Alice Emasu on USAID cuts: 'I choose to be hopeful'

I’ve known Alice Emasu for a long time, and I’m always amazed at the calm sense of purpose she brings to every challenge. She’s faced many uphill battles in the 25+ years since she dedicated her life to ending obstetric fistula in Uganda. She’s a fiercely effective advocate for gender equity, reproductive rights, and maternal health — especially for women and girls who suffer preventable and treatable childbirth injuries like obstetric fistula.

Alice always figures out a way to hang onto hope — and inspire others to do the same — even when the word “hope” feels out of reach. I’ve been feeling that way a lot lately, when every day brings new predictions of dire consequences looming for vulnerable populations across the world because of massive cuts in U.S. foreign aid.

Since my last update, we’ve learned that Terrewode Women’s Community Hospital is bracing for a $75,000 funding shortfall— about 8 percent of its operating budget. We are actively working to find new funding sources, so the hospital can meet its 2025 goal of treating 500 women and girls and continue providing the holistic support services that help fistula survivors return to their families and communities feeling whole, confident, and hopeful about their future.

Alice had such thoughtful answers to several questions I emailed her recently that they felt worthy of sharing in full (edited slightly for brevity and clarity):

You’ve been working in this field a long time. How are you feeling about the cuts?

I feel disappointed. The cuts are disastrous. Even with the funding from USAID (U.S. Agency for International Aid), resources for the integration of routine obstetric fistula management into government health facilities at all levels were inadequate. One can only imagine the insufficiencies that the funding cuts will create. I am choosing to be hopeful that an opportunity may be presented among this, and when we catch a glimpse of it, we will embrace it.

What would a loss of funding mean for TERREWODE?

A loss of funding could threaten the holistic care we provide to women and girls. We would also have to rethink strategies for implementing some of our programs, such as providing economic and psychological training for members of Fistula Solidarity Groups — a social support network for survivors that raises awareness and advocates for survivors’ needs in the community.

How would patient treatment be affected?

Quality patient treatment will remain our top priority. Although, the loss of funding could result in longer wait times for treatment as we work with a lower quarterly budget.

How will cuts in funding for USAID programs in maternal health impact women in the region?

It will stall and potentially undo the progress that Uganda and other East African countries have made towards eliminating obstetric fistula. It will complicate the UN’s goal to end obstetric fistula by 2030. Without proper and timely care, there will be a rise in preventable childbirth injuries like fistula, and more women and babies will die in childbirth. As the Ugandan economy suffers from layoffs and increased hardship, we expect a rise in gender based-violence, poverty, and psychological distress among patients and survivors of obstetric fistula.

Stay informed about USAID cuts on our blog

If you’re feeling overwhelmed trying to stay up-to-date on USAID-related news, you are not alone. To keep you informed, we’re adding headlines to our blog as news develops.

Learn more about Terrewode Women’s Community Hospital’s origin story.

Want to read more stories like this straight from your inbox? Join our email list!