Volume 1 Issue 1 January-June 2012

TERREWODE: empowering women and girls of

The Association for the Re - orientation and Rehabilitation of Women for Development

P UTTING OBSTETRIC FISTULA ON THE NATIONAL AGENDA:

T HE BIRTH OF TERREWODE fistula. Fistula is a childbirth between men and women injury which results in the irrespective of gender, TERREWODE’s vision is formation of a hole between religion, cultural beliefs, e m p o w e r e d w o m e n , the woman’s birth canal and age, and race; to c h i ld r en , a n d yo uth her bladder or, less continuously pursue embracing the world with commonly, her rectum. This knowledge and learning as improved livelihoods. Their leaves the woman a p r e - requisite for mission is to empower incontinent of urine and/or professionalism; to women, children, and youth feces. When this occurs, a empower and inspire to actively participate in woman is often rejected by women and girls to demand development activities to her community and forced for full enjoyment of their improve their livelihoods, into a life of poverty. It is human rights; and to be and that of their families not uncommon for her land transparent and and communities. TERRE- to be taken from her or for accountable to their clients, TERREWODE is head-quartered WODE’s main concern is the her to suffer domestic partners, stakeholders and in , located within the Teso to each other in all the region shown in green above. deteriorating reproductive violence. and maternal health In order to mitigate the business that relate to the TERREWODE, a Ugandan- situations among Ugandan situation and improve the work of TERREWODE. based non-governmental women. lives of these women, The organization began organization, was founded in TERREWODE seeks to TERREWODE seeks to its work in the Teso region 1999 by women of the Teso effectively address the nurture and enhance strong and has since been asked region who were committed b r o a d e r i s s u e o f beliefs in the power of to expand nationally. Given to improving the lives and reproductive health and to collective women action and its humble roots, it has statuses of women and girl find treatment, prevention, self-sacrifice to achieve the accomplished much. children. and rehabilitation services enjoyment of human rights for victims of obstetric for all; to promote equality

WOMEN DELIVER GIVES TERREWODE I NTERNATIONAL RECOGNITION

Despite its small start, and women. who are suffering from TERREWODE has expanded Out of hundreds of obstetric fistula with its reach and improved its submissions from countries treatment, counseling, and status in the realm of NGOs around the world, a social reintegration through an internationally- selection committee of services. The program recognized honor given by experts and advocates from trains a diverse set of the organization Women leading global NGOs and volunteers to serve as Deliver. foundations narrowed the advocates, identify and Every year in conjunction entries to 125 finalists. support obstetric fistula international level and has with International Women’s These were then voted on survivors, and educate their opened the door for Day, Women Deliver, a by more than 6,000 communities. future success. g l o b a l a d v o c a c y individuals to select the Through community-wide Following this award, organization, celebrates the winners. collaborations, the network TERREWODE has launched progress made on behalf of Through these efforts, raises awareness of fistula the Obstetric Fistula girls and women worldwide. TERREWODE received the and advocates for women’s Alliance in the Teso region The Women Deliver 50 is honor of being selected health and political rights. of Uganda, a diverse group a compilation of the most among the top 125 for their This honor bestowed upon of individuals and inspiring ideas and solutions Obstetric Fistula Awareness TERREWODE for its work in organizations that help tap that are calling for action to and Advocacy Network. The Women’s Rights has into available resources for improve the health of girls network provides women improved its visibility at the fistula survivors in the community. Page 2 TERREWODE: empowering women and girls of Uganda TERREWODE F OUNDER AND DIRECTOR: A LICE E MASU

