I not only have the personal pleasure but also the immense privilege of knowing Catherine Hamlin, who was part of the fabric of my early childhood growing up in Addis. I recall Catherine as a tall, elegant and gracious lady who was as charming and kind as she is talented and dedicated and she is still that same person today aged 87.
I have memories of a time when Addis was more rural when Dr. Hamlin would ride her horse over from the hospital grounds to the radio station compound nearby (where my family lived) for afternoon tea! At the former Princess Tsehai Memorial Hospital, Dr Hamlin delivered my brother Alexander Stewart in 1967 and countless other healthy babies until her attention gradually turned to the less fortunate women with fistula conditions which then became the focus of her life’s work.
Catherine is passionate about her work and wants people globally to become aware of these women from the developing world, who suffer in silence, women who due to lack of education traditionally have no voice and find themselves marginalised in small communities. Husbands and family members do not understand their condition and they are consequently ostracised by family and society and feel ashamed and unworthy as individuals. Fistula in simple terms is an injury that occurs as a result of an obstructed labour and in developed countries can be treated by a caesarean section. When a peasant woman goes into labour there are local women on hand to assist but only if the labour is normal and if the baby does not appear in the normal labour process, they are not skilled or knowledgeable enough to be able to do anything further. These untreated women then begin to leak urine and often live for long periods with a dead baby within them. It is most prevalent among small and young women, often malnourished, whose bodies (in particular the pelvis) are not fully developed for childbirth and who are married at an early age. Tragically Ethiopia still has the highest maternal death rate in Africa and the rate of fistulas has not diminished both factors due to the population explosion and simply not enough medical facilities in the country despite the positive efforts of the Ethiopian Minister of Health.
Catherine Hamlin was born in Australia and after graduating from the University of Sydney; she met her future husband New Zealand native Reg Hamlin while she was a resident at a hospital for women where he was the director.
Catherine and her husband Reg in their roles as Obstetrician and Gynaecologist then travelled to Ethiopia in 1959 at the invitation of Emperor Haile Selassie to open a midwifery school. This was an initial three-year contract but unfortunately the Ethiopian Government ran out of funds to pay ongoing salaries after only 8 midwives had been trained and the Midwifery school had to close.
However, by now Catherine and Reg had become all too aware of the plight of women with childbirth difficulties who arrived at the hospital seeking treatment but were instead initially turned away and treated as outcasts. They were not women ready to give birth normally; instead they were incontinent and smelling and no one knew how to treat them. Catherine and Reg had never seen an obstetric fistula before but these forgotten women touched their hearts and they made it their mission to find a cure. They studied the writings of early fistula surgeons and learned that obstetric fistula conditions were virtually eradicated in the USA by the 20th century due to the caesarean section. Their countless hours of dedicated research allowed them to develop a surgical technique to successfully repair fistulae caused by obstructed childbirth in 93% of cases; when the pressure of the obstruction creates a hole in the woman and needs to be surgically repaired.
As one door closed (the sudden closure of the Midwifery School), another one opened and the Hamlin’s were able to turn their attention exclusively to the treatment of these outcast women. After the closure of the Midwifery School, they built a Fistula clinic on the grounds of the Princess Tsehai Hospital and Catherine and Reg became completely committed and absorbed in the work of treating these women. Having this clinic meant that after treatment, women could return to their local villages cured. In their first year the Hamlin’s treated 30 women but as word spread, the number of women seeking treatment increased rapidly and after three years, 300 women had been healed! Women would often travel for days on end first on foot over mountainous terrain before they reached the only road and then by bus from remote and virtually inaccessible villages to seek treatment in Addis. As news of a cure spread, more and more desperate women arrived in Addis for treatment and the Hamlin’s very much wanted to not only open a unique hospital to treat and cure these fistula patients but to also provide a sanctuary and haven for these women who had suffered immeasurably from physical pain and mental anguish.
It took years of fundraising and hard work but finally in 1974 they were able to open the doors of the Addis Ababa Fistula Hospital on a scenic hill above a river and to this day it remains the only hospital dedicated exclusively to fistula repair. Despite the following turbulent years of political and civil unrest in Ethiopia, the Hamlin’s were able to treat and cure around 15,000 women in almost 20 years.
In time five Hamlin Fistula Regional Outreach Centres (mini hospitals) were opened in other parts of Ethiopia and the Hospital began training doctors from other developing countries to be able to return home and treat fistula patients. Former fistula patients have also been trained to perform a variety of tasks assisting nurses and doctors at the Fistula Hospital. They are not only a tremendous help to the hospital staff but also an inspiration to new patients offering them nurturing support and hope.
In 1993 Dr Reg Hamlin OBE died but Dr Catherine Hamlin committed herself to the continuation of the essential and rewarding work they had started as a team together. This included recruiting more doctors and building additional hospital buildings as more and more women arrived on the doorstep. By 1998 the Hospital had been extensively refurbished and expanded allowing up to 140 patients to be treated on site and four operations able to be performed simultaneously.
Catherine’s Dream stemming from those early days in Addis Ababa had always been to ultimately be able to open a school for midwives and to particularly train women from remote and rural parts of Ethiopia to be able to provide on site treatment and education to local women in these remote locations. It took almost 50 years but this dream was fulfilled in 2007 when the Hamlin School of Midwives was opened. Catherine’s long held belief has always been that by eventually establishing a resident midwife in every village, that obstetric fistula can really be eradicated; and this is finally on the way to being realised. In 2010 the first hand picked graduates from some of Ethiopia’s most remote regions, after successfully completing their three-year course are now busy educating women, delivering babies and preventing fistula conditions in the rural communities where they themselves came from.
The Ethiopian government supports Catherine’s work and generously provided land just outside Addis in 2003 where Desta Mender (Village of Joy) is located and functions as a conference centre. The Midwifery College can be found on land adjacent to Desta Mender. It is a peaceful and rural idyllic oasis and has a positive role in providing training and jobs for fistula patients who are unable to be fully cured (in some cases the women’s injuries are too extreme sometimes requiring ongoing medical attention and they are unable to return to their former lives). These women however are taught new income generating skills including catering and operate The Juniper Café which is open to external visitors. These women also learn life skills and help run the hospitals purpose built self-supporting agricultural and dairy farm. It is a lovely place to visit to relax on a Saturday or Sunday and enjoy a delicious lunch!
Catherine has received countless international awards and much well deserved recognition. She still operates every Thursday and has described her work as a labour of love. She clearly enjoys the interaction with the hospital staff (who all love and respect her) as well as the relationship she has with all her patients. I have witnessed Catherine stop and speak to patient after patient and make each woman feel as if she is the only person that matters in the world and her honest and genuine warmth is both touching and tangible….
The Hospital provides completely free treatment to women and has treated more than 30,000 women with a cure rate of 90%. Dr Hamlin and her staff (including her dedicated son Richard Hamlin who is a Board Member and actively involved with the management of the hospital) are reliant on constant international fundraising and donations to keep their vital work going.
Please help make Catherine Hamlin’s motto and wish for “A Midwife for Every Woman” to become a reality….
Arabella Stewart 