Kampala, Uganda – A silent health crisis is gripping Uganda as the nation grapples with a critical shortage of fistula specialists – with only five fully trained doctors available to treat an estimated 1,900 new cases annually.
The Hidden Epidemic
Obstetric fistula, a devastating childbirth injury caused by prolonged obstructed labor, leaves women with chronic incontinence, pain, and social isolation. In Uganda, where it’s locally called “leaking” or “constant dripping,” the condition disproportionately affects:
- Young mothers in rural areas
- Teen brides with underdeveloped pelvises
- Women without access to emergency obstetric care
“Each surgery costs ~Shs 1.4 million (USD 370), but money isn’t the only barrier – we simply don’t have enough specialists,” explains Dr. Ronny Bahatungire, a Ministry of Health Commissioner.
By the Numbers
✔ 5 – Certified fistula surgeons nationwide
✔ 10 – Supporting medical surgeons
✔ 1,900 – New cases reported yearly
✔ 74,000 – Women currently living with fistula (2022 UDHS data)
Hotspot Regions
- Buganda, Ankole, Lango – Highest prevalence
- Karamoja, Rwenzori – Likely underreported due to diagnostic gaps
Why So Few Specialists?
Training a fistula surgeon takes years of specialized fellowship – time Uganda’s overburdened health system can scarcely afford. The Ministry has now prioritized:
✅ Local training programs to grow specialist numbers
✅ Prevention campaigns promoting:
- Skilled birth attendance
- Delayed first pregnancies
- Universal antenatal care
A Glimmer of Hope
While 17,000 annual fistula repairs show progress, experts stress that:
⚠️ Surgical backlog keeps growing
⚠️ Social stigma prevents many from seeking help
⚠️ Regional disparities in care persist
“We’re fighting both biological and cultural battles,” admits a midwife from Masaka Regional Referral Hospital. “Some women hide their condition for decades.”
