Fistula management appeals to COVID-19 national taskforce

 

 

The strict restricted access to sexual reproductive healthcare in communities, for instance, to emergency obstetric care, to sexual violence emergency support and post exposure prophylaxis services has added insult to injury and affected mainly rural areas. 

 

The above were the words of Alice Emasu Seruyange in a press release she issued over the weekend on behalf of her organisation, which the New Vision saw.

 

The founder and executive director of the Association for Rehabilitation and Re-orientation of Women for Development (TERREWODE), Emasu was appealing to the COVID-19 national taskforce to simplify accessibility of health services for women and girls suffering from obstetric fistula during this time of the corona virus. 

 

TERREWODE is a leading national civil society organisation prioritising the campaign for elimination of obstetric fistula in the country, working in partnership with Ministry of Health. The organisation has spearheaded the campaign against obstetric fistula clients, survivors and other marginalised women and girls in rural areas where they are most affected.

It increases community awareness on fistula issues, supports treatment and reintegration, empowers vulnerable women and girls as change agents in maternal health, does advocacy for better health care systems and capacity enhancement of communities to support the cause for Sexual Reproductive Health and rights for women and girls.

 

Emasu regretted that "our national efforts to eliminate obstetric fistula in the country have been gravely halted by the COVID-19, and going by what we see and hear, we shall experience a backlash in the campaign as more fistulas are being caused daily, while some of our sisters and mothers are perishing due to preventable childbirth complications because of not accessing health services".

 

Emasu observed the country had made significant progress in treating fistula case backlog that stood at 200,000 women and girl sufferers to 175,000 to-date, quoting statistics by the United Nations Fund for Populations Activities (UNFPA).

 

The press release said Uganda still stands out among the countries in the sub-Saharan Africa with the highest numbers of maternal mortalities and morbidities, with 16 mothers dying daily while at least two of them end up with fistula due to preventable complications of child birth. 

 

"Prevention of obstetric fistula and maternal deaths stillremains our challenge and any slight set back escalates the situation," she said.

 

She stressed that fistula patients earnestly need quick medical intervention, which they are no longer accessing today because of being in immobile state and home-bound. Emasu expressed concern that the ministry of health did not issue regular guidelines to ensure their safety.

 

"Let us not disown fistula patients in the face of difficult times, let us have compassion and support each other," she emphasised.

 

Last August, TERREWODE commissioned Terrewode Women's Community Hospital (TWCH) in Arapai sub-county in Soroti District, the only hospital treating fistula women in the country. The specialised hospital has since treated over 100 women and girls suffering from fistula and other child birth injuries, but has since suspended its services due to the lockdown.

 

According to health experts, obstetric fistula is a medical condition where a hole develops in the birth canal as a result of childbirth. This can be between the vagina and rectum, urethra or bladder of a woman that results in the constant leakage of urine or human waste. The condition is predominantly caused by prolonged or obstructed labour lasting more than 24 hours.

 

Uganda's maternal mortality rate has consistently been high, with 16 mothers dying every day due to a complication related to pregnancy or delivery, Emasu said quoting United Nations Children's Fund latest data.

 

"Currently, two women out of every 16 who are lucky to have survived death during childbirth complication will end up with fistula. But fistula is fully preventable when all women and girls have access to high quality, comprehensive sexual and reproductive health services."

 

It is estimated that in Uganda, 140,000 women are living with fistula and 1,900 new cases occur annually, according to the 2017 Uganda Demographic and Health Survey (UDHS). About 2% of Ugandan women of reproductive age have experienced fistula, translating to over 140,000 with the condition.

 

Emasu said that they are currently exploring working relations with the district COVID-19 taskforces and health facilities to strengthen referrals and access to health care for vulnerable women and girls including those that may need to be put in institutional quarantine.