Seeing at firsthand the outcomes at the Hamlin Fistual Hospital in Addis Ababa has left a big impression on Dr Cynthia Innes.
Last January, 10 friends flew to Ethiopia for a bus journey organised by a couple who had worked as volunteers there. Solomon, our Ethiopian tour guide, was to be our bus driver and from Addis Ababa we travelled north to explore this amazing mountainous country.
There we were to find out about the rich history of this country with its past emperors as well as being in the midst of daily life and ritual. The majority of the population in this part of Ethiopia are Coptic Christian and to a lesser extent Muslim.
We passed so many robust and cheerful village people living in homes constructed mainly from straw, mud with thatched roofs. Some had electricity, most had no windows and the floors were earthen. We would pass people leading their donkeys laden with goods, or people threshing teff, the local grain.
What we did not see, however, were the thousands of young girls in exile from their villages due to their socially unacceptable medical issue – vesico-vaginal fistula, resulting from having been married too young and consequently given birth with their immature bodies. The girls either die in obstructed labour, their babies die, or if they survive the women are confronted with permanent leakage of urine or faeces. Due to the permanent odour, they are no longer wanted in their communities.
In 1974, Dr Catherine Hamlin and her husband, Reginald, arrived to work as gynaecologists and soon saw the need to develop surgical procedures to repair the fistula. Thus the hospital in Addis Ababa was founded. I was fortunate to have been shown over the hospital, seen the wards with women now cleaned and prepared for surgery.
[One of the patients, I discovered, had taken six years to save enough money to catch a bus to the hospital. They arrive in urine-soaked clothing, hungry and desperate].
We met the trainee midwives, visited the physiotherapy department where women receive pelvic floor rehabilitation, many preoperatively as they need to develop muscles which have been wasted.
We then went on to see where the women were learning crafts, how to sign their name, instructions on birth control, and given ongoing support as so many are psychologically damaged.
Dr Hamlin is now in her 90s and no longer operates, but visits the patients frequently. She lives on the premises surrounded by gardens which make this hospital such a nurturing environment.
There is an ongoing program of training surgeons and midwives. There are now five outreach hospitals where about 4000 procedures are performed annually. Since its establishment, the Addis Ababa Fistula Hospital has treated more than 42,000 women. The hospital has 140 beds and the majority stay for one month. Three surgeons can operate at a time and 85% of patients have a full recovery after the first operation.
The hospital is free to all patients and is reliant on foreign donor support – 39,000 women are on the waiting list.
ED: For more information about the Hamlin Fistula Ethiopia organisation, www.hamlin.org.au or email HQ@hamlin.org.au