We were touched and appalled by the sadness of our first fistula patient: a beautiful young woman in urine-soaked ragged clothes, sitting alone in our outpatients department away from the other waiting patients. We knew she was more in need than any of the others. She had been through a long labour of five days with only the village women to help. And so we saw the first of many fistula sufferers.
– Dr Catherine Hamlin
A Lifetime of Caring
Catherine and Reg married
Drs Reg and Catherine Hamlin met and married when they were both medical officers at Crown Street Women's Hospital in Sydney Australia.
An Ethiopian adventure
Their adventurous spirit inspired them to accept a three-year contract with the Ethiopian Government to work as obstetrician-gynaecologists and set up a midwifery school in Addis Ababa.
On the evening of their arrival in Ethiopia, a fellow gynaecologist told them, "The fistula patients will break your hearts." The Hamlins had never seen an obstetric fistula case before and there was little or no treatment available in Ethiopia.
The early years
Initially working from the Princess Tsehai Memorial Hospital in Addis Ababa, Catherine and Reg refined the surgical technique to close obstetric fistula injuries, while continuing to treat a broad range of obstetric cases. Within the first three years, Reg and Catherine had operated on 300 fistula patients. As news of a cure spread, many more patients came seeking treatment.
The world's first modern-day fistula hospital
To cater for the demand Catherine and Reg began fundraising and officially opened the Addis Ababa Fistula Hospital in 1975.
Rehabilitation for long-term patients
Opened in 2002, Desta Mender (Joy Village in Amharic) was built on land donated by the Ethiopian Government about 10 kilometres from the hospital. The village's 10 houses accommodate patients with chronic long-term injuries which prevent them from returning home.
The emphasis is now on reintegration, enabling the women to develop skills useful in the community so that they can leave Desta Mender and find permanent work. There is a large market garden where vegetables are grown. These supply the whole of Desta Mender and the surplus is used in the main fistula hospital in Addis Ababa.
The Juniper Cafe by the lake opened in 2009. Initially to teach patients hospitality, they are now running the cafeteria by themselves. Some have been able to leave Desta Mender and set up their own cafe not far away.
Hamlin Fistula Regional Hospitals
Due to a lack of transportation infrastructure and difficult geography, many patients cannot access the capital for treatment at the Addis Ababa Fistula Hospital. For some patients even 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 Hospitals.
There are now hospitals in Mekele and Bahir Dar in the north, Yirgalem in the south, Harar in the east and Metu in the southwest.
These hospitals ensure many more women are able to access quality maternal healthcare. Obstetric fistula injuries are being both treated and prevented.
A College of midwives
Catherine was determined not only to treat, but prevent these childbirth injuries, so she established the Hamlin College of Midwives in 2007. The College has an active program of recruiting the brightest students from rural areas, putting them through rigorous training as midwives, and then deploying them back to their villages where their skills are needed.
This is a cornerstone of the Hamlin Fistula Ethiopia program - ensuring that women in Ethiopia have access to qualified midwives so they no longer suffer for days on end with an obstructed labour.
Since 2007, 125 midwives have graduated from the Hamlin College of Midwives. Another 92 are currently studying.
There are currently 40 rural Hamlin Midwifery Clinics staffed by Hamlin midwives. Midwives in these centres are preventing hundreds of maternal and neonatal deaths and are saving many mothers from suffering devastating childbirth injuries.
Hamlin Fistula Ethiopia today
Today, Hamlin Fistula Ethiopia is a healthcare network of over 550 Ethiopian staff servicing six hospitals, Desta Mender rehabilitation centre, the Hamlin College of Midwives and 40 Hamlin Midwifery Clinics.
To date, over 50,000 women have had their health and dignity restored.
We are now taking Catherine’s vision and expertise to a new frontier: Uganda. Hamlin is supporting development of the Terrewode Women’s Community Centre – replicating the Hamlin Model of Care, a fistula treatment centre with capacity to treat 600 patients each year.
Transforming maternal care
Catherine and Reg Hamlin travelled to Ethiopia for the first time almost 60 years ago, and initially only planned to stay for three years. On the evening of their arrival in Ethiopia, a fellow gynaecologist told them, “The fistula patients will break your hearts.” And indeed they did.
The Hamlins had never seen an obstetric fistula case before and there was little or no treatment available in Ethiopia.
But, they did something about it.
Catherine and Reg Hamlin refused to turn their backs on the women of Ethiopia. These two surgical pioneers remained in Ethiopia following their initial three-year posting to continue treating the most marginalised women: those who have suffered an obstetric fistula, an internal injury caused by an obstructed childbirth, which leaves them incontinent, humiliated and lingering with a horrible odour, causing social isolation and shame.
They went about dramatically transforming the maternal healthcare landscape for the women of Ethiopia.
The Hamlin dream
My dream is to eradicate obstetric fistula… I won’t do this in my lifetime, but you can in yours.
– Dr Catherine Hamlin
Our new fistula frontier – Uganda
Catherine’s success in Ethiopia has encouraged the Hamlin team and its partners to help women in other countries to access the Hamlin Model of Care in eradicating obstetric fistula.