The First of Thousands

A shocking introduction to fistula

Doctors Catherine and Reg Hamlin had been working at the Princess Tsehai Hospital for only a week when they came across their first patient with an obstetric fistula. It was a shock for the couple who had not previously seen a fistula case.

In Western countries, obstetric fistulas are virtually a thing of the past because there is access to effective maternal healthcare.

In countries like Ethiopia, more than 70% of births take place without a doctor or nurse present and more than 3000 fistulas occur each year. Imagine suffering for days through an excruciating obstructed labour, losing your baby and then suffering the most horrendous internal injury, just because you are a woman without access to effective maternal healthcare.

A tragic injury

Early in Catherine and Reg’s tenure at the Princess Tsehai Hospital, they were introduced to the devastating nature of obstetric fistula injuries. Catherine details this in her book The Hospital by the River, where she encountered a 17-year-old girl who had endured five days of labour before giving birth to a stillborn baby. Deserted by her husband, she had endured a complete breakdown of the bladder and was brought to the hospital by her father.

“Her father brought her in and told us she was his only child and he would spend every cent he had if we could make her better.” – Dr Catherine Hamlin 

As they had never experienced a fistula case – let alone one this severe – Catherine and Reg sent the patient to a German gynaecologist with experience of fistula repairs.

This woman would be the first of 60,000 others that Catherine would encounter and help in Ethiopia.

The path to prevention

Catherine and Reg’s first exposure to fistula was shocking – but what was more startling was how easily the injury could be treated and prevented.

“What shocked us most was the realisation that if this girl had access to a trained midwife early in labour, or better still, a doctor, they would have recognised something was wrong and sent her to the nearest hospital. These poor women were left without any skilled help while they laboured for days in agony.” – Dr Catherine Hamlin 

This fuelled their desire to establish a midwifery school that would prevent fistulas from occurring. In 2007 the Hamlin College of Midwives was born.

Today, 145 Hamlin midwives have graduated from the college, working across more than 50 Hamlin-supported midwifery clinics in regional Ethiopia. They provide quality maternal healthcare to expectant mothers – saving the lives of mothers and babies and preventing fistula.

You can read more about Hamlin Fistula Ethiopia’s Prevention Program here.