something to help. In 1999, Washington University’s Because of her past as a she became a journalist with Brown School of Social journalist, Emasu has , Uganda’s Work. Emasu also received strong communication skills leading English newspaper. the honor of being named in and a unique ability to Four times during her years the top 3 high-impact convey her ideas and as a journalist, Alice women in Uganda for her insights to a wide-variety of received the honors of Best grassroots work in Maternal audiences in a very Journalist for her activism Health and Women’s Rights compelling way. She has surrounding population and in rural Uganda by been invited by the UNFPA women’s issues in rural New Vision. and the Ugandan Ministry of areas. In 2011, Emasu was Health to assist with the Emasu soon gave up named an Ashoka Fellow. development of the journalism and in 2007 went Ashoka Fellows are national obstetric fistula to receive her Masters in entrepreneurs who are strategy—the first major Social Work with a focus on recognized to have step that the government Alice Emasu, Founder and women’s health from Wash- innovative solutions to has taken to eliminate Director of TERREWODE ington University in the US. social problems and the fistula. Using her talents and potential to change patterns Her dedication and innovative ideas, Emasu has across society. They passion for the women of Alice Emasu, founder and worked to make obstetric demonstrate unrivaled the Teso region of Uganda director of TERREWODE, is fistula a tragedy of the past. commitment to bold new have driven the success of an integral part of the She works efficiently and ideas and prove that TERREWODE, helping it be organization, driving forth incredibly, aptly managing compassion, creativity, and named in the top 15 its success with her the little resources that collaboration are grantees from among passion. For her, the fistula TERREWODE has. She has tremendous forces for thousands of European campaign is a passion that received many honors and change. All Ashoka Fellows Union (EU) grassroots grant started years ago when she awards for her innovative undergo a rigorous search recipients around the world would go home from school work in women’s health and and selection process. From by the EU. on holiday. Visiting her empowerment in rural nomination to election as a home village and Uganda. Fellow, candidates go “Her dedication and passion for discovering that many of through an extensive series the women of the Teso region of her girlfriends had passed In 2010, Alice was of in-depth interviews, a away during childbirth awarded the Dr. Clara Uganda have driven the success judging panel, and a final invoked in Emasu a Louise Myers Outstanding executive board vote. of TERREWODE…” relentless desire to do Practicum Student Award by

longest fistula resource in region. It was founded in P ARTNERING ORGANIZATIONS Teso but phased out its 2000 by Richard Haas and TERREWODE has Foundation, the Fund for services this past year. The his daughter after visiting partnered with many Global Human Rights, the Fistula Foundation is the the Addis Ababa Fistula organizations including the Independent Development lead partner to TERREWODE Hospital in Ethiopia. It African Medical Fund, the Norwegian Human and is moving towards currently helps fund Research Foundation Rights Fund, and the Urgent being the main funder for programs in 15 countries (AMREF), the Fistula Action Fund. AMREF was the fistula treatment in the Teso and 38 facilities worldwide.

C HALLENGES to this shortfall, women are marriage and subsequent Network has made great often forced to endure long pregnancy is one of the strides to improve the Despite all of TERRE- waits and are discharged too main risk factors for situation in , WODE’s progress, it still soon after treatment, before developing obstetric fistula, however, their work is not faces many challenges in its their bodies have had time to girl-child marriage is still finished. They are efforts to eradicate fistula. heal. This puts them at an very common in parts of dedicated to continuing Although there is a growing increased risk for rural Uganda. TERREWODE this important work by awareness of the issue and reoccurrence, as adherence is continuing to educate conducting outreach with increased commitment by to medical advice is often government officials and communities throughout the Ugandan government to challenged when one returns communities in order to Uganda until the chains of respond, Uganda is still home, mainly due to the prevent this tragedy. stigma, misunderstanding, lacking a national budget conditions of poverty. Stigma and and discrimination are and rehabilitation center, Another challenge is the discrimination shrouds fis- broken. and there is a huge deficit presence of child marriage. tula patients and survivors, in the health system’s Despite laws prohibiting the a situation hard to change. capacity to both prevent The Obstetric Fistula and treat the condition. Due practice and the well-known Awareness and Advocacy knowledge that early Page 3 OBSTETRIC FISTULA AWARENESS & ADVOCACY NETWORK

Since 2001, TERREWODE identify obstetric fistula women’s health and political the causes of fistula, has worked to create a survivors and help connect rights, and promote working available treatment, and sustainable Obstetric Fistula them with TERREWODE to relationships with key prevention. It is successful Awareness and Advocacy seek treatment. stakeholders. in highlighting the urgent Network (OFAAN) that has DWSF members utilize In addition to utilizing need for health helped more than 700 another volunteer these established networks, professionals to work women suffering from workforce, usually retired TERREWODE’s media closely with activists to obstetric fistula in eastern professionals within the campaign makes use of radio address not only the Uganda receive treatment, community, to promote programs to spread primary causes, but also counseling, and social obstetric fistula treatment awareness about the the root causes, of fistula. reintegration services. and prevention. Although occurrence, treatment, and By utilizing a diverse The holistic model both men and women are social reintegration services volunteer workforce already TERREWODE has developed invited to participate, the for obstetric fistula survivors. active in the communities, involves training three strategic advantage here is Drama groups, composed of TERREWODE has created a d i s t i n c t g r o u p s o f the critical decision-making fistula survivors, perform for sustainable model that volunteers: Home Based power men hold. This local forums, such as schools, makes the most of Maternal Health Care aspect of the model has community groups and local valuable, existing resources (HBMHC) Volunteers, the been particularly successful government policy makers. and ensures the Dignity Watch Society in getting men in the TERREWODE’s model has continuance of the essential Forum (DWSF) members, community to hear the proven itself to be both work of treating and and Law Enforcement important information and effective and sustainable. The preventing fistula even Officers, technocrats and messages the volunteers model is effective in raising after initial efforts settle. policy makers. TERREWODE have to share. DWSF community awareness about conducts training members are uniquely able workshops designed to give to influence cultural targeted information and practices and cause skills in obstetric fistula systems transformation in awareness and advocacy, the way society, and safe motherhood especially other men, preparation, and human perceive ideas about and legal rights advocacy. maternal health and human HBMHC volunteers are rights of vulnerable groups male and female community such as women, children members, who are often and youth. leaders of women’s or Law enforcement officers, community groups, and judiciary officials, and fistula survivors, who self- district technocrats also identify as willing to attend attend TERREWODE’s workshop training and serve workshops. Through this indefinitely as community collaboration, TERREWODE volunteers. Volunteers are is able to raise fistula equipped with the awareness, advocate for knowledge and skills to Fistula Survivors at Soroti Hospital Post-Treatment

