Vesico-Vaginal-Fistula (VVF) is a result of prolonged obstructed labour. In 99% of cases the baby will die, and because of the damage the baby’s head has caused during the labour to the tissues of the walls of the vagina, bladder and rectum, a fistula occurs and the mother is left incontinent of urine or stool or both. The women can also suffer from nerve damage and have disability in walking. VVF is commonly seen in developing countries because of poverty, malnutrition, distance from medical help and lack of knowledge.
Women with VVF suffer greatly. They are often ostracized from society and have to deal with the physical and psychological problems of their condition. Often they do not know that there is help available to them and are too ashamed to ask. Because of this women sometimes live with this condition for many, many years.
Kitovu Hospital has offered fistula repair services since 1993. Kitovu was the first place to hold training programs in obstetric fistula repair for Ugandan doctors and nurses. The training of local doctors started at Kitovu in November 2004. In April 2005 the St. Annes Obstetric Fistula Unit was officially opened and the Ministry of Health in Uganda has given it special recognition as the first training centre of its kind in Uganda.
In November 2008 a fistula operating theatre was also opened. It is financially supported by USAID through Engender Health and UNFPA and private donors. Having this dedicated unit and funding from generous supporters allows Kitovu to host ‘Fistula Camps’ four times a year with 60-100 women being treated each camp.
Specialist surgeons from around the world come voluntarily to Kitovu to conduct the surgery and training. Patients are not charged for treatment and any future maternity healthcare is also covered to ensure that the repair does not breakdown with subsequent labours. Kitovu depends heavily on international donors for this to happen.
After successful fistula repairs, these women are continent and dry for the first time in a long time and this allows them to rebuild their self esteem and dignity, and they are able to integrate back into society. Some are even able, with appropriate medical care and advice from Kitovu, to have a successful pregnancy with the baby delivered by caesarean section.
Kitovu Hospital is one of eight hospitals in Uganda that are able to provide fistula repair surgery and it is the Ugandan Ministry of Health’s aim that every referral unit should have people trained to do the repair surgery.
Since 2006 1,886 women have had obstetric fistula repair surgery. Between 2007 and 2011, 26 doctors, 22 anesthetic officers and 46 nurses/midwives have been trained at the obstetric fistula unit.
The first Fistula Faculty Meeting was held in August 2012 at Kitovu Hospital. Please see the News page for details of awards that were given out at this meeting. The results from the August 2012 Fistula Camp can also be seen in this section.
Please see our Media section to read articles and link to a Facebook page about the VVF project at Kitovu Hospital. Please visit: http://www.youtube.com/watch?v=FkoNn-0aegU&feature=share to see a short video about the work done by the VVF teams.
CURRENT VVF INFORMATION AS OF June 2013:
- From 1987-2004, the VVF repairs were mainly carried out by two (2) doctors, Dr. John Kelly (R.I.P.) and Dr. Brian Hancock, plus other interested volunteers from the UK and Ethiopia. From 2004 to date, Kitovu Hospital became a VVF training centre for doctors.
- We have doctors who always visit Kitovu Hospital for the four varying camps in addition to Dr. Brian Hancock and these include: Mike Breen, Andrew Browning, Shane Duffy, Ramesan Navaratnarajah, Paul Flynn, Jerry Putman, and Mike Bishop.
- Four camps are carried out each year.
VVF CATCHMENT AREA:
Patients come from all over Uganda even from the remotest districts: Busia, Kapchorwa, Kabalole, Kasese, Isingiro, Kiruhura, Mbarara, Rakai, Lwengo, Lyantonde, Ssembabule, Bukomansimbi, Mpigi, Ggomba, Mityana (a grandma of 87 years was successfully operated last year), Mubende, Wakiso, Kampala, Mukono, Namayumba and we also receive patients from Rwanda, Tanzania and Kenya.
NUMBER OF OPERATIONS PER YEAR SINCE 1987
YEAR No. of Patients operated
Jan 2014 80
Mar 2014 57
Aug 2014 77
Oct 2014 60 (camp still in progress)
Training Unit for Fistula Repair
The V.V.F. Unit has been recognised as a Training Unit for Fistula Repair, training doctors, anaesthetic officers and nurses from all over Uganda since November 2004. It is financially supported by USAID through Engender Health and UNFPA and private donors and recognised by Ministry of Health.
V.V.F. workshops are offered several times a year, each lasting for two weeks. Experienced doctors from all over the world visit Kitovu for these workshops, and their work enables 60-100 women to receive treatment each time. The director of the project is Dr. Maura Lynch.