We conducted an outreach program at Kitovu Hospital in the western part of Uganda, which is one of our primary centers for advocacy and the fight to prevent fistula. This is the only known hospital in Uganda offering vesicovaginal fistula (VVF) repair. Our intentions were to strengthen collaboration with the hospital by providing psychosocial support, resources, health education, and mental health counseling to women still undergoing treatment, as well as those with lived experience, in order to capture their unique stories.
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| Kitovu Hospital Outreach on Fistula: Strengthening Care Beyond Surgery |
We engaged these women in four sessions:
First: Reproductive Health Session – Led by Dr. Chris Byaruhanga
- Maternal and newborn care: Addressed safe pregnancy and the importance of seeking antenatal care for safe delivery and postnatal support.
- Family planning: Encouraged access to effective methods and planning with partners regarding how many children to have.
- Reproductive screening: Emphasized early detection and regular checkups for conditions like fistula and cervical cancer.
Second: Importance of ANC and Early Intervention – Led by Dr. Henry
Dr. Henry discussed the importance of antenatal and postnatal care. He sensitized the women on how ANC allows early detection and identification of pregnancy risks, the need for continued care after birth to avoid complications, and general health education. Antenatal care is vital for reducing maternal mortality and detecting early complications like fistula. During the interaction, some mothers mentioned: “We sometimes seek health care in village clinics because we don’t have money to go to the hospital at the time of giving birth, and we get difficult complications.”
Third: Integration of Mental Health in Maternal Health – Led by Justine
The discussion focused on depression management among the women as a result of prolonged illness, significant psychosocial distress, and societal misunderstanding. We looked at family distress, high associated costs of management, and how to overcome depression. The session was interactive. One mother inquired about how to manage their distress; she further mentioned that despite the distress caused by fistula, she also has a child with epilepsy who has not received treatment. Many of the women deal with family distress without professional counseling sessions and fear sharing their distress and condition with others, which leads to late help-seeking, they mentioned.
Fourth: In-Depth Interviews
We interacted with two different women who had unique stories about their condition.
One mentioned: “I lived with fistula for 7 years and sought treatment from over 5 facilities, both government and private, including where I got this complication from, but did not get help until I was referred to Kitovu Hospital, where I had to borrow transport to come.”The other was a woman who lived with fistula for 26 years: “I did not seek treatment early after the hospital where I gave birth failed. I learned to cope with the illness until a relative got information from a radio station program and informed me about treatment at this facility.”
These testimonies show how poverty affects health-seeking behavior, the lack of information, the rising need for awareness creation in communities, and the lack of specialists in government facilities for some health conditions – which creates a significant health gap.
