Coming together to stop fistula

Can you imagine 80 visits to Africa in less than 50 years? At Uganda Village Project, we have knowledgeable staff with years of public health and development experience. None of us, however, come close to 46 years of work in Uganda. That honor goes to Dr. Brian Hancock, a talented surgeon

who has been volunteering his time in Uganda helping fistula patients during 50 visits to Uganda (80 total to Africa!) over 46 years.

Not long ago, we were at Kamuli Mission Hospital to meet with everyone involved in the most recent fistula camp. We were pleased to spend time with Dr. Hancock, who graciously invited us to sit down for a cup of tea and talk more about the women who come for surgeries and how things have changed over four decades of fistula treatment. He can remember tiny details of the majority of his patients, and he talks about each one with a genuine appreciation and a sparkle in his eye. During other visits to fistula camps, I’ve been struck by the resiliency and strength of the women. This time, during our conversation with Dr. Hancock I was reminded how important it is to work together to achieve change for women with fistula. It really does take a village, and in this case, the village comes from England, Scotland, Norway, the US, and across eastern Uganda.

Loy, UVP’s Fistula Coordinator, was monitoring patients who had just come out of surgery. Nurses from Scotland were working with nurses from Uganda who had recently been trained in fistula care at another Ugandan hospital. Everyone was really impressed by their skills and excited for the potential of them taking on more duties in the future. There were doctors from the UK being assisted by Ugandan nurses in the surgical theater. When we talked with Dr. Hancock, he said it used to be just him and one nurse attending to fistula patients. Now, there are multiple people from multiple countries all dedicated to healing women.

As we sat with a Scottish nurse waiting to support the next surgery, she acknowledged that it takes a lot of energy to work at the camps, often 12 or more hours a day, in order to meet the demand for surgery. All the international doctors and nurses use their personal vacation days to come here. She deflected our appreciation, though, with a reminder that none of their work would be possible without efforts to identify women suffering from fistula and bring them for the surgery in the first place. It’s not only doctors and nurses from multiple countries who make this happen, it takes Fistula Ambassadors who share their stories with women in their communities to encourage them to come for surgery. It takes UVP staff who support the Ambassadors, organize camps, and make sure the women heal and return home safely. It takes the Fistula Foundation, who provides funding for many of these programs, and it takes donors from around the world who help us support women before and after surgery.

I'm still impressed by the resiliency of the women who come for surgery. They're the entire reason we all do this. But watching this global village come together to help the women was just as inspiring.

Return to Uganda

By Alison Schroth Hayward, UVP co-founder and Board Chair

It had been over 10 years since my first trip to Iganga, when I performed a needs assessment and co-founded Uganda Village Project, and more than five since my most recent one. The last time I walked through our gates on Moses Kintu Road, six years previously, we had just moved in. Walking into the compound felt unreal – I had returned to the office so many times in my mind’s eye, during the intervening years of volunteer work from home, that being there again felt like being present in a daydream.

Not only is the Uganda to which I arrived different from the Uganda of five years ago, now I am different too. No longer do I even consider jumping on the back of a boda boda, letting my hair fly behind us as we zip around the traffic. I stick strictly to cars for transport. There were no crazy mataatu encounters, stacked like sardines in a tin can barreling down the road with chickens at our feet. Although Entebbe is still the same small, sunny airstrip, it now has jetways, security cameras at immigration and fingerprinting machines, and functioning conveyor belts for luggage. Kampala is still a dust bowl of crowds, traffic, and mayhem, but there are traffic lights now. And Iganga is still the same sleepy, agrarian town along the highway – aside from what appears to be a newly flourishing industry in woodworking along the old Kaliro road, it all still looks the same to me as the day I left.

The trip was emotionally different for me as well. In the past, when I witnessed one of the routine tragedies of life in rural Uganda – such as seeing a five year old carrying a toddler on his or her back, far from sight of any parent – I previously just registered how foreign that sight was, then how tragic, and I would momentarily acknowledge to myself that this was something that should not happen and I kept moving. I was able to compartmentalize my horror, file it away mentally under “things that I wish were different.” Something about being a mother has changed this for me. Now, when I see that tiny child bent under the weight of their baby sibling, it carries a much deeper meaning for me. I’ve carried that weight. I know much more about exactly what that tragedy might truly entail, on a daily basis. The situation is no more sad than it always was, but now my sadness is personal, and I struggle to keep my composure and hold back the tears when I see children suffering. – or even now, just writing about it.

This feeling of intense heartsickness made it much easier to feel overwhelmed at the enormity of the need in rural Iganga. I wanted to protect my heart, I tried to push the images and feelings out of my mind because there were too many wrongs I could not right. Ironically, feeling more personally affected by these situations made me want to run further away from them, to surround myself with happier thoughts and put my head in the ground.

Then, on the last day of my stay in Iganga, Maureen arranged for some of the beneficiaries of our programs to come visit with me at the office. I once again met Josephine Nakalimo, then a very quiet and shy secondary school student, now a confident young college graduate who just registered her own nonprofit to help other vulnerable children. She explained to me that she was postponing the idea of marriage and children, because she wanted to secure a job and her financial independence first. She launched into a speech of gratitude that seemed like it had been mentally planned for quite some time. “I want to thank you so much for what you have done for me. If you were not you, then I would not be who I am today,” she repeated to me several times. “You are my mother, because you cared for me like I was your child.” Once again, I was fighting back tears, but this time they were happy ones. I was full of pride at what Josephine had accomplished and who she had become. On a personal level, the experience clarified resoundingly that it was possible to make a difference, to change lives – something I theoretically knew, but had been having trouble accepting as true.

Fighting against poverty and preventable disease in rural eastern Uganda continues to be one of the most rewarding things I’ve done in my life. Revisiting Uganda reminded me that all the work I’ve done, all the dollars I’ve spent – these efforts have not been meaningless gestures in the face of an overwhelming tide of need. Each choice to help has meant something real to a person or a family in Iganga, even if I did not have the opportunity to meet and speak with each of them or to know their names. I returned home with a renewed commitment to improving community health in those places where the need is greatest. I wish I could have taken you with me, but I hope that through this narrative, you’ve been able to see the trip through my eyes.

Sincerely, and with many thanks for all you have done to support Uganda Village Project –

Alison Schroth Hayward