A 'cursed' women living in shame

In a rural central Ugandan village, 17-year-old Sulaina sits on the mud floor of the tiny home she shares with her mother and younger brother and sister.

She wants to help provide for her family. But she can't. She can barely leave her house.
Wherever she goes, a sickly smell follows her. That's because she is constantly leaking urine.
The rags she has stuffed in her underwear are drenched quickly, and then the urine starts running down her legs. She has sores all over her thighs where the urine has burned her.

"I want this treatment so that I can go back outside and enjoy my life like others”

Sulaina has a condition called obstetric fistula. She developed it after giving birth to a baby girl last year.

Like so many women in rural parts of the country, she left it too late to get to hospital.
"I was in labour for two days, then on the third day I went to a clinic and gave birth there. I had a baby girl," she said.
"She died before I got to see her. I never even held her in my arms."
"Cursed" Sulaina says she believes a neighbour cursed her and that's why her baby died and why she now has a hole in her bladder.
"My baby survived for two days but she had something pulling her away.
"When it left her the curse caught me. I felt as though black ants and termites were biting me. I would not be in this condition now if they hadn't bewitched me."

Many people in such rural areas believe in witchcraft over medical science says Dr Florence Nalubega, a gynaecologist at Kitovu Hospital in Masaka.
Today she has teamed up with local popular radio DJs in the centre of Lwamaggwa village to talk about family planning and the importance of getting pregnant women to hospital to give birth rather than relying on traditional birthing attendants in the community.
She says these older women in the community have little or no medical training and don't know what to do when things go wrong. But many women trust them over doctors.
"Some people here have told me that we in the hospital actually cause fistulas by using catheters which we put in the bladder," says Dr Nalubega.

"They also think we do excessive operations like Caesareans. They think if they come to hospital they are going to get 'scissored'.

"They also use their own local plants like leaves from mango trees, they dry the leaves and then mix them with watered-down clay. They then drink it because they think it softens the (pelvic) bones and allows an easier birth."
It's these sorts of attitudes and beliefs health workers are trying to change. The other major obstacle for women giving birth safely and avoiding complications is money.
 

Getting to the nearest hospital can take hours and is expensive. Plus there is the cost of treatment on arrival. That's why a traditional birth attendant and herbal remedies, rather than expensive medicines, can seem like the better option.
Around 7,200 women die during or soon after childbirth in Uganda every year.
The organisation's representative in Uganda Fundira Esperance said: "For every maternal death, six to 15 mothers survive with chronic debilitating ill health such as obstetric fistula.
"The face of fistula is represented by women who live in rural areas, are not educated and are within the lowest wealth quintile."
The organisation started an "End Fistula Campaign" in 2003 with the goal of making obstetric fistula as rare in developing countries as it is in the developed world.
But the surgery to repair fistula is complex and expensive. At around $700 it's completely out of the reach of those who need it.