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  • Bonnie Ruder

Welcoming and healing all mothers

Though it’s been several months since I returned home from my latest trip to Uganda, the women I met at Terrewode Women’s Community Hospital are still fresh in my mind. As a mom and a midwife, the number of babies and toddlers in the hospital with their moms really stood out to me.

I’ve been visiting women receiving treatment for fistula since 2011, yet I’ve rarely seen babies or young children in any government fistula ward. In fact, when I’ve asked women to tell me about their difficulties accessing treatment, I heard many times that they were the primary caretaker for their children, so they couldn’t leave for several weeks to get the surgical treatment they so desperately needed.

Sadly, having young children is a major barrier to receiving treatment for fistula.

Alice Emasu and the Terrewode team know this. They have been working closely with women suffering from fistula since 2001. They dreamed of building a hospital that would break down barriers to seeking treatment, and provide loving, nurturing care to every woman who enters.

Terrewode Women’s Community Hospital is that dream. Every woman is welcome. Free of charge. If a woman arrives with her child, both are welcomed with open arms.

If she arrives with no money, leaking urine, feces, or both — she’s assured she will receive the care she needs at no cost. If she calls from her village and says she cannot afford bus fare to the hospital, she is told not to worry: Terrewode will pay for her transportation.

Every woman is told that she matters. That her life matters. That Terrewode will stand by her and support her as she finds her way back to health and a life worth living.

Terrewode Caregivers — themselves former fistula patients — help care for patients’ children throughout their stay at the hospital.

Caregivers also work as nurses’ aides, filling a critical role in the hospital by shifting lower-level tasks from the nurses, and thereby freeing up the nurses’ time for more intensive patient care.

The Terrewode team created the Caregiver role with intention and purpose. These positions are reserved for women and girls whose home lives are so precarious, they have nowhere to return to after treatment, nowhere else they feel safe. They are also reserved for women with incurable fistula, who need ongoing medical care and for whom returning to their village still leaking would be traumatic. Instead, as Terrewode Caregivers, they have an important role in caring for patients. They are perfect for this role, for who else understands the suffering a fistula patient has experienced better than a former patient?

Terrewode Caregivers embody a spirit of care and competence borne of empathy and experience.

Having employment and earning their own income gives Caregivers their own self-confidence and a renewed sense of purpose in life. They are a needed and valued part of the Terrewode team.

On International Women’s Day this year, I wrote about fistula survivor Eunice and her 3-year-old granddaughter Laticia. Laticia was all smiles at the hospital, with Eunice by her side. Other patients at the hospital and Terrewode staff showered both Eunice and Laticia with love. Toward the end of my visit, when another toddler arrived, Laticia quickly took her by the hand and showed her around. The two of them filled the ward with precious giggles.

Many women, however, arrive at Terrewode Women’s Community Hospital grieving the loss of their baby. Only 10% of babies survive the excruciating long labor that causes obstetric fistula. Terrewode counselors help these women talk through their grief. They learn positive coping methods to help them recover from their loss, to begin the healing process — physical and psychological — and start their new life after fistula.

I was working as a midwife here in the United States years ago when I first heard of obstetric fistula. And as a midwife, I knew birth should never end this way. Obstetric fistula is virtually unheard of here in the U.S., yet it continues to happen in Uganda and other countries where women lack access to high-quality reproductive and emergency obstetric care.

To put it bluntly, Uganda’s maternal health care system is failing these women.

The Terrewode Women’s Fund community is changing that by providing the financial support Terrewode Women’s Community Hospital needs to give mothers with fistula a place to begin healing.

Our long-term partnership with the hospital is breaking down barriers to make sure more women have access to high-quality health care — including community education and advocacy in order to also prevent fistula from happening in the first place.

This Mother’s Day, and every day, I dream of a world where fistula is a thing of the past. Until then, I will continue showing up for women who deserve better care — and receive it thanks to generous support from people like you.


Bonnie Ruder is co-founder and Executive Director of Terrewode Women's Fund.


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