When 17-year-old Sanyu began leaking urine uncontrollably after a prolonged labour, she did not know she was suffering from a childbirth injury.
Like many young women in her community, she believed she had been bewitched. Her family sought help from traditional healers, administered herbal remedies and pursued spiritual interventions, hoping to reverse what they thought was a curse. Instead, her condition worsened.
‘My boyfriend advised me to seek help from a traditional birth attendant. I thought it was witchcraft. My family first took me to witch doctors, and we also tried traditional herbs because we believed someone had bewitched me. The condition only became worse,’ Ms Sanyu recalls.
Today, Ms Sanyu is among a growing number of obstetric fistula survivors in Namayingo District using their experiences to educate young women about the dangers of delayed medical treatment and the misconceptions surrounding the condition.
Health workers say beliefs linking obstetric fistula to witchcraft continue to prevent many women, especially teenage mothers, from seeking timely treatment, leaving them to suffer from a condition that is medically treatable.
Obstetric fistula is an abnormal opening between the birth canal and the bladder or rectum, usually caused by prolonged obstructed labour without timely medical intervention.
The injury results in uncontrollable leakage of urine or faeces and often exposes survivors to stigma, isolation and psychological trauma.
According to the Ministry of Health, more than 200,000 women in Uganda are living with obstetric fistula. After losing her baby during childbirth, Ms Sanyu spent months searching for treatment through traditional means before learning that surgery could repair the condition. She sought treatment in Soroti and Jinja before eventually undergoing a successful operation during a free fistula repair camp in Namayingo.
‘It was my third operation, and this time it was successfully treated,’ she says.
‘I want other girls to know that this is not witchcraft. It is a medical condition, and it can be treated,’ she adds.
Her experience mirrors that of 26-year-old Christine Nachisikwe from Madowa Village. Ms Nachisikwe developed fistula after complications during her second pregnancy.
Having delivered her first child with the assistance of a traditional birth attendant, she returned to the same attendant when labour began during her second pregnancy. However, prolonged labour forced her to seek emergency medical care. Doctors later performed a Caesarean section, but her baby did not survive.
Challenges
Ms Nachisikwe says she began leaking urine.
‘I did not know what had happened to me. I was leaking urine all the time and thought it was witchcraft,’ she says.
The condition eventually contributed to the breakdown of her marriage before she was referred for specialised treatment and successfully operated on. Today, she uses her experience to encourage other women to seek medical help immediately when they experience similar symptoms.
Health experts say teenage pregnancies remain one of the leading factors behind obstetric fistula cases. Ms Abagail Musenero, a registered midwife at Bumonoli Health Centre III, says many adolescent mothers avoid seeking medical care because they fear being judged.
Ms Musenero says delayed referrals from traditional birth attendants continue to pose a major challenge.
‘We still have many traditional birth attendants conducting deliveries in villages instead of referring mothers early to health facilities. By the time many women arrive here, they have already developed serious complications,’ she says.
According to her, some mothers arrive at health facilities after enduring many hours of labour, often with severe bleeding, retained placentas or fistula injuries that could have been prevented through skilled birth attendance.
Despite the challenges, health workers say awareness campaigns are beginning to yield results, with more women attending antenatal clinics and opting to deliver in health facilities.
Mr Wilberforce Mukone, a male champion working with Naguru Teenage Centre, says stigma remains one of the biggest barriers preventing young mothers from accessing healthcare services.
‘Many young girls fear going to health facilities because they are ashamed of being questioned about becoming pregnant at a young age; that is why many of them opt for traditional birth attendants,’ he says.
Through school outreach programmes, village meetings and community sensitisation campaigns, volunteers are educating young people about family planning, early antenatal care and safe delivery practices.
Health workers believe sustained community education remains the most effective way to dispel myths surrounding fistula.