Surviving a pregnancy, but only just Digital Stories about Fistula Clients and Services from Uganda

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Surviving a pregnancy, but only justDigital
Stories about Fistula Clients and Services from
Uganda
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Fistula

• A tear between the vagina and the bladder and/or
  rectum that causes uncontrollable leakage of
  urine and/or feces.

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How an obstetric fistula forms
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• Fistula can also be caused by rape.
• Accounts of TRAUMATIC GYNECOLOGIC FISTULA have
  been reported in Chad, DRC, Guinea, Liberia,
  Rwanda, Sierra Leone, Sudan and northern Uganda

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Social Determinants of Fistula

• Poverty
• Poor nutrition
• Early marriage and pregnancy
• Low use and poor quality of health care services

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The Impact
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What is USAID Doing?

• USAID Bureau for Global Health Fistula Strategy
• Goal reduce the prevalence and severity of
  obstetric fistula.
• Objective advance and promote best practices and
  programs to prevent and repair obstetric fistula.
  
• Strategies
• improve data base on the extent and severity of
  obstetric fistula
• increase public and community awareness
• improve quality of care for prevention and repair
  
• support advocacy and improve policies

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Global and Regional Progress

• Support to 17 sites in 9 countries with two
  regional programs in east and west Africa
• Facility-based study on determinants of
  post-operative outcomes in fistula repair surgery
• South-to-south learning through Uganda study tour
  for delegates from Rwanda and Guinea
• Development and testing of fistula counseling
  curriculum
• First-ever meeting on traumatic gynecologic
  fistula

Surgeon, Mulago HospitalFistula Partner
Institution Kampala, Uganda
Curriculum developed with private funds
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Spotlight on Uganda
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Country Progress Uganda

• USAID funding began Oct. 04
• 18 surgeons trained in fistula repair and 735
  women repaired through June 07
• Establishment of public/private partnership model
  to improve referrals and link repair and
  prevention services
• 24 providers trained in counseling
• Workshop on Engaging Men in the Prevention of
  Obstetric Fistula conducted for local NGOs
• Joint planning between partners of National
  Fistula Technical Working Group
• Development of fistula resource center at Kitovu
  Mission Hospital

Recovering after fistula repair Kitovu Mission
Hospital, Uganda
Figure may include repeat trainings
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• Digital Storytelling for Fistula
• What is Digital Storytelling?
• Short digital videos combining voiceover
  narration, still images, video clips, and music
• Supportive group process
• Told in the first-person
• Participatory production methods

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Digital Storytelling for Fistula
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The Story Circle
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(No Transcript)
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Photos from home
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(No Transcript)
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Sharing stories.
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What did you learn?

• What are some of the main messages of the
  stories?
• What did you learn from the stories?
• How could these stories be used in programs?

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What Participants Learned
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What they learned
In the villages, people are ignorant about
fistula. I will continue to spread the word that
women must deliver in the hospital. I am very
thankful to you for helping me learn. I will not
remain the same from this new experience. - Jane
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(No Transcript)
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What We Learned

• Digital stories are an effective counseling and
  educational tool
• Working in multiple languages is challenging
• Telling stories is empowering!

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Using the Stories in Programs

• Provider trainings

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• Counseling and Capacity Building

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• Training Community Health Educators
• Public education and advocacy

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The Way Forward What Can Be Done?

• Strengthen health systems capacity and resources
  to address backlog
• Upgrade EmOC to decrease incidence
• Advocate for policy change to tackle root causes
• Engage the community around issues of prevention,
  improving access to treatment, stigma reduction,
  etc.

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Thank You!