Justice for the forgotten women of Eastern Uganda

Dr. Ariho Boaz fights against Obstetric Fistula in Mbale

#FistulaDay is May 23, 2019

Dr. Ariho Boaz is on a mission to change lives. He is hoping to prevent and treat cases of obstetric fistula in Eastern Uganda. If you’re reading this in North America, you may not understand why obstetric fistula is such a problem- or you may not even know what it is. But many Ugandans know about it only too well.  Uganda is the country with the second-highest fertility rate in the world (USAID), and maternal mortality and pregnancy-related disability, like obstetric fistula, remain high due to inconsistent access to quality, or even reasonable, maternal care.

Obstetric fistula is a vaginal injury– a hole between the vagina and rectum or bladder- that is usually caused by long, obstructed labour, and when there is no timely medical attention. Sometimes labour can last up to a week long, but 75 percent of obstetric fistulas occur after 3 days of labouring.

Fistulas leave women incontinent of urine or feces, or both. It is unpleasant, to say the least. Women who live with it often self-isolate, or are rejected by their community, or even by their husbands due to this issue. The instance of this injury is fairly common in labour across the world, but where access to health care and education remains low, many women do not know that it can be treated and repaired.

According to the Fistula Foundation, “for every woman that gets treatment, at least 50 go without.” That’s where Dr. Boaz comes in. As a physician, Proprietor and Managing Director of the Mbale People’s Hospital, and a graduate of the Save the Mothers Master’s in Public Health Leadership program in 2012, he sees too many older women who have lost everything due to an obstetric fistula sustained years before.

“It is a horrible situation,” remarked Dr. Boaz, “[Women] innocently sustain this condition, and, after they are traumatized they are isolated, they are abandoned… I’ve seen a majority of mothers kept indoors, they take food inside their bedrooms, that’s the kind of situation we are trying to correct and advocate for safe motherhood,” he added.

Using his medical background, position in the community, and skills acquired in the Save the Mothers Master’s of Public Health Leadership program, Dr. Boaz is on a mission to both prevent and correct obstetric fistula. On the prevention side, he’s working with the local Rotary Club in Mbale, Eastern Uganda, to promote safe motherhood. After realizing the impact of the many delays women face when it’s time to deliver baby, he mobilized fellow Rotarians to ensure all mothers attend their antenatal (pre-birth) check-ups and then go to the hospital when it is time to deliver, instead of staying home with a traditional birth attendant or relative. These are two very important measures when it comes to preventing pregnancy-related disability like obstetric fistula.

He also aims to reach younger women, even before pregnancy, with important health messages about safe motherhood. He believes that if women know how to deliver safely, even before they are starting families, their outcomes will be much better.

He is currently working with the government-supported hospital in Mbale to build a fistula clinic onsite. He believes that by providing women of the area with a permanent, trusted place to have their fistula repaired, hundreds of women who have been living in the shadows could lead a renewed life. Usually, in rural or smaller-town Uganda, fistula is corrected at a ‘camp.’ This is usually a once-or-twice-per-year opportunity for women to see an OB/GYN specialist who will repair her fistula. It often means waiting, sometimes for days, to be seen. Dr. Boaz believes that women in eastern Uganda should have better access to that service when they need it.

We are so proud of our alumni who recognize an injustice for women and strive to correct it. We wish Dr. Boaz all the best as he fights to solve obstetric fistula in Eastern Uganda.