A Father's Perspective

by Patrick Tulibagenyi, Program Manager

The phone rings – once, twice. And a third, long ring before he answers. I wasn’t sure how David would react to my phone call, so when he finally answered, I held my breath for a moment, hoping he would be open to discussing his daughter’s situation. 

It’s not often you get the story of a father affected by fistula, which is why I wanted to speak with David. He believes that education is of utmost importance, so he has fought to keep all of his children in school. So it is understandable the devastation he felt when his teenage daughter, Agnes, told him she was pregnant. Traditionally, when a woman becomes pregnant, it is time to marry the father of the baby, which is what David demanded. So, at 17, Agnes married the father of her child, left school, and went to live with him. And that’s where things turned sour.

Agnes’ husband was not supportive of the pregnancy, which resulted in poor care for Agnes. Due to the lack of support, there were few options for Agnes when she went into labor. With the help of her father, she was able to seek care at a local health center, but the challenges continued. Her ordeal resulted in a stillborn baby and a fistula.

Knowing his daughter would not be well cared for by her husband, David brought Agnes home. He wasn’t sure how to treat her condition, in fact, he wasn’t even sure what her condition was called. While he was trying to figure out what to do, he heard a radio announcement about a camp at Kamuli Mission Hospital to treat a condition that sounded similar to what Agnes was experiencing. Not knowing what to expect, David sent Agnes to the camp with a caretaker. Not only did Agnes receive care, her surgery was successful. The family was elated!

To ensure Agnes healed completely, and because he was an advocate of education of any kind, David suggested she join the extended reintegration program and learn a trade. So she did. Agnes completed UVP’s reintegration program in 2018 and then returned home. But only for a short time.

The next time I saw Agnes, she was walking through the gates of Top Care Secondary School in Iganga where she was resuming her studies in level Senior 3. Unlike before, the day she returned to school she was confident and full of hope.

David’s support meant a different outcome for Agnes, which is why UVP’s Fistula Ambassadors work to educate men also. Good health is not just for one person; it is most impactful when it is a group effort.

See Agnes’ full story here. We have 30 former fistula patients that serve as Fistula Ambassadors who conduct outreaches throughout the year in rural communities. In 2018, UVP’s Fistula Ambassadors reached more than 49,000 people with education about preventing fistula and battling stigma. Photos by Ben Blankenship.

What Ownership Looks Like

by Nampiima Maria Gorret, Program Coordinator

Photo by Ben Blankenship

I was walking through Bufutula A with the VHTs visiting individual households answering questions about sanitation when we came across Kawanguzi* and his 16 year-old son digging a hole. Or more appropriately, digging a pit.

When I first saw Kawanguzi, he looked so serious. His bold features did not give any indication to the feelings beneath them, so I began asking the quiet man some questions. I wanted to learn his story.

A month earlier, Kawanguzi’s latrine was washed out in the severe rains. It undermined the foundation and filled the pit with mud. The roof was no longer secured and the door was missing. Oftentimes latrines are constructed out of local materials such as trees and mud, so severe rains have detrimental effects. It is typical for a family to start practicing open defecation once their latrine is destroyed, but Kawanguzi was determined to avoid that.

Talking openly about sanitation is not common, but as I chat with Kawanguzi, he does not seem shy despite the small crowd of neighbors and children that has formed around us. He answers my many questions with confidence because he clearly knows the importance of sanitation. Kawanguzi tells me that most people think that building a latrine is work reserved for women, but he doesn’t agree. “It is my responsibility to provide the right facilities to my family. It is my responsibility to show my young son the right habits.” That’s why Kawanguzi was enlisting the help of his 16 year-old son: to teach his son the habits Kawanguzi learned from interns Jake, Debbie, Bridget, Kirsi, and Kennedy in 2016. In addition to the shallow well that UVP built with the community, the interns conducted educational outreaches discussing the importance of handwashing and using a latrine to ‘ease oneself’.

Photo by UVP staff

As we finished our conversation, I matched Kawanguzi’s feelings of appreciation. He thanked me profusely for the work UVP has done in his village. And I thanked him extensively for acting as a change agent in his community and showing his son how to take ownership of his responsibilities and serve as a dependable citizen to Bufutula A.

Behavior change does not happen overnight. The seeds our interns sew and that UVP staff continuously care for over the years take time to flourish. There are many people involved in this slow process, but the most important ones are the community members who take ownership and responsibility to keep their family and community healthy.

*To respect his privacy, Kawanguzi's name has been changed.

A Second Chance at Secondary School

by Nampiima Maria Gorret, Program Coordinator

Despite the fact that she’s the youngest member of her cohort in the reintegration program, Agnes is confident. Energetic, yet soft spoken, Agnes treats everyone with the utmost respect.

When her water broke, Agnes knew she needed to go to the clinic, just like she had learned during her ANC visits. She took the little money her family had saved, and made her way to the nearest health center riding on the back of a motorcycle. Once there, the clinic staff felt her situation was beyond their ability and sent her to another health center. Again, she travelled by motorcycle to her next destination. Upon reviewing her condition over several hours at the second health center, Agnes was once again referred to a different facility. And once again, she rode on a motorcycle to seek the care she needed. Finally, at Rubaga Hospital in Kamuli District, she learned that she needed to have a cesarean section to deliver the baby. Unfortunately, it was too late. Having been obstructed in the birth canal too long, the baby was stillborn. Agnes recalls that day she had to take on two bitter realities: she lost her baby and had begun leaking urine uncontrollably.

After returning home, she was traumatized, despite the support she was given by her care takers was broken by the fact that her friends made fun of her situation and spoke ill things behind her back. Agnes began to feel despair, thinking there was no way for her to live a normal life again. But upon meeting a Fistula Ambassador in her village, she started to feel more hope, a feeling that continued to grow through surgery and all throughout the reintegration program, particularly from the support of the other women in her cohort. With all the hope you felt, Agnes began making plans for the future: she was going to return to secondary school.

The Malaria Revolution

by Josephine Asio, Program Coordinator

On a quiet afternoon, I meet Ivan in a neatly swept compound in Bulondo village. Although it isn’t immediately obvious, Ivan is part of the transformation happening in Bulondo; the revolution of how community members understand and prevent malaria. You see, this four year old boy is so committed to preventing malaria that he insists on sleeping under his mosquito net at all times, even in the middle of the day. And that’s where I find him, waking up from his afternoon nap under his carefully tucked mosquito net.

Ivan’s mother, Sarah, recalls long stretches where Ivan was at the health center to treat malaria every month, sometimes more. On more than one occasion, Sarah wasn’t sure if Ivan would leave the health center alive. Because their home is situated next to a sugar cane field, Sarah felt hopeless at avoiding malaria. Until she learned more about it.

Last August, Bulondo VHTs visited Sarah’s house and encouraged her to purchase a mosquito net. The VHT knew Ivan and others in the family had been sick recently and asked Sarah how much she spent traveling to the health center and for treatment. She blushed slightly and admitted nearly 30,000 shillings. The VHT asked her to make an investment in her family’s health that was a fraction of the cost: for 3,000 shillings, she could by a mosquito net. And she did.

Since then (nearly 6 months ago), Ivan hasn’t visited the health center at all! Ivan says, “When will it by my time to go to school?” a question he frequently asks. “Soon,” Sarah says with a chuckle. She turns to me and says, “Sometimes we overlook everything we are taught about how to live a healthy life, and only remember when you are directly faced with it. I now know that prevention is much cheaper than a cure.”