ENCINITAS — A Ugandan hospital began treating patients on March 7 at a surgical ward expanded through the efforts of an Encinitas-based nonprofit.
The newly completed Urogynecology and Fistula Care Ward at Lira Regional Referral Hospital — in the Lango subregion of northern Uganda — increased its capacity from 12 to 45 beds, according to a news release.
The Musa Project, based in Encinitas, raised $200,000 for the project.
The nonprofit was founded by a team that included father-daughter duo Hal Tilbury and Anastasia Marks.
Marks said she initially believed the effort would focus on treating women suffering from fistula, a childbirth injury that can be highly stigmatizing. That focus helped inspire the launch of The Musa Project on May 23, 2025 — the International Day to End Obstetric Fistula.
Obstetric fistula is a severe childbirth injury typically caused by prolonged, obstructed labor without timely medical care. The condition creates a hole between the birth canal and the bladder or rectum, often leaving women with chronic incontinence and serious medical complications.
In many parts of the world, women with untreated fistula face social stigma, isolation and limited access to care.
Marks told The Coast News it became clear early on that The Musa Project would need to broaden its mission to address a wider range of women’s health needs in the region.
In 2025, the Ugandan surgical team, supported by the nonprofit, performed 599 complex childbirth-injury surgeries, in addition to 8,800 obstetric and gynecologic procedures.
The nonprofit’s name comes from Dr. Musa Kayondo, head of the Department of Obstetrics and Gynecology at Mbarara Regional Referral Hospital, who is also spearheading training efforts throughout Uganda. Marks said that of the six surgeons in Uganda capable of performing complicated obstetric fistula surgeries, Kayondo trained four.
“Musa’s amazing,” she said. “He’s hard working and so dedicated to these women. It’s inspiring.”
Marks said that when she first met Dr. Kayondo, she asked, “‘If money were no object, what would you do in Uganda over the next five years?’”
His answer that day was essentially what the nonprofit has been working to accomplish since, Marks said.
“If we are serious about reducing severe childbirth injuries, we must expand both surgical capacity and training,” Kayondo said in the release. “This expansion allows us to treat more complex cases while building the workforce needed for the future. My goal is to see at least 100 well-trained urogynecologists serving across Uganda and neighboring countries in the next decade.”
Following the completion of the project in Lira, which Marks called “a strong beginning for The Musa Project,” the nonprofit launched a new campaign to raise $750,000 to expand the Mbarara Regional Referral Hospital.
The effort aims to increase training capacity for new Ugandan urogynecologists, expand the number of beds from 40 to 80, and enlarge operating and recovery spaces. The nonprofit also hopes to consolidate surgical theaters within the gynecology ward to improve efficiency and increase patient safety.
Tilbury said such a project would have an outsized impact in Uganda compared with the United States.
“In the United States, a hospital expansion of this scale would cost several million dollars,” he said. “In Uganda, we can complete it for a fraction of that amount, creating measurable surgical capacity gains while strengthening long-term medical training infrastructure.”
Research by the National Institutes of Health found that in Uganda, there is one doctor for every 25,000 patients and one nurse for every 11,000 patients. For comparison, the Association of American Medical Colleges estimated that in the United States, the ratio is one physician per 337 patients.
“Those numbers — to me — are mind-blowing,” Marks said.