S UCCESSES annual treatment camps, over 700 women have been successfully launched the the result being an treated, with a majority Regional Maternal Health As a result of TERREWODE’s enormous backlog of having been treated in the Alliance, which brings work to prioritize awareness untreated patients. TERRE- past 5 years with help from together stakeholders to and treatment of obstetric WODE also has several a 12 month grant from the increase advocacy and fistula, there are now eight development partners who Fistula Foundation in 2011. awareness, with the goal of hospitals in Uganda where are supporting short-term In addition, this past year influencing national policy surgical treatment is fistula camps in an effort to in the Teso Region, it and budget allocation. consistently available. This make headway on the is in stark contrast to ten backlog of cases and treat years ago when TERRE- women in underserved Fistula Survivors at the WODE began their advocacy areas. This development campaign. At that time, launch of the Regional has resulted in a significant Maternal Health Alliance there were no treatment increase in the number of this past year in Teso hospitals in Uganda and the women receiving fistula region, Uganda government was relying on treatment annually. Since visiting surgeons and the organization started,

Page 4 T HE FACE OF A S URVIVOR: J OYCE INGWEDO

her fistula. Living in Oderai, over the years through the have earned her respect Soroti, Ingwedo, a mother Micro-credit revolving loan from members of her of six, had lived with the from TERREWODE. She family who once despised stigma from her fistula for received the interest-free her and chased her away two decades. She has fresh loan twice. Initially, she from home. She is now a accounts of her experience used the loan to buy and role model and has been with fistula including sell smoked fish within the crowned the Chairperson of isolation, stigma, and local markets. She then women within her clan. discrimination. She was used those proceeds to buy Today, Ingwedo holds the rejected by her clan and goats. Later when the goats responsibility of mobilizing isolated from her multiplied in numbers, she women while also making community for years, but started to barter them for decisions pertaining to now, with the help of cows. Currently, she barters women in her clan. As TERREWODE, she is living a 10 goats per cow. When such, she acts as their dignified life as a respected TERREWODE first met representative on a number leader in her community In Ingwedo, she was isolated of occasions. Such a order to symbolize her and stripped of all position never existed in transformed life, she plans possessions, but now, she the African tradition to build a permanent house owns 6 cows. previously and is indeed a Joyce Ingwedo, Featured on her property. As one of Cows are not all that great step in the Obstetric Fistula Survivor the most successful Ingwedo has gained since empowerment of women beneficiaries of the TERRE- she recovered from fistula. and the treatment of In 2005, TERREWODE WODE Social Reintegration The good and constructive obstetric fistula. helped Joyce Ingwedo, a program for fistula patients leadership skills which woman who had lived with designed in 2005, Ingwedo Ingwedo has portrayed in fistula for 20 years, plans to build her house her local drama group, the receive surgery to repair using savings she made Gweri Fistula Survivors,

WANT TO BE I NVOLVED?

TERREWODE is eager to interested groups apply visit their website at the donating to one of the expand the reach of similar services in their address located below or organization’s program obstetric fistula services to home regions in order to contact them at: areas, please contact: all women who are in need help. If you are interested [email protected]. [email protected]. of them. They hope to be in their programs and want If you are interested in able to help other more information, please volunteering with them or

Founding members of TERREWODE with two fistula survivors (from left: Founding Member Margaret, fistula survivor Among Stella Rose, Executive Director Alice Emasu, and fistula survivor Ikiai Janet) on follow-up visits to the women’s homes after surgery. TERREWODE strives to follow-up on every patient as part of its social reintegration program.

Empowering women and girls of Uganda www.terrewode.org National Office: Plot 101 B Martyrs Way Road Ntinda, , Uganda