Despite years of government interventions and campaigns to eradicate Female Genital Mutilation (FGM), the harmful practice continues to endanger the lives of women and girls in parts of Uganda, particularly in the Karamoja Sub-region.
Health experts warn that beyond violating the rights of girls and women, FGM contributes to severe childbirth complications, including obstetric fistula – a debilitating condition that leaves survivors leaking urine or faeces uncontrollably and often facing lifelong stigma and social isolation.
Obstetric fistula is one of the most devastating childbirth injuries. It occurs when prolonged and obstructed labour causes a hole to develop between a woman’s birth canal and her bladder or rectum, resulting in continuous leakage of urine, faeces, or both. The condition often leaves women with chronic medical problems, emotional distress, and social isolation.
According to health professionals, FGM significantly increases the likelihood of obstetric fistula because it causes permanent damage to the female genital tissues. During the procedure, parts of the external genitalia are cut or removed, and in some forms of FGM, the vaginal opening is narrowed by stitching or sealing the tissue.
Dr Loyce Nangiro Faith of Amudat Hospital in Karamoja Sub-region said fistula is affecting some women who were mutilated.
‘We have managed such cases before and we normally refer them to Soroti Regional Referral Hospital for fistula repair. The wounds heal, thick scar tissue forms around the birth canal,’ Dr Nangiro said.
Dr Nangiro, who is also an advocate for women’s rights and has been involved in various initiatives to support breastfeeding and combat female genital mutilation, said that during childbirth, the scar tissue cannot stretch adequately to allow the baby to pass through the birth canal, leading to prolonged and obstructed labour.
She made the remarks on Tuesday at AIC Kaichom Local Church Council in Losidok Sub-county, Amudat District, during an experience-sharing, storytelling, self-care, and collective care session led by role models during a meeting with child mothers. The event was organized by ActionAid International and funded by the European Union as part of its initiative to end harmful practices and promote the rights of adolescent girls in the Karamoja Sub-region.
Dr Nangiro also said that women who undergo FGM often face serious complications during childbirth.
‘Such women are unable to deliver normally because the scar tissue obstructs the birth canal, making it difficult for the baby to pass through. As a result, many have to undergo Caesarean section (C-section),’ Dr Nangiro said.
She explained that the procedure is often carried out without proper medical knowledge, leaving women with severe injuries and lifelong health complications. She further noted that some girls become pregnant at a very young age, when their bodies are not fully developed for childbirth, making it difficult for them to push the baby during delivery.
Nurse Esther Acheng, the Assistant District Health Officer in-charge of Maternal and Child Health in Amudat District, emphasized that these practices not only endanger the health and dignity of girls but also undermine their education, economic potential, and future opportunities.
‘The persistence of these practices is closely linked to widespread unemployment, low literacy levels, and lack of opportunities for young people. Many families still see girls as a source of wealth through bride price, while boys, frustrated by unemployment and idleness, are increasingly vulnerable to cattle raids, alcoholism, and violence,’ Acheng said.
Ms Susan Chuwai, the Sub-County Chief of Amudat Sub-county, said she received a government scholarship because she refused to undergo Female Genital Mutilation. She urged girls across the region to reject FGM, saying the practice is harmful and poses serious risks to their health, wellbeing, and future.
Ms Mercy Asiwatum, a mother of five, said that women living with fistula often endure continuous leakage of urine or faeces, recurrent infections, chronic pain, emotional trauma, and social rejection. Many also lose their babies during the prolonged labour that causes the injury.
Although Uganda has outlawed FGM, Ms Asiwatum said sustained community engagement, stronger enforcement of the law, and support for affected women remain essential to ending the practice and protecting future generations of girls.
‘Eliminating FGM, strengthening community awareness, and ensuring access to skilled birth attendants and emergency obstetric care are critical to preventing obstetric fistula,’ she said.
They also called for increased access to fistula repair surgery and rehabilitation services for survivors.