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Fatuma is one of the many girls in the Myanzi village who use tree leaves and old rugs during her menstrual period. When we talk of lack of pads to use during menstruation in Myanzi village, its understatement. The situation in Myanzi is chronic period poverty.

Kato a young boy narrated that his grandmother keeps on reprimanding his sisters for cutting off pieces of her mattress to be used for pads. Whenever he finds patched holes in the mattress, he knows that his three sisters are in their monthly periods.

“Some of the girls sleep with men like motorcycle riders to get money three thousand five hundred shillings for sanitary pads. Their parents can hardly afford their scholastic materials later sanitary pads. This exposes these young girls to HIV and STIs, unwanted teenage pregnancy with its associated consequences of dropping out of school, being forced into early marriages, getting fistula and social stigma,” narrated one teacher from St Noa Secondary School.

Under the AmplifyChange funded project “Fistula-Free Girls and Young Women” in Uganda, Sanyu Centre for Arts and Rights (SARI) and its partner Slum Youth Rehabilitation and Development Organisation (SYRADO) conducted menstrual health and hygiene management under the campaign of #PeriodFriendlyWorld. The campaign conducted during the menstrual hygiene week (27th to 31st May 2024) was led by SYRADO Uganda who reached over 170 girls and 80 boys in Mt Sinai Secondary School, St Noa Secondary School and Salvation Primary School. The campaign aimed at raising awareness on the need to support girls to have menstrual hygiene products as well as moral support from the males. The participants in the campaign included school heads and teachers, local leaders, media and civil society members. A call was made for menstrual hygiene products to be tax free so that they were affordable to the girls. Moreover, schools needed to have more supportive structures such as gender responsive bathrooms and clean water for girls to stay clean during menstruation.

Through activities including a band procession walking around the community with banners on promoting better menstrual health and hygiene management, skits, question and answers and practical demonstrations, the participatory campaign enabled learning and experience sharing among the girls, boys and community members.

Moreover, girls got more knowledge and practical skills on making and maintaining reusable pads. Girls were equipped with knowledge on washing and changing the pads using warm water and wearing them with clean underwear. They learnt that useable pads needed to be soaked in warm water with very little liquid soap in it. The girls learnt that they were rinsed in the following and hanged with moderate sunlight to dry in a clean environment.

Furthermore, girls and youth got more knowledge on some of the dangers of teenage pregnancies among which was obstetric fistula. Most of them had never had about fistula and how detrimental it was to their health and future. Obstetric fistula one of the most severe aftereffects of birth was largely because of prolonged childbirth with limited access to timely and quality health care. Educators, local leaders and parents saw the need to provide age friendly sexual reproductive health educations to young people, so they make wise decisions.

“I have learnt to value my body and myself. I don’t have to put myself in vulnerable situations that may expose me to getting unwanted pregnancies. Then again, I don’t want to expose myself to devastating health effects of early unwanted pregnancy such as fistula. I will encourage my fellow girls to hold their bodies in high esteem and keep away from wrong relationships that may destroy their lives.” Female student at St Noa Secondary school

“Staying in school is better than getting an unwanted early pregnancy. I now have the knowledge to make better health decisions for my life. I will pass on this information to my peers, so they don’t suffer such negative consequences.” Female student at St Noa Secondary school.

“Now I understand the kind of hardships go through during their monthly periods. I have stopped making fun of them. I will also encourage my fellow boys to stop stigmatizing girls during their periods.” Male student at St Sinai Secondary School.

“When I go back home, I will train my younger sisters and friends in my neighborhood on how to make reusable sanitary pads. This will help us to manage our periods better. We don’t have to miss school anymore or feel embarrassed during our periods.” Female student at Mt Sinai Secondary School.

Every girl deserves to have better menstrual health and hygiene management!

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Dorah painting one of her flower vases

Her hands move swiftly yet so carefully as she folds the pieces of paper to make the beautiful flower vases. Following the pattern she afore designed, Dorah sets to entwine the papers to create a flower vase. After a day or two, she completes a flower vase then sets out to dry it and apply vanish for final touches.

