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Case study: Harriet’s story, Kitovu Hospital, Uganda

This is one of the stories from the RCOG’s trip to Uganda to witness the work that RCOG volunteers are doing to improve women’s health in the region.

Kitovu Hospital, UgandaIn a quiet location overlooking the hill just outside of Masaka is Kitovu Hospital. It is here that some 400 women come every year to have operations to repair their fistula.

Fistula is a result of prolonged obstructed labour. In 99% of cases the baby will die and, because of the damage the baby’s head has caused during the labour to the tissues of the walls of the vagina, bladder and rectum, a fistula occurs and the mother is left incontinent of urine or stool or both. The woman can also suffer from nerve damage which results in difficulty walking. Fistula is common in developing countries because of poverty, malnutrition, distance from medical help and ignorance.

Women with a fistula suffer greatly. They are often ostracised from society and have to deal with the physical and psychological problems of their condition. Often they don’t know that there is help available to them and are too ashamed to ask. Because of this, women sometimes live with this condition for many, many years.

Child, UgandaHarriet Nabatte was pushing for 9 hours with her first baby. The result was that her baby died and she developed a fistula. She feared that she would lose her job and her husband. Here she tells us her experience.

‘I went to the clinic in the village to have a baby but I pushed for about nine hours. “Push! Push!”, the nurse was telling me. “Push! Push!” My baby died. After I went back home the urine started dropping and dropping. I didn’t feel that I have to go for urinate, but the urine just dropped out. I spent my time all day pardoning myself.

‘I carried on going to my job as a teacher but I would have reached a time where I couldn’t have carried on because I was kept having to pardon myself to pad myself and it became sore. My husband was very patient about it. He was trying to comfort me during that problem and he was the one who brought me here for my operation but I worried that if I couldn’t get this operation, I could lose my job and my husband.

‘I went to the hospital and the doctor checked me and told me “go to Kitovu where they will operate on you and you will be okay”. When I realised I that I get help, I was contented. I had to be patient through that period though because they told me the surgeons will come in November. I waited for about two months. It would be better if we had Ugandan doctors to operate us, not to wait doctors from the UK. It would be better if we had doctors in our country because we would only wait for very short time.

Fistula ward, Kitovu Hospital, Uganda‘After the fistula operation I was well. I had no problem or any pain after the operation and they cared for me for two weeks afterwards. Since my operation, I have had four babies. I deliver by caesarean and all of my babies are well.’

RCOG Fellows and Members are involved in faciliating fistula camps for women in Uganda and the RCOG is currently looking into the possibility of training local doctors in order for fistula operations to take place all year round.

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