Hamlin Fistula Ethiopia (Australia) is an Australian charity which was created at the request of Dr Catherine Hamlin to raise funds for the Addis Ababa Fistula Hospital, five regional centres, the Hamlin College of Midwives and Desta Mender, a farm and training centre for long-term patients. Hamlin Fistula Ethiopia (Australia) is the only organisation in Australia authorised to represent the work of Dr Catherine Hamlin and the Hamlin Fistula Ethiopia team in Ethiopia. Dr Hamlin is our patron.
THE NEED IN ETHIOPIA
While Ethiopia is one of the fastest growing economies in Africa and is home to the African Union, Ethiopia carries an enormous population of poor people and is struggling with a lack of health services and infrastructure.
For a population over 90 million, Ethiopia has less than 250 obstetrician/gynecologists and less than 7,000 trained midwives.
A woman dies every two minutes due to pregnancy and childbirth related complications. Most of these largely preventable deaths occur in low-income countries like Ethiopia and in poor and rural areas. The horrific death toll has halved in the last 20 years, from one woman dying in pregnancy or childbirth every minute, to one every two minutes. But there is still much work to be done.
Hamlin Fistula Ethiopia is working towards the eradication of obstetric fistula from Ethiopia altogether. This is through treatment, rehabilitation and the training of midwives. The number one way to prevent obstetric fistula is to provide the women of Ethiopia with emergency obstetric services.
There are only 156 hospitals in Ethiopia. Many of the hospitals are in cities and far from the rural population. Our obstetric fistula patients report that, on average, the nearest health facility is two days walk away from their homes. This trek is often done alone. Many women will stuff their clothes with rags to prevent leakage caused by the fistula. All risk ridicule and humiliation on their journey to be cured, but for them there is no practical choice as less than 15% receive any form of care from a skilled childbirth attendant.
Ethiopian women are actively involved in all aspects of their society’s life. Women are both producers and procreators and they are also active participants in the social, political, and cultural activities of their communities. Obstetric fistula not only disables the woman in so many ways, the entire village feels the effects. Women with obstetric fistula are often outcast and therefore unproductive. Their family and community suffer. By treating an obstetric fistula patient, Hamlin Fistula Ethiopia helps to rehabilitate communities as well.
HAMLIN FISTULA ETHIOPIA
Hamlin Fistula Ethiopia is the registered charity in Addis Ababa which runs the Addis Ababa Fistula Hospital, its regional centres, the Hamlin College of Midwives and Desta Mender.
The wonderful, loyal Ethiopian staff are the backbone of Hamlin Fistula Ethiopia. There are over 550 staff across various sites: the main hospital in Addis Ababa, our five regional centres strategically located in the provinces, Desta Mender and the Hamlin College of Midwives.
Hamlin Fistula Ethiopia employs gardeners, drivers, cooks, cleaners, seamstresses, teachers and guards as well as administration and office personnel and medical staff including pathologists, physiotherapists, nurses, nurses aids (many of whom are cured fistula patients) and of course fistula surgeons.
Some members of staff have been working with the Hamlin’s since their arrival in Ethiopia in 1959 and with Hamlin Fistula Ethiopia since the organisation began in 1974.
Hamlin Fistula Ethiopia provides stable employment for many local Ethiopians while also providing much-needed health services for the women of Ethiopia.
Hamlin Fistula Ethiopia’s work on the ground in Africa is sustainable and enriching – run by Ethiopians, for Ethiopians. The legacy of Drs Reg and Catherine Hamlin has a strong and vibrant future!
THE ADDIS ABABA FISTULA HOSPITAL
The main hospital campus is in the capital of Ethiopia, Addis Ababa. Built in 1974 on land leased to the Hamlins by the Ethiopian Government, the Addis Ababa Fistula Hospital has a number of wards, a large operating theatre accommodating two surgical teams, a physiotherapy department and pathology services. The hospital has a 120-bed capacity but at times has two patients in some beds.
HAMLIN FISTULA REGIONAL CENTRES
Due to a lack of transport infrastructure and harsh geography, many patients cannot access the capital for treatment at the Addis Ababa Fistula Hospital. For some the cost of a bus fare to Addis is just not possible for their family. For this reason, in 2003, Hamlin Fistula Ethiopia began an ambitious plan to build five regional Hamlin Fistula Centres. These capital works have been funded by international donors and have enabled us to treat many more patients in the provinces where health services are very limited. We have now built Hamlin Fistula Centres in Mekele in the north, Yirgalem in the south, Harar in the east, Metu in the northwest and Bahir Dar in the northeast. Each Hamlin Fistula Centre is close to a government-funded general hospital. Pictured below is the 40-bed ward at Yirgalem in the south of Ethiopia. At times this hospital is so busy there are two patients in each bed. This region needs an additional 20 bed ward for the Hamlin Fistula Centre Yirgalem, but we need funding for this.
THE HAMLIN COLLEGE OF MIDWIVES
The Hamlin College of Midwives is an important step towards a sustainable prevention strategy for the women and girls of Ethiopia to avoid obstetric fistula in the first place. According to the UNFPA, every two minutes, somewhere in the world, a woman dies in pregnancy or labour. In Ethiopia alone, approximately 9,000 women die in obstructed labour each year with another 9,000 surviving but with a fistula.
The Hamlins’ original intention for working in Ethiopia was to train midwives so that women have access to a clean, safe birth. Almost 50 years later, Dr Hamlin has seen to it that local Ethiopian midwives are recruited from high school graduates in the provinces, trained in a four-year degree with a vigorous curriculum of theory and practice, then deployed back to the provinces to work alongside mothers and families. In 2010, the first 11 graduates were employed in health centres in areas close to our regional centres. More than 80 students have now graduated and another 87 are currently studying.
On the outskirts of Addis Ababa is a farm and training facility built on land beside a mountain, given to Hamlin Fistula Ethiopia by the Ethiopian government. Dr Catherine Hamlin’s youngest brother Jock Nicholson, a farmer from Tamworth, and his wife Louise helped to establish this property in 2001.
Desta Mender, which translates to Joy Village, is where long-term patients can live for a period of time, learn skills and gain some independence so that they can return to village life while living close to one of our hospitals. If a patient cannot be cured and she has to have a stoma, she needs access to clean equipment and ongoing medical care.
Desta Mender has market gardens, an orchard, dairy and chicken farm as well as the Juniper Café where residents learn hospitality skills. In 2010, Rae Newman, an Australian home economics teacher from Canberra, spent a year at Desta Mender teaching the residents how to make meat pies and Lamingtons. We have had a number of past fistula patients who have gone on to establish their own businesses including a dairy, jewellery business and a cafe on the road between Desta Mender and the Addis Ababa Fistula Hospital.
The centre is run by a talented team including centre manager Beletshachew Tadesse who has an exciting strategic vision for its development into a conference venue but most of all as a facility providing training for our past patients and reintegration back into village life and meaningful employment.
Desta Mender is also the location of the Hamlin College of Midwives’ campus.
You can read the first chapter of Dr Hamlin’s autobiography “Hospital by the River” here. Read and weep! The story of obstetric fistula patients in Ethiopia is truly heartbreaking.
You can also read the opening chapter of John Little’s book, Catherine’s Gift here. This book gives a more up to date picture of the work in Ethiopia and Catherine’s legacy.