Training Midwives to Prevent Fistula

In 1959, Drs Reg and Catherine Hamlin travelled to Ethiopia for the first time. They had accepted a post advertised in the Lancet Medical Journal calling for doctors to work as obstetrician-gynaecologists and set up a midwifery school on a three-year contract with the Ethiopian government. That initial three-year contract would become their life’s mission.

The key to eradicating fistula

When they experienced their first obstetric fistula patient, Catherine and Reg were heartbroken; they were also determined to care for these most vulnerable women. Their journey would see them establish the Addis Ababa Fistula Hospital in 1974 and refine the surgical technique used in fistula repair surgery. It was not until the opening of the Hamlin College of Midwives in 2007 – almost half a century after the Hamlins first arrived in Ethiopia – that Catherine fulfilled the initial brief of establishing a midwifery college. For Catherine, the need for a midwifery college is key to her mission to end fistula in Ethiopia. By training quality midwives, more women have access to maternal healthcare, preventing fistulas from occurring in the first place.

Catherine’s dream is for every woman in Ethiopia to have access to a midwife and a clean, safe birth. Since 2007, 170 midwives have graduated from the Hamlin College of Midwives. Hamlin midwives are industry leaders, working in over 50 Hamlin-supported midwifery clinics across rural Ethiopia. One of the 170 graduates working to save lives and prevent fistulas is Kamali.

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Learning to save lives

Kamali had to leave her small, under-resourced rural town near Gonder, Northern Ethiopia in order to attend high school. An excellent student, Kamali was offered a scholarship to study midwifery at the Hamlin College of Midwives. Catherine’s dedication to caring for the poorest women, as well as the quality teaching at the College, inspired Kamali to complete her four-year Bachelor of Science (Midwifery) degree. When she graduated earlier this year, Kamali was the second highest-ranking student in her class. For Kamali, Catherine “will always be my inspiration to be successful in my professional career.”

Kamali’s work as a Hamlin midwife is possible thanks to the generosity of Hamlin supporters. “I personally witnessed how life-changing it is to help a woman suffering from the traumatic effect of fistula. Hamlin supporters are giving life back to these poor women of my country and I have no words to express my gratitude,” she says. Working in a Hamlin-supported midwifery clinic near her hometown, Kamali has been able to save the lives of women and their babies, in her community.

The importance of midwives cannot be understated. Last year, Hamlin midwives delivered 30,095 babies and not a single fistula occurred. The difference a midwife like Kamali can make in a rural community is the difference between life and death. 

A preventable tragedy

Had a midwife like Kamali been there to assist her, Aida’s story would have been very different. Like a lot of women in her village, Aida faced childbirth without the assistance of a midwife. Over 70% of births in Ethiopia occur without a trained medical professional present.

Aida endured an obstructed labour for five agonising days. Eventually, Aida was carried, unconscious, on a home-made stretcher for four hours to the nearest government hospital where she delivered a stillborn baby. Her trauma was compounded when she realised that she had suffered a fistula injury, leaving her with urinary incontinence.

For 12 years, Aida suffered in isolation, ostracised from her family and community. When she was finally referred to Hamlin’s Addis Ababa Fistula Hospital, Aida received life-changing surgery. Today, Aida is totally dry and plans on starting her own business.

Aida knows the value of a midwife better than most. “Midwives save the lives of mothers and their infants and prevent the tragic lives of women like me,” Aida says. Had a midwife like Kamali been present during her labour, Aida could have been fistula-free and able to experience the joy of motherhood.

No woman deserves to suffer the pain and indignity of an obstetric fistula. The more midwives we train, the closer we are to eradicating fistula. Forever.

You can help us realise Catherine’s dream of a midwife for every woman by donating here.