Dr Leta, fistula surgeon explains the importance of prevention

Eight years ago, Dr Leta was a student in Gondar University when Dr Catherine Hamlin visited to inaugurate a fistula centre. Her words made a lasting impact on him.

“During her speech, Dr Catherine said that to cease the suffering of obstetric fistula patients, you must put yourself in someone else’s shoes. Even then, she said, it is difficult to truly understand their suffering and how much of their dignity they have lost.

“At the time, I was involved in patient identification in Gondar and I could see how much the patients with obstetric fistula were suffering. So, I was inspired by Dr Catherine’s words and how she described what is involved in obstetrics and gynaecology.”

Almost five years later, Dr Leta is Medical Director and fistula surgeon at Hamlin’s Harar Fistula Hospital, more than 500km from the capital of Addis Ababa. He loves his work, saying “I am very happy when my patient is cured and I can see them smiling because they have regained their dignity”.

Building awareness and knowledge

For Dr Leta, knowledge is power, and crucial to achieving Dr Catherine’s vision of a fistula free Ethiopia. This means letting women know treatment is available if they suffer a childbirth injury, but also increasing their understanding of safe birthing practices, and the importance of having trained birth attendants.

The vast geography of Ethiopia, however, presents an ongoing challenge. “In some areas, there is no radio or television. There may be no local health services who can support mothers.

“That’s why we work alongside government and combine our work with other health initiatives. For example, if there is immunisation campaign taking place, nutrition screening, or response to a malaria outbreak, we will collaborate with the government health team and get them to provide information about obstetric fistula to the local community. We also ask the health workers to register anyone they find who has a historic injury.”

Training traditional birth attendants in rural villages is also vital. He explains: “We need them to understand how to prevent obstetric fistula, and where to seek treatment for those that are affected.”

Increased rural health capacity

Dr Leta views the Hamlin College of Midwives as a foundation stone of Hamlin’s prevention work. He explains: “Obstetric fistula occurs largely because of the lack of skilled birth attendants. Most health professionals in Ethiopia will work in urban areas, but obstetric fistula happens in the most remote and rural village.

“A Hamlin midwife, once they have completed their four years of training, will serve for four years in a rural area. They can prevent obstetric fistula from occurring, but they also inform women who are living with childbirth injuries that they can come to a Hamlin Hospital for fistula surgery.”

Dr Leta and his team will also train and support health officers in each woreda [district]. “We create telegram chat groups with their personnel and share information. They learn how to identify obstetric fistula in any patients and can refer women to us for treatment.”

A whole of community approach

Hamlin’s prevention program is community focused. Dr Leta explains: “We work to ensure that mothers have access to skilled care during birth so that obstetric fistula and other birth complications are prevented.

“We also provide information to women on family planning and increase awareness on other issues that result in obstetric fistula, such as early marriage.”

As a fistula surgeon, Dr Leta is committed to treating women living with horrific childbirth injuries but he is also determined to prevent a new generation of women from suffering the same fate.

“Obstetric fistula is not only a hole or a failure to control of urine. It affects every part of a woman’s life and can result in other health complications, psychological problems, family difficulties, social shunning, and economic hardship.”

This Christmas, we are raising much-needed funds to train more Hamlin midwives to serve women in the most remote communities. Please donate today to give more Ethiopian women access to skilled, compassionate care.