Running a Fistula Hospital During the Red Terror

As Ethiopian civil, political and economic life was utterly uprooted by the Derg regime, Drs Reg and Catherine Hamlin tenaciously opened the Addis Ababa Fistula Hospital in 1975. They displayed even greater bravery and perseverance to look after friends and continue treating obstetric fistula patients throughout the horrors inflicted by the Derg during the Red Terror.

A ruthless time

Like many of the military regimes of the 20^th century, the Derg imposed a harsh reign of terror. Lead by the Chairman Mengistu Haile Mariam, the Derg used violence and indoctrination to instil fear and control on the Ethiopian populace. The atrocities of this period are oft forgotten yet are significant: it is suggested that over 250,000 deaths occurred during the Red Terror.

In the early days of the regime, the Derg command consisted of Mengistu, Brigadier General Tafari Benti, Colonel Atnaf Abate and Lieutenant General Aman Andom. Aman Andom lived next door to the Princess Tsehai Hospital; his son often played with Reg and Catherine’s son Richard. In her autobiography written with John Little, ‘The Hospital By the River’, Catherine recalls the chilling November night when Mengistu and his soldiers surrounded Aman’s house and eventually killed the General and his supporters for purported disloyalty. With horrific violence at their doorstep, Catherine and Reg recognised the need to maintain a low profile in order to survive.

Whilst mandatory communist indoctrination classes were enforced on all staff working at government factories, schools and hospitals, Catherine and the staff at the Addis Ababa Fistula Hospital were not subjected to such treatment – it is uncertain whether this was due to the government forgetting about the hospital or simply considering its staff numbers too small to worry about.

Protecting a political dissident – and a friend

One of the key atrocities of the Red Terror was the extra-judicial killing of anti-Derg students by Mengistu’s soldiers. One young dissident who was targeted by the regime was the son of Catherine’s good friend Yeshi. Yohannes, Yeshi’s son, would distribute anti-government pamphlets that read ‘Everything is becoming more expensive, only life is cheap.’ To avoid capture, Yohannes would constantly move from one place to another. Catherine, seeking to comfort her friend, offered to hide Yeshi’s son in the Hamlin cottage.

Six months after they had opened the Addis Ababa Fistula Hospital, Catherine and Reg moved into their cottage on the grounds of the hospital. The construction of their home along the banks of the quiet river had been discreet: they had not asked for permission nor had registered a house number – in effect, government officials were oblivious to the existence of their secluded home. Thus, Yohannes lived in the Hamlins’ laundry for several weeks, evading the detection of the military regime. The Derg’s hunt for Yohannes and other students continued unabated. With hospital staff voicing their concerns of the closure of the hospital and violence if Yohannes was discovered at Reg and Catherine’s home, the Hamlins reluctantly advised Yohannes to leave.

With limited ability to contact him, Yeshi and the Hamlins went over a year without word from Yohannes; during this time Yeshi was arrested, detained and interrogated on the whereabouts of her son. Fortunate to be released unharmed shortly thereafter, Yeshi remained steadfast in her belief that her son was safe and well. Miraculously, a government amnesty was proclaimed and Yohannes turned himself in, having disguised himself as a beggar and fled to a farm in the north of the country. He eventually returned to his family and today he works in a Mercedes dealership.

Steadfastly caring for the forgotten and most vulnerable

Throughout the civil wars, famines and oppression, the plight of women suffering from obstetric fistula continued – as did the assiduous care for them. During the Derg’s 15-year regime, the Hamlins continued to treat patients with respect, love and quality care. Catherine’s autobiography details numerous anecdotes of the surrealness of working in the midst of revolution and tyranny; while briefly working in the Black Lion Hospital, Catherine and a fellow gynaecologist were scrubbing up for an operation when they heard gunfire around them. One of the most bizarre experiences was when Catherine was required to work in the heart of the brutal regime: Mengistu was desperate for another son, so he ordered Catherine to examine Mengistu’s wife at the old imperial palace, which had been repurposed as the seat of government. Once the surrealness of the situation had worn off, Catherine was on familiar ground: a clinic, caring for a patient.

Considerable government negligence exacerbated the famine of 1984 leading to shortages of every essential supply; when Reg went in search of supplies, he enquired what was in left in the shop and was met with the dispiriting response of “nothing but the shelves.” Obtaining medical supplies was of particular difficulty as almost all of them were sent to the army who were in the midst of an aggressive war against Eritrea. Reg or Catherine, along with Mamitu, would go in their Volkswagen to the numerous disparate medical suppliers where they would bargain for antibiotics, surgical sutures and other essentials.

People would often ask Catherine why she would not flee the violence and upheaval of Ethiopia under the Red Terror. For her, there was no debate: she could not turn her back on the most vulnerable women in need of her aid.

Catherine’s resilience and commitment to her patients has been the hallmark of her 60 years in Ethiopia. Throughout war, famine and atrocities, Catherine’s dedication to eradicating fistula has been unwavering. You can make Catherine’s dream of a fistula-free Ethiopia a reality by contributing here.