After witnessing the silent suffering of countless women living with obstetric fistula, Alice Emasu Seruyange set out to build a lifeline of dignity, treatment, and hope. Her work is transforming lives one healed woman at a time.
At just 16, Alice Emasu Seruyange had a vision that would shape her future. While still a secondary school student, she witnessed the deaths of four of her friends due to preventable childbirth complications and saw two others silently suffering from obstetric fistula, a condition that causes women to leak urine or faeces due to prolonged labour. Shocked and determined, Emasu decided to enter the media industry to raise awareness about maternal health and childbirth complications.
Although her early career in journalism provided her a platform to advocate for women, she quickly realised that awareness alone was not sufficient. In 2001, she founded the Association for Rehabilitation and Reorientation of Women for Development (Terrewode), a non-profit organisation dedicated to raising awareness and supporting women living with fistula. Her vision later culminated in the establishment of the Terrewode Women’s Community Hospital (TWCH) in Soroti District, a specialised hospital for treating fistula patients.
A childhood shaped by loss
Emasu’s determination was rooted in personal tragedy.
‘Even though I was still a teenager, I felt the need to take action instead of just sitting and watching young women die from a preventable condition.’
After completing her secondary education, she returned to her village in Kaberamaido and was confronted by the devastating toll that childbirth had taken on her friends. Four of them had died, and two others were socially isolated due to fistula. Unfortunately, community leaders had done nothing to address these issues.
Motivated by this injustice, Emasu began listening to radio programmes in Ateso and Luo. She called in as a student to ask how she could become a journalist. The presenters advised her that she needed to complete her education first, which only fuelled her determination. Emasu pursued a Bachelor’s degree in Mass Communication at Makerere University and began writing for The New Vision newspaper in 1999, focusing on women’s issues.
‘I did not even know what fistula was at that time,’ she admits.
‘I was as ignorant as many Ugandans, except for a few medical personnel who treated women in silence.’
Fistula: A silent epidemic
Dr Edwin Andante, a gynaecologist at Soroti hospital, explains that an obstetric fistula is a hole that develops in the birth canal, bladder, or rectum due to prolonged labour. As a result, women experience constant leakage of urine or faeces. This condition is most prevalent among rural women who give birth without medical assistance. Labour can last for days, often leading to the baby’s death, and leaving the mother with permanent incontinence.
Uganda has one of the highest maternal mortality rates in the world, with 336 deaths per 100,000 live births. Each year, 6,000 women die from preventable causes during pregnancy, while an additional 1,900 develop fistula. The country ranks third globally in fistula prevalence, with adolescent girls being particularly vulnerable. Nearly 25 percent of girls experience pregnancy before the age of 18, and sexual violence, especially in northern Uganda, is alarmingly high, further exposing young girls to various maternal health risks.
Journalist to advocate
Emasu’s journalism career exposed her to the silent suffering of women, but she longed to do more than just report. In 2008, she left active journalism to pursue a doctorate in women’s health, focusing on obstetric fistula at Washington University in the US. There, she met Louis Wall, a lecturer who was passionate about building specialised fistula hospitals, which inspired her to envision a dedicated facility in Uganda.
Her research across the Great Lakes region deepened her understanding of maternal health systems, and in 2019, her dream became a reality with the opening of the Transcultural Women’s Clinic and Hospital (TWCH). Located on six acres in Soroti, the hospital provides specialised fistula surgeries and holistic care, including post-recovery counselling, legal guidance, HIV/Aids education, and entrepreneurial support for former patients.
Stories of healing, hope
For women like 19-year-old Robinah Akoi from Lira, TWCH was life-changing.
Forced into early marriage and abandoned by the father of her child after a traumatic childbirth that left her incontinent, Akoi lived in isolation for more than two years. She lost hope and was shunned even by her own family. In 2023, she learnt about a Terrewode health camp, received surgery, and fully recovered.
‘Akoi’s experience is typical,’ notes Emasu. ‘We have treated women who have lived with fistula for more than 10, even 20 years. The relief and joy they feel after surgery is indescribable.’
Some patients are so overwhelmed that they demolish the homes where they were once confined, symbolising a rebirth into dignity and freedom.
In villages such as Gweri, more than 20 women have been treated, saving families the money that would have been spent on traditional healers and restoring their place in the community.
A hospital that transforms lives
TWCH operates as a National Centre of Excellence accredited by the International Federation of Gynaecology and Obstetrics (FIGO) and trains doctors from Uganda and abroad in fistula care.
The hospital not only provides surgical treatment but also promotes systemic improvements in maternal healthcare, advancing sexual and reproductive health rights, safe motherhood, and the empowerment of women and girls.
Emasu emphasises that Terrewode uses fistula as a catalyst for transforming healthcare, addressing underlying issues such as poverty, early marriage, and lack of education that contribute to maternal mortality.
The hospital’s holistic approach ensures women not only recover physically but are also reintegrated socially and economically.
A vision for the future
From a curious 16-year-old asking questions on the radio to the founder of a fistula hospital, Emasu’s journey is a testament to courage, compassion, and unwavering commitment.
She has restored dignity to thousands of women, transformed communities, and shaped the discourse on maternal health in Uganda and beyond.
As she continues to expand Terrewode’s reach, her message is clear: no woman should suffer needlessly from preventable childbirth injuries.