conference

by Kelly Child, Managing Director
The room was full of surgeons, midwives, nurses, social workers, nurses, former patients, and executive directors discussing fistula. And it was electrifying.
It was the first ever National Conference on Obstetric Fistula in Uganda, planned and executed by a small planning committee at the end of August. Approximately 300 people participated including members of parliament with the Speaker of Parliament Hon. Rebecca Kadaga, the guest of honor, and several District Health Officers.
Obstetric fistula, a condition typically acquired by prolonged labor, results in incontinence – an uncontrollable leaking of urine and, in some cases, feces. In Uganda, there are estimated more than 150,000 untreated cases with 1,900 new cases each year. From the efforts of UVP and the other fistula fighting organizations present at the conference, we treat approximately 2,500 cases each year. At this rate, we will eliminate fistula in 400 years. Clearly, we have a lot of work to do.
The United Nations Fund for Population Activities (UNFPA) started the Campaign to End Fistula, which focuses on three key areas: prevention, treatment, and reintegration. In recent years, our community of fistula fighters has shifted focus from solely looking at treatment to integrating prevention and reintegration as key components of fistula services. UVP’s average patient lives with the condition for 10.9 years prior to receiving treatment. Nearly eleven years of being stigmatized, neglected, and ostracized. Even though the physical treatment takes less than a month, the psychological and socio-economic healing process can take much longer.
Erin Anastasi, UNFPA Global Coordinator, congratulated Uganda in several areas:
  • Uganda is part of a small group of countries with a formal strategy surrounding fistula
  • Of 50+ countries participating in the End Fistula Campaign, Uganda is one of only 2 countries to answer the call to conduct a national conference
  • Uganda’s fistula repairs annually is one of highest in the world
Anastasi also mentioned inadequate human resources and expertise, lack of focus on social reintegration, and a backlog of cases as challenges moving forward.
During presentations, representatives from other organizations such as Engender Health, Medical Teams International, and TERREWODE covered topics from nurse care and utilizing VHTs (village health workers) to the proper execution of surgical procedures and improving surgeon mentoring programs. One of the most interesting presentations delivered findings surrounding the effects of fistula on the spouse. According to the study, approximately 65% of men strive to support their spouse and maintain the relationship and are also affected by the social stigmatization of fistula. By focusing on social reintegration of former fistula patients, programming can support the entire family unit.
UVP currently addresses patient identification and social reintegration in a very personal way with multiple in-person visits. Additionally, the programming is evolving to more wholly address social reintegration by implementing a longer approach to social reintegration after treatment in order to incorporate income generating activities and other educational opportunities. Approximately 25% of fistula patients have a primary level of education and most patients indicate a desire to either continue formal education or skills learning. Thank you to the Fistula Foundation and our donors for their generous support of our programming and their role in eliminating fistula in Uganda!

A donation of $260 covers UVP's costs of bringing a woman to the hospital for fistula repair surgery, her room and board, outreach to and follow up with women receiving treatment, and community education initiatives.

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