A tough journey to recover from obstetric fistula

It is like a dream come true that she leaks no more. Ironically, the two depressing years of suffering obstetric fistula caused by obstructed child labour, would lay a foundation for her current career as a social worker. While this was the silver lining to her traumatising experience, the memory of the ordeal is still fresh for Stephany Adupa. Three unsuccessful surgeries to correct fistula left the fighter in her hopeless, it is no wonder that she describes her recovery as “too true to believe”.
“I remember at one of the medical camps, we were 20 patients, 19 of whom recovered apart from me,” the 23-year-old says of the two years she lived with fistula.
Unlike most medical illnesses where family and friends console patients to give them hope that their condition will improve, obstetric fistula is probably not one such condition in most communities. The birth complication is aggravated by stigma and Adupa’s case is not exceptional.
Born in Akriwon village in Moroto, Adupa got pregnant at the age of 13 while in Primary Six in 2006.

Angry, her parents threw her out of home. She would then find refuge at one of the parish quarters.
Although she was under the care of one European priest there, Adupa stayed alone in a single room in one of the parish quarters until her last trimester, thus there was no one with her when labour set in. It happened one evening while she was resting in her room at around 8pm.
“I started feeling cramp-like pain in the stomach. I went to the neighbours for help because I was in pain and could not go to the parish to find the priest who had become my guardian. My neighbour called other women for help because there was no health centre nearby. They kept telling me to push the baby in vain.
“The priest came to my rescue the next day at 2pm. Even then, we had to move 47 kilometres to Moroto Regional Referral Hospital at 6pm.

The midwife there also urged me to push, but I failed and was taken to the theatre where I was operated on. Unfortunately, I lost the baby,” she says.
Before she could come to terms with the stillbirth, the teenager realised that urine was flowing uncontrollably.

It is at this moment thatshe realised she had developed a complication that the doctors later confirmed as fistula.
Having failed to manage her condition, the hospital referred Adupa to another hospital in the neighbouring Kumi District that also referred her condition to Mulago Hospital.
She further laments that she had already lost hope as only a few people supported; her guardian and mother.

All her friends and other family members stayed away from her. She was depressed and hopeless. “It is only when I was taken at Mulago Hospital that I saw many other patients and realised that I was not alone. However, the first operation was not successful. They told me to return after six months and even after I returned, [the second ] operation did not succeed and they again asked me to return after another six months but I vowed not to go back to hospital,” she says. She stayed at home most of the time and used diapers.
“It is not until one day when I was told that there were some specialists coming to Matany Hospital [now in Napak District] that I went back to hospital but my operation was not successful,” she narrates. In January 2008, one of the specialists at Matany Hospital insisted on carrying out a fifth operation which fortunately went well.

With the help of the Women at Work International organisation (WAWI), which strives to improve the quality of women through health and income improvement, Adupa was able to go back to school.
Since then, the now 24-year-old has been doing social work activities to create awareness among young girls in school about obstetric fistula and also counsel them about early pregnancy as the major cause of the medical condition.
As she celebrates nine years of recovering from fistula, Adupa joined several other women last weekend in the annual charity walk organised by WAWI in Kampala to raise awareness on obstetric fistula. The theme of the walk was “Hope, healing and dignity for all” and it attracted more than 1000 women.
The walk begun at 8am at the Parliament gardens through a designated route and back to parliament.

Walking for Fistula
Last Saturday women under their umbrella body, Women at Work International (WAWI), an organisation started to improve the quality of life for women through health and income empowerment, participated in the 6th fistula campaign charity walk.
The walkers were flagged off at around 9.30am by the speaker of Parliament Rebecca Kadaga who was also the chief walker.

Amid the Police brass band, the women walked along Kampala Road towards City Square and Kampala Serena Hotel before they returned to the CHOGM gardens where the event was to take place.
WAWI carries out the walk in partnership with the ministry of Health across the country to create awareness on fistula, mobilise patients and organise fistula awareness campaign walks in all districts.
Halima Namakula, the executive director of WAWI, thanked different companies including Monitor Publications Limited, for their support.

Namakula also gave out medals to different individuals and companies whom she said have played a big role in the fight against fistula. These included Andrew Sorowen, the Commander General Duties in the office of the Inspector General of Police (IGP). Speaker Kadaga applauded Alex Makada, 63, who supported his wife for the 18 years she suffered fistula saying that there are few men who would do the same as most of them end up abandoning their families.
“I am going to nominate Alex to the national Awards committee because 18 years of commitment and support are not easy. Not very many people can do that. It is not very easy to stay with someone who has fistula; the leaking, the smelling,” Kadaga said.
She interacted with the patients, encouraging them not to give up on seeking treatment.

About Fistula
Fistulas are classified depending on the cause although most fistulas in Uganda are obstetric due to delays in the delivery process. One is at risk of suffering the condition when attended to by inexperienced birth attendants or failure to access proper medical attention. In Uganda, although there is a backlog of 200,000 fistula cases and 1,900 new cases are recorded every year, there are only 25 fistula surgeons in the country. Mulago Hospital has the capacity to carry out only 600 operations in a year.