As Uganda marked the close of International Women's Month, the Association for Rehabilitation and Reorientation of Women for Development and its flagship Terrewode Women's Community Hospital have released alarming findings linking gender-based violence (GBV) to the country's persistent obstetric fistula crisis.
The retrospective study, conducted in collaboration with the University of Minnesota and launched during International Women's Day commemorations, reveals that 70 percent of women seeking treatment at the hospital for fistula and other childbirth-related injuries had experienced some form of GBV. Among women diagnosed specifically with obstetric fistula, the figure rises to 77.4 percent.
The research reviewed medical records of 360 women treated at the hospital between 2019 and 2022. Of these, 252 had experienced gender-based violence, while 108 had not. Among those with other childbirth-related injuries, nearly 60 percent reported experiences of GBV.
Emotional and psychological abuse emerged as the most prevalent forms, affecting over 88 percent of survivors. Economic and sexual abuse were each reported by more than 60 percent, while physical violence affected more than one-third of the women studied.
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These findings come as Uganda joined the rest of the world in observing the 2026 International Women's Day theme, "Rights. Justice. Action. For ALL Women and Girls," with national celebrations held at Kololo Ceremonial Grounds emphasizing increased investment to accelerate access to justice for women and girls.
TERREWODE Executive Director Alice Emasu Seruyange, who led the study alongside researchers including Rahel Nardos, Laura Miller, and Mary Aono, described the findings as urgent and impossible to ignore.
She noted that as operators of one of the country's largest specialized fistula hospitals, they have long listened to survivors' experiences through policy briefs, and the evidence now clearly demonstrates a strong link between GBV and fistula cases.
Seruyange called for immediate action and urged men to support their partners after fistula repair, emphasizing care, patience, and dignity during recovery. She also condemned early marriages and harmful cultural practices, noting that authority within households must be matched with responsibility.
TERREWODE member Grace Nakirijja Lwanga reinforced the findings, emphasizing that the research--conducted over three years with women from across the country--reflects a widespread and deeply rooted problem.
She noted that emotional violence was the most common experience among fistula patients, although many also endured sexual, economic, and physical abuse.
The study was informed by survivor-led policy briefs developed over several years with support from the National Endowment for Democracy, capturing lived experiences of poverty, violence, and institutional barriers.
Since its establishment in 2019, Terrewode Women's Community Hospital has treated more than 2,000 women and girls, offering free, holistic care that includes surgery, counselling, rehabilitation, and reintegration.
With an annual capacity of 600 patients, the hospital has also become a regional center of excellence, training over 100 health workers from dozens of facilities.
Government officials have acknowledged systemic gaps contributing to the persistence of fistula. Bukombi Geofrey Mugisha, Principal Medical Officer at the Ministry of Health, cited delays in seeking, accessing, and receiving care as major challenges.
He encouraged pregnant women to attend antenatal care regularly, plan pregnancies, and seek skilled medical assistance during childbirth. He also highlighted the availability of free fistula treatment services, as well as high-risk clinics and ambulance systems.
Legal and advocacy voices are calling for stronger support systems. Nakimbugwe Balidde Bernadette, a lawyer and member of TERREWODE's Technical Research and Advocacy Committee, emphasized the need for family support and institutional sensitivity, urging law enforcement agencies to treat fistula patients without discrimination.
Medical experts have also underscored the importance of proper post-repair care. Fistula surgeon Alia Godfrey advised women to allow adequate healing time after surgery and to avoid normal delivery in future pregnancies, recommending cesarean sections to prevent recurrence.
Similarly, Kusiima Odeth emphasized the importance of pregnancy planning and seeking care from qualified health professionals.
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Uganda's broader GBV statistics remain concerning, with more than half of women aged 15 to 49 having experienced physical violence and over one-fifth reporting sexual violence since the age of 15--despite laws such as the Domestic Violence Act and national policies aimed at eliminating GBV.
The study warns that unless gender-based violence is addressed, Uganda's fistula burden--currently estimated at between 75,000 and 100,000 cases--will continue to grow, with nearly 2,000 new cases emerging each year.
TERREWODE and its partners are now calling for decisive action. They urge the government to enforce GBV laws within maternal health services, the Ministry of Health to integrate routine GBV screening and strengthen referral systems, and health professionals to adopt trauma-informed care approaches.
Development partners are also being called upon to invest in survivor-centered programs that address both the medical and social dimensions of the crisis.
