Fistula Repair Outreach at Hoima Regional Hospital

Six army canvas tents were installed on the green lawn between buildings at the hospital in Hoima, Uganda. It was a lovely day, and more

than 100 women sat out on the grass. Children ran around, mothers breastfed young children; someone seemed to be perpetually carrying a suitcase from one tent to another.

It was Day 1 of an obstetric fistula repair outreach at Hoima Regional Referral Hospital in western Uganda. Over the next 14 days, surgeons and medical staff would pool their efforts to provide care. Even before the repairs began, many people—including staff from the Uganda Ministry of Health, Fistula Care, and officials from the town and district of Hoima—put time and energy into planning the outreach. The United States Agency for International Development (USAID) provided the funding through Fistula Care to make the repairs possible.

Hoima Region in western Uganda is traditionally underserved in maternal health services compared with other parts of the country. Dense forest and mountainous terrain make roads and access to care difficult. As the result of unrest in northern Uganda and in the bordering Democratic Republic of Congo, essential health services are less available here. The Ministry of Health selected the Hoima Hospital as the site for outreach after an assessment of potential sites. The ministry wants to establish regional fistula repair hubs throughout the country, so that women everywhere can have access to repair services.

Women responded to radio ads informing them of the repair camps, and five national surgeons and a team of nurses and counselors were ready to provide them with care. The two senior surgeons providing care included Dr. Emintone Odong and Dr. Fred Kirya. Dr. Kirya is a senior consultant surgeon and urologist, and Dr. Odong is a senior consultant in obstetrics and gynecology. Collectively, they have more than 40 years of experience, much of which has been spent in the operating room. They paired up with less experienced surgeons and mentored them in the advanced surgical repair of complicated cases. Counselors at Hoima had received specific training for counseling women with fistula in a Fistula Care–sponsored training earlier in the year.

By the end of the camp, 84 eligible women underwent fistula repair surgery. In a three-bed operating room, surgeons and nurses spent up to 11 hours a day closing fistula. The efforts and dedication of these providers, along with all those involved in planning the camp, transformed the lives of the women who received surgery and of their families.