December 2007 Newsletter

Fasika gets behind her friend Wube
Fasika came to the Hamlin Fistula Centre in Bahir Dar earlier this year. She was in a dreadful state, malnourished and weak. She had been living with a fistula for ten months after a three day labour and stillborn child.

Her family and friends rejected her and she was reduced to begging. Even this was difficult. She smelt so badly that people would not come near her to give her money or food.
Fortunately, a mission found her and brought her to our Fistula Centre. We were able to operate and cure her.

She returned to her village where she got a job making injera – the local pancake like bread made from teff with a slightly sour taste. With the income she earned she was able to rent a room and began to do quite well for herself.

Soon she discovered another fistula sufferer, Wube, living in her village. Fasika took it upon herself to care for Wube in her home. When Fasika had saved enough money she took Wube by the hand and walked with her six hours to the nearest road. Then they travelled by bus on the three day bumpy journey to our Centre.

Fasika stayed with Wube for three weeks and helped us look after her friend. Wube’s operation was successful and she was cured. Fasika then accompanied Wube on the three day bus journey and six hour walk back to their village.
A ‘walk to beautiful’ ... and home again.

From Dr Andrew Browning

FROM DR CATHERINE HAMLIN, AC.
Dear friends in Australia,

This is to send my love and thoughts as you celebrate Christmas, and to wish you joy and peace in the New Year.
I am writing this from England where three of us were invited to partake in a big three-day Conference in London on all sorts of women’s issues, which naturally included the Fistula Problem in the poor countries of the world. We were also able to see the completed new documentary film “A Walk to Beautiful”, which was very moving. I hope some of you will be able to see it in Australia where it will be shown in Sydney, Melbourne and Perth. We met some influential people at the Conference, so made valuable contacts there.

Now I am enjoying a few weeks in Cornwall where my son and his wife have moved to live. It is a lovely part of England, with some beaches quite like the beautiful Australian ones, but the sea is now far too cold for even the most determined surfer.

Since my last letter, when we were still experiencing the rainy season, we have seen the countryside around Addis Ababa ablaze with the beautiful bright yellow Maskal Daisy which brings “sunshine” around the poorest of hovels and decks the top of the many ceremonial bonfires lit on Maskal Day at the end of September. We also experience the usual increase of patients as the rain eases off and the country roads and tracks become passable again.

DR AMBAYE’S SURGICAL SKILLS
We were so glad to welcome back Dr. Ambaye after she completed her course in Leeds, UK. She graduated with a Masters in Public Health, a great achievement, considering her struggle with homesickness, loneliness and a very wet and dreary summer!

She is without any doubt a most skilled fistula surgeon and we had several cases saved up for her return which I expect she has already dealt with. Earlier in the year when she spent two weeks holiday in Ethiopia on a break from her UK course, she was able to operate on a Tchadian patient sent over by air to our Hospital after a failed operation there. She still had a fistula in her bladder and a severe rectal injury as well - it was worth this patient waiting for Dr. Ambaye’s skill and she went home later cured.

Some of the rectal injuries we see are often thought by visiting gynaecologists and colo-rectal surgeons to be inoperable, however, when tackled by Dr. Ambaye they prove not to be!

WOTATE – A LABOUR OF LOVE
The story of little Wotate from the far South, whom I saw when I visited our Centre in Yirgalem earlier in the year is a story with a happy ending.

A tiny girl lying in the corner of the ward hardly looking human, arms like sticks and skin stretched tightly over a little face, lying listless in the bed - weighing only 3 stone 6 lbs (less than 22kg). She had delivered many months before after a labour of six days and a stillborn baby, then incontinent of urine suffering social ostracism, shