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Fistula: Restoring hope and healing through male involvement

Twenty-three year old Beatrice Katushabe was only 19 years when she met 24-year-old Mike Tumusiime. The casual labourer and then teenage girl both from Ruhama in Ntungamo district in south western Uganda got married and she conceived in the same year.

The evening the UNFPA team met Katushabe, she was recovering from a fistula ward at Mbarara Referral Regional hospital after a successful fistula repair, a condition she had developed at childbirth after a prolonged labour delivering in the hands of a Traditional Birth Attendant in the village. She also lost her baby.

“It took three days of labour and my wife kept pushing until we went to the village birth attendant.  When the attendant failed to deliver the baby, she referred us to the nearby health centre, but it was already too late. Our baby did not survive,” narrates Tumusiime.

But what the couple did not know was that she had also developed a fistula. She thus lived with the condition for two years without knowing the cause. Obstetric Fistula is a condition where a woman, after delivery begins to leak urine or stool. This usually happens when a woman does not get skilled attendance while giving birth.

 “Women who develop fistulas are dejected and rejected by everyone. They lose their husbands on top of having lost their babies when they are giving birth. This condition can occur to any woman in her reproductive age,” said Dr. Moses Kayondo, regional fistula surgeon at Mbarara Regional Referral Hospital in south western Uganda.

“The main thing is to prevent these fistulas from forming by attending antenatal care and deliver under skilled attendance. Family planning is also important so that you space your children. If you deliver frequently, you are increasing your chances of getting a fistula,” he added.

For Katushabe, living with a fistula was a nightmare: “I was never comfortable. People did not want to be near me because I was always leaking and smelling. I would just stay indoors most of the time,” Katushabe narrates.

It was two years later that the couple decided to take the three hour journey to Mbarara hospital to seek medical attention. They did not know that the condition was a fistula.

Luckily for the couple, with support from UNFPA and partners, a free fistula repair camp was taking place at the hospital. After screening, the health worker identified Katushabe with a fistula and recommended that she stays for the repair.

She was among the 40 women who got fistula repairs during the surgical camp that was running as part of the national activities to commemorate the International the Day to End Fistula.

Healing and restoring hope

Katushabe is now grateful to her husband who stood by her in spite of the smell and leakage.

Her husband says that he never gave up, even when discouraged by his friends. “They would tell me to leave her and marry someone else. But I stayed with her because she is my gift from God. I will to take care of her until she completely recovers,” Tumusiime said.

The couple say they have big plans for the future: “We want to work hard and save some money so that we can live a better life. My wife got a fistula because we were poor. We did not know that childbirth can cause a fistula,” Tumusiime says.

 The couple also say they will practice family planning as advised by the health worker. “We shall start thinking about having another child after she has fully recovered,” Tumusiime said.

The number of women suffering from obstetric fistula in Uganda is estimated at 2% of women of reproductive age (UDHS 2011), translating to range of about 140,000- 200,000 women with the problem.  The large backlog coupled with ever increasing new cases - 1900 per year -   surpasses Uganda’s existing capacity to repair the cases as the Country is only able to repair between 1,500- 2,000 fistulas every year.

Story by Evelyn Matsamura Kiapi