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"Social reintegration of women and girls affected by Fistula is a process" For Shadiah Umuhirwe family reunion, children and a
wedding was the climax.


TERREWODE realizes that surgery alone is not enough to heal from the trauma, stigma and the absolute poverty situation that most slip into in the face of an obstetric fistula and thus is committed to improving post-surgical care and social rehabilitation services to improve livelihoods.

In June 2013, TERREWODE launched the first ever national reintegration center of excellence for women and girls affected by obstetric fistula. The center known as the Women’s Empowerment and Economic Self-reliance Centre (WEES) although located in Soroti is a national referral facility to facilitate social reintegration. The center provides vastly post-surgical care along with nutritional support, counseling, skills development training in vocational , literacy and social entrepreneurship including; health education as key aspects of social reintegration services.  

TERREWODE’s Obstetric Fistula Awareness and Advocacy Network (OFAAN) members conduct continuous assessments of the social reintegration needs of individual vulnerable women and make referrals to the center. Although all women affected by fistula are vulnerable, some of them are twice worst hit by the condition especially those who have spent years living with fistula and lost all social support networks and are homeless. These women are enrolled at the center for a two weeks comprehensive capacity enhancement curriculum based on their reintegration needs.

TERREWODE approaches social reintegration from a human rights perspective by separating the total process into six stages including:

1) Continual counseling

2) Assessment

3) Social reintegration training and support

4) Solidarity groups formation

5) Income generating activities

6) Savings and credit schemes

Following surgical treatment, the women are assessed on their medical condition and on their social vulnerability. The medical assessment tests the effectiveness of the surgery and assesses the survivor’s physical well-being. The social vulnerability assessment focuses on the systems of oppression that the women might be dealing with including poverty, homelessness, and whether she experiences physical, economic, psychological, or emotional abuse. This assessment is performed to determine the individualized care that each woman receives. Assessment starts during a woman’s hospitalization and continues when she returns home to ascertain her progress and needs.

Throughout all of the stages, counseling is provided in the communities where survivors live.

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FACT 1 Obstructed labour accounts for up to 6% of all maternal deaths. It is a cause of maternal mortality and morbidity. FACT 2 Obstetric fistula is a hole in the birth canal caused by obstructed...