Sanyu Centre for Arts and Rights (Uganda) in partnership with Trust for Indigenous Culture and Health /Braid Arts and Cultural Fund conducted an initiative Valuing Creatives Preserving Culture to build the business acumen of young artists like Dorah to develop and expand their enterprises. The initiative reached over 50 creatives including artisans and fashion designers in Kyebando and Kamwokya areas in Kampala through training and mentorship in creative businesses. Our focus was on handicrafts made from recycled materials, traditional woven handicrafts, and fashion design. SARI did monthly workshops on marketing, product development, financial management, and business registrations. Participants also learnt to enhance their online presence through social media and group learning.

Through training and capital support, Dorah has honed her skills in making different products including flower vases and necklaces out of recycled paper (an initiative also contributing to a clean planet), floral arrangements and custom made bead work. Furthermore, through the capital support, Dorah has expanded her product line to include African bags to diversify her income. Dorah has managed to transfer her work from home to setting up a business.

Kisa kya Maria Arts and Crafts women group with some of their basket products

Kisa kya Maria Arts and Crafts women group is a team of weavers in Kasengejje village that was supported to access more raw materials to make different decorative baskets and in greater numbers. Through the trainings in enterprenuership, they have improved capacity in the management of their group enterprise through better records keeping and increased marketing of their products.

Joanna is another passionate fashion designer who has finally formalised her fashion enterprise- Lulungi Couture, Uganda. This has been though her participation in the project, Joanna acquired knowledge and skills in intellectual property rights and tools, registration processes and putting together required  documents. Having her business registered has been one of her dreams but never knew how to go about it . After registration, she has got a bigger space to have a training workshop for young fashion creatives.

We are happy for these creatives and look forward to seeing them grow their enterprises and be an inspiration to many upcoming ones. SARI is grateful to the partnership with Trust for Indigenous Culture and Health /Braid Arts and Cultural Fund (Kenya) for this initiative that has contributed positively to increasing creative and culture businesses in Uganda.

Some of the crafts that are made by creatives during the program.

SARI calls for more collaborators and like-minded actors to support many young creatives especially girls and young women profitably engage in the creative sector.

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Mahoro was a beautiful young girl of thirteen years. I met her in one of the reproductive health education sessions at Rwengo primary school. She was active and a quick learner. Mahoro was an exemplary girl. She was the head prefect at her school. She was an excellent performer. However, one would think she was over eighteen years. You see Mahoro was being put on a fattening diet of cow milk, ghee and bushera (millet flour) to grow her into womanhood. Many young men in my village fancied Mahoro as a desired wife. Fights broke out over her. However, Mahoro’ heart was in school. The fattening diet that her parents had put her on was against her will. She however had no choice in the matter.

One day, I was having conversation with one of my fellow Village Health Team (VHT) members when I got to know about Mahoro’s heart breaking story. The VHT told me that Mahoro had been forcefully married off. She had had a complicated birthing process and had developed fistula. My colleague had checked on her a few times. My heart sunk. Fistula was one of the worst after birth effects any mother could experience. The hole made in the birth canal and rectum arising majorly from obstructed labour lasting more than 24 hours was a traumatic experience. A woman who developed it was unable to control urine or stool, leading to other health complications. It was a condition that could easily be avoided but for limited access to better health services, fistula occurrences continue. The worse thing was that it mostly affected young girls who had the rest of their lives. I remembered a young girl in my neighbouring village who committed suicide because she could no longer live in isolation and stigma of fistula. I decided to pay Mahoro a visit the following day.

When I reached her home in Rwego village, her mother led me to a small hut where Mahoro stayed. She lived separately from the rest of her family. When Mahoro came out, I was not prepared for the sight. She had lost a lot of weight and had a stare of hopelessness. On the other hand, she then looked her more or less her age since she was not going through the fattening diets. When she saw me, she cried. She has a leso (wrapper) tied around her. She limped a little. I could tell that she was self-conscious because of the putrid smell she exuded. Such a bright young girl! Why did she meet such fate? I sat next to her to listen. Her mother left. Mahoro then tearfully narrated her ordeal.

“One day during my primary seven vacation, I was going to the well to collect water. I was with a team of other girls as we have always been advised to collect water in groups to avoid physical or sexual assault.

We were going back home after collecting water when we were ambushed by three assailants carrying sticks. We shouted for help. The quick ones threw their cans down and scattered in different directions. One unfortunate girl stumbled over a stone and got a sprain.

Given my weight, I could not run as swiftly as the others. I was captured by the three men who then hid me in a remote place far from my home for five days. There, each man took his turn of pleasure with me. In fact, the assailants were all brothers from the same family.

They then sent a message to my parents that they had me and that the parents should name their bride price. Like many girls from our tribe I have no say in the matter. Many women from my tribe were married off in this way. This is a popular practice called Kuhamba (to capture).

My parents agreed to a bride price of twenty heads of cattle. The marriage ceremony was organized and I become a bride against my will. I was to marry the eldest brother but like the custom demanded, all the males in the family including my father in law could sleep with me. In fact, I had to spent my wedding night with my father in law.

Nine months later I gave birth to triplets. I don’t even know who their actual father is because almost all the men in the family that I married into slept with me. I had no idea that I was carrying triplets. My husband’s family didn’t prioritize my need to go for Ante Natal Care at the Health Centre because they had a great Aunt who was a traditional birth attendant. My husband told me that the great Aunt had helped all his sisters and sisters-in-law to give birth without any complications. I would not be any different. I didn’t know any better. The birthing process was extremely painful. I experienced a lot of bleeding and tears. It was after some few days that realised that I could not hold urine or faecal matter. At first I thought that was how I was supposed to be after giving birth. However, my condition became worse that I could no longer share a room with my husband because of the smell. I could not nurse my babies. After one month, my husband sent me and my babies back to my parents saying I could no longer perform my wifely duties. Managing my menses is another thing all together with all the pain and discomfort of not having enough sanitary materials.

I asked Mahoro why she never went to hospital. If she had gone, her condition would be treated.

“Can I be treated?” Mahoro desperately asked. For the first time since our conversation, I saw her eyes light up.

“Yes, you can be treated. It takes some time to totally recover but you will get better.” I assured her.

However, the smile that had come on her face quickly disappeared. When I asked her what the problem was, she told me that she didn’t know who would take her to the health centre. Her mother- step mother didn’t care about her. Her father didn’t want to her to come close to their home. She was the oldest child in her family so she had only younger siblings. She had no one else to help her apart from the members of Village Health Teams.

After my conversation with Mahoro, I made up my mind to bring up the issue of fistula treatment and prevention at the following Kasamba Sub county council meeting. I made a narrative report and petition which I presented. I advocated for more resource allocations towards the community awareness and treatment of fistula. I also shared that there was need to educate young girls on prevention of teenage pregnancies while addressing the traditional practices that escalated child sexual abuse and child marriages. I reported that we had at least two documented cases of fistula in our location while others could have gone unreported. This was a high occurrence and the problem needed attention. I also presented Mahoro’s story. I saw a few leaders shed tears. When I finished presenting my case, a woman councillor stood up.

“Marrying off young girls is one of the causes of complicated births leading to fistula. We need to pass an ordinance against this custom of forcefully marrying off young girls in our community.”

“And in addition, the activities of the traditional birth attendants have to be regulated so that mothers are not put in danger,” another councillor stood up and said.

The council moved the motion to allocate resources to fistula awareness and treatment. After months, our district health team together with some community based organisations conducted a three-day outreach campaign against fistula at Konda health centre iii. I mobilized households to bring their daughters. Mothers came with their children. Many of the girls put on veils to avoid the shame of being seen. Fistula and shameare closely knitted.

Mahoro was among the girls that came for the treatment camps. After a few months, Mahoro was leaping like young calf. One day, she called for me and requested me to persuade her parents to take her back to school using the bride wealth of cattle. The cattle had multiplied hence could be used to pay for her school fees. Thankfully, her father agreed to take Mahoro back to school. He put her in a boarding school to help her concentrate on her studies.

“If you never reached out to me, I don’t know how my life would be now. I am grateful that you never turned your nose away from me during my time of illness. Musawo Sewava, may God bless you so much.” Mahoro tearfully told me as she gave me a basket of choice fruits in appreciation.


The 2020 Uganda Demographic and health survey shows that 2% of Uganda Women of reproductive age have experienced fistula meaning over 140,000 are living with the condition while 1,900 new cases are reported every year. It is also true that many cases go unreported. According to UNPFA many survivors of fistula are teenage girls.

UNFPA Uganda, 2021, Fact sheet on teenage pregnancy 2021 at pdf/teenpregnancy_factsheet_3.pdf

Short story from Centre One, Novel by Sylvia Nalubega.

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