Discos, teenage pregnancies, making fistula endemic in Zombo district

It is common to see babies carrying babies in Zombo district, Dr Denis Bakomeza, a public health specialist in Reproductive and sexual health, says with so much disappointment. 

He says the high number of discos across the district is increasing the number of teenage pregnancies. 

As a result, many teenage girls who have problematic labour and trouble during delivery have developed obstetric fistula, a preventable disease.  

“Prolonged labour that is mismanaged causes obstetric fistula,” Dr. Bakomeza who is also the programme Co-ordinator for the United Nations Population Fund (UNFPA) Arua office, says. 

Obstetric fistula is a hole in the birth canal caused by protracted, obstructed labour in the absence of timely medical care, leaving women to leak urine and faeces. 

The burden is estimated to be at about two million in Africa and Asia with about 100,000 new cases every year.

According to the Uganda Demographic Health Survey (UDHS) of 2016, between 75,000 and 100,000 women are living with the condition. 

There are about 1,900 new cases that are added to the already big backlog of women with this condition. 

In Zombo district which currently has the highest fistula burden in Uganda, a total of 57 women are grappling with the condition and others remain unnoticed, the district health department says. 

If left untreated, obstetric fistula can lead to infection, disease, and infertility. 

According to experts, this devastating condition is an indicator of poor-quality healthcare, and its occurrence implies a failure of health systems to meet the needs of affected women and girls. 

It is a tragic sign of prevailing global social injustice and a violation of human rights as reflected by broader health inequities and healthcare system constraints. 

Unfortunately, the plight of the women has not been prioritized as it should in terms of the resources that are availed to address this complication. 

May 23, every year is set aside by the United Nations as International Day to End Obstetric Fistula. 

The day is gazetted to promote action towards treating and preventing obstetric fistula, a condition that affects many girls and women in developing countries. 

In Uganda, national activities to highlight the challenge of fistula in Zombo district was marked on Friday, May 27, 2022. 

Bakomeza says the major avenue to eliminate fistula is to ensure girls below 20 years do not conceive and give birth. Those above 20 years are at less risk of developing obstetric fistula. 

To avoid fistula, a pregnant mother must attend antenatal care, get the right care at the health facilities and must deliver at the health facility where they can be assisted to have birth without much difficulty.