Join the fight

The campaign to eliminate obstetric fistula in Uganda is today gaining widespread momentum but this achievement can partly be attributed to TERREWODE’s over 14 years of experience when it broke the silence surrounding fistula in rural parts of Teso sub-region.

Through the organization's innovative, cost effective and sustainable Obstetric Fistula Awareness and Advocacy Network (OFAAN), originally located in Teso, the word fistula is soon becoming a domestic term especially among the rural population. Increasing awareness locally and nationally on obstetric fistula is critical in the fight against the condition.

The OFAAN is a vibrant grassroots network of trained outreach volunteers utilizing local government structures like Village Health Teams  working in community settings to provide continuous health education on obstetric fistula, identifying women and girls affected by fistula and coordinating with TERREWODE to make referrals to treatment facilities.

The volunteers also support individualized social reintegration efforts of the affected women following successful surgical treatment of fistula as they adjust back to the communities that previously ostracized them. Based on the needs of each woman, the OFAAN play a huge role in empowering and linking them to community media platforms where they also join the OFAAN to provide continuous heath education regarding the condition.

The OFAAN spread awareness about the cause and risk factors of obstetric fistula. It identifies and supports those at high risk pregnant women including vulnerable girls to access relevant government services within their community.

OFAAN involves training four distinct groups of volunteers: leaders of local women’s groups and community groups, retired community leaders (known as the Dignity Watch Leaders), Leaders of community women , village health team members who also include reformed Traditional Birth Attendants) and finally, women who have already received fistula treatment known to TERREWODE as fistula advocates.

The training consists of obstetric fistula awareness education, along with safe motherhood preparation,legal rights and economic empowerment. The OFAAN is sustainable due to the fact that the work is carried out by a diverse group of volunteers  with a person to transform system of oppression and victims of reproductive rights violations including gender inequalities for which fistula is thriving. This not only preserves valuable resources for treatment and social reintegration services delivery for women who have experienced fistula, it also continues to work to end fistula long after the initial resource input through use of preventative messages and empowerment.

In addition to its four groups of community volunteers, TERREWODE also provides OFAAN training to law enforcement officers, medical professionals, health workers, schools, community clubs, and members of the media for greater awareness. In this way, fistula awareness, the core message of OFAAN, is widely disseminated throughout the community. To date, TERREWODE has over 3,000 trained OFAAN volunteers working throughout eastern, northern and western Uganda.

At under level TERREWODE joins hands with districts and relevant government ministries to take advantage of national and global events such as the International Fistula Day marked annually on May 23rd, International Safe Motherhood day, international Women's day including the 16 Days of Activitism to sensitize the public about obstetric fistula both as a result and cause of sexual reproductive rights violations of females.

Needs: There are two needs associated with this program. First, TERREWODE would like to expand the number of OFAAN members in the existing communities where the network already exists and keep the members engaged and updated by providing different programmatic events. Second, TERREWODE hopes to scale up OFAAN networks in new areas of the country to engage community members in maternal and reproductive rights nationwide.


Ending Fistula is a concerted effort: A cross section of Fistula stakeholders in a procession within Hoima Municaplity mark the International Fistula day on May 23rd. The day was organised by the Fistula Technical working group of the ugandan ministry of health of which TERREWODE is a member.