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The assistant commissioner of clinical services in the ministry of health, Dr Alex Wasomoka, has raised concern over the increasing backlog of fistula cases in Uganda.

He told a media breakfast meeting on obstetric fistula in Kampala on Wednesday (May 8) that at least 1,500 surgical operations annually are conducted in both government and private-not-for-profit hospitals across the country. 

“We can do about 1,500 operations in a year, but there are about 1,900 new cases reported every year. So, you can see that balance of unoperated cases of about 400 and these cases keep increasing,” he later told New Vision in an interview after the meeting.

Wasomoka said each fistula patient needs $400 (about sh1.5m) to undergo surgery.

“Fistula surgery is expensive as the average cost of an operation is about $400. The number of surgeons is 25 to cover the whole country but we need at least two surgeons per site because these 25 end up moving from one place to another,” he said.

There are 13 fistula treatment centres across the country. “But we also need midwives to manage the conditions of these patients. If we don’t train more doctors in that area, we shall continue having a backlog of fistula cases waiting for surgery,” Wasomoka warned.

Birth injury cases

The Uganda Demographic Health Survey of 2016 (UDHS) said between 75,000 and 100,000 women were living with obstetric fistula, an abnormal opening between a woman’s genital tract and her urinary tract or rectum.

Health experts say the development of obstetric fistula is directly linked to one of the major causes of maternal mortality: obstructed labour.

The UNHS also said the sub-regions of Buganda, Ankole and Lango registered the highest number of birth injuries in the country, while Rwenzori and Karamoja the lowest.  

The West Nile and Central sub-regions had the highest number of urinary fistulas at 17% and 15%, respectively.

Wasomoka also said estimates put the burden of obstetric fistula at about 2,000,000 million in Africa and Asia with about 100,000 new cases every year.

The UN General Assembly in December 2012 designated May 23 as the International Day to End Obstetric Fistula to be observed every year beginning 2013.

This year’s national celebrations will be held in Namayingo district under the theme, “Breaking the cycle: Preventing Fistula Worldwide.”