Published on 28/05/2025
Ministry of Health Officials have called for increased public awareness to prevent obstetric fistula — a debilitating condition resulting from prolonged obstructed labor where a mother develops a hole between the genital tract and either the urinary tract or rectum or both.
According to ministry statistics, Uganda records about 74,000 cases of obstetric fistula annually. However, only 1,700 women, or approximately 2.2 percent, access surgery. Speaking at a news conference on Monday, Dr. Ronny Bahatungire, the Acting Commissioner for Clinical Services, said the figures are alarming.
He revealed that despite ongoing efforts to improve access to treatment, many mothers continue to wait an average of seven years to undergo corrective surgery. This prolonged delay leaves them enduring the distress and stigma of uncontrollable leakage of urine or stool.
Bahatungire also expressed concern about the persistent rise in teenage pregnancies and poor adherence to antenatal care schedules. These factors, he said, increase the likelihood of prolonged labor, which in turn leads to fistula.
Dr. Geofrey Mugisha, Principal Medical Officer for Clinical Services, identified Buganda, Ankole, Lango, and Busoga as regions with the highest number of birth injuries. He attributed this to early marriages and cultural resistance to Cesarean sections, with some communities insisting on traditional vaginal deliveries regardless of complications. He noted that the Rwenzori and Karamoja regions currently contribute the fewest cases.
At the United Nations Population Fund (UNFPA), Dr. Richard Mwesigwa, the Maternal Health Programme Analyst, said they have launched a treatment programme in Busoga, where many women are now turning up for services. These include surgeries and psychosocial support to help address the mental health impact of the condition.
Mwesigwa added that the agency is also training health workers, a development he credits with reducing the average waiting period for surgery from twelve years to seven. However, Uganda still faces a critical shortage of trained specialists. The country has only five surgeons qualified in fistula repairs, most of whom are based in Kampala, limiting access for women in rural areas.
To address the specialist gap, Bahatungire revealed that the government has launched a three-year fellowship at Mbarara University of Science and Technology to train obstetricians and gynecologists in Urogynaecology — a specialty that includes fistula treatment.
Outside of donor or government-funded programs, treatment remains unaffordable for many women. Dr. Godfrey Alia, an obstetrician and gynecologist specializing in fistula repairs, said women typically need between $350 and $1,000 to access the procedure privately.
