Men urged not to divorce women because of fistula

Obstetric fistula (known as ‘ecwilili’ in Ateso, the local language) is a severe medical condition in which holes develop between the rectum and vagina or between the bladder and vagina after a traumatic labor.

Obstetric fistula (known as ‘ecwilili’ in Ateso, the local language) is a severe medical condition in which holes develop between the rectum and vagina or between the bladder and vagina after a traumatic labor.

Women with fistula often become incontinent and are the subject of stigma. Many men reject their wives due to the odor produced by the incontinence and they are rendered helpless in society.

“I got scared when one morning I woke up to find my vagina no  longer functioning. It is a bad condition. I need to enjoy my sexual rights”, Alice  Emasu, executive director of the Association for Re-orientation and Rehabilitation of Teso Women for Development (TERREWODE), said. “What to do if your vagina is not functioning?”

TERREWODE is a non-government organization whose mission is to empower women and girls to actively participate in development activities with the aim of improving the livelihoods of women in Teso, north eastern Uganda and that of their families and communities.

The organization works in Katakwi, Kaberamaido, Bukedea, Serere and Soroti districts. This excludes Ngora and Kumi districts although TERREWODE plans to expand into these areas if more funds become availed.

TERREWODE also addresses other issues connected to the plight of fistula sufferers such as ignorance, poverty, bad governance and a lack of rights for women.

More than half of fistula cases are in young women or child mothers as fistula tends to occur in females of a tender age. Women who do not seek maternal health advice tend to be the group most affected.

“The young girls are exposed to fistula because their organs are not yet matured. They  suffer labor pains for five days. Babies suffocate when they are being produced. 95% of babies survive during childbirth,” Emasu added.

Records show that 200,000 women are living with fistula cases in Teso sub-region in eastern Uganda. Currently, TERREWODE has treated 400 women in Teso.

“On average, a woman [in Teso] has lived with fistula for almost three years. The hormones in the rectum do not interfere with the sexual reproductive organs,they are still sexually active. Unfortunately, they are divorced early by their sole husband,” Emasu explains.

“When the numbers of holes are many, the treatment is difficult for the doctor to perform at once. We worked hard to repair more than 400 women and put them back to the community. The community needs a lot of psycho-social counseling; they need a lot of follow ups,” Emasu adds.

She cites the case of one woman who had fistula. She raised her son then was shunned at 80 due to her condition. “She was isolated in an old hut due to fistula case. Three days later she died.”

Emasu regrets the current situation in which some women with fistula are dragged to court to be divorced. “Some parents demand bride price to be paid back when fistula cases arise, yet during marriage they were normal.”

She urges men not to divorce their wives suffering from fistula but love them instead. “These women are normal, sexually active and functioning; once they are repaired you can love them again. Let’s love and care. Nobody has invested money in TLC [tender, loving, care], which makes our women suffer. Psychologically, such women are tortured by loneliness and lack of care,” Emasu adds.

She also said that some men become violent with their wives due to fistula and commended Soroti police for wide investigations over fistula cases.

A recent dialogue with top district leadership in Soroti led to a commitment for TERREWODE’s work plans to be incorporated into a bigger district work plans for action against fistula

Prior to the meeting, TERREWODE officials discussed with leaders of women’s groups in Katine, Gweri, Soroti, Kadungulu, Kumi and Bukedea about fistula situation. These groups have become very powerful in the fight against fistula in the region.

Emasu adds: “We are the best advocates of maternal health and poverty issues prior to fistula. We have at least 30 members, mostly women and some young people, most of whom are engaged in agriculture activities to help them acquire basic needs. They also interfere in promoting girl child education.”

During the meeting Donath Eswilu, Soroti’s Assistant Chief Administrative
Officer, said that it is important to support TERREWODE activities in fighting fistula cases.

He said that a different form of fistula is found in men. “When will we start this kind of intervention in men?” Eswilu asked the audience. Eswilu urged government to intervene in TERREOWDE activities in the region so that their initiative can expand to other areas.

“Once a mother suffers from this condition, the chance of child survival is minimal. Let government take action in providing us with huge grants for maternal health,” Eswilu added.

He urged the police to reduce the number of cases in which under-aged children are married off.

“We [society] even participate in their marriage yet they are not ready to produce in their marriage yet. Let’s join hands to fight fistula; the media, government, district,” he said.

Eswilu said there was only one doctor handling fistula case in Soroti, meaning that many patients suffer. He called for the social integration of community development for fistula patients in psycho social support and for women with fistula to be introduced into rehabilitation earlier in the process.

He also called upon the public to support education for girls movement and said moves should be in place to tackle the delay many women in labor face when trying to reach a health facility.

“Let’s join our heads together to fight fistula cases in our midst if we are to support and emancipate our women for development,” Eswilu said.

Also at the meeting Chief Ejupu, chairperson on TERREWODE’s board of directors, called upon development partners to support TERREWODE in repairing more fistula women so as they are restored and able to join society.

Ejupu added that TERREWODE’s activities should be expanded to the parishes, sub-counties and the districts and information and experience shared with technical staff. He commended the work of TERREWODE for repairing school girls and restoring them to school.

Joseph Ekalam, Soroti district Probation and Welfare Officer, urged stakeholders to restore hope amongst women with obstetric fistula.

“Do not shy away from fistula news; preach about fistula cases and put the knowledge learnt into practice,” Ekalam said.


  • comment-avatar
    apicha lydia 5 years

    its true women suffer a lot of stigma, it’s because people lack knowledge on this disease. Am an advocate for the government to put more money in reproductive health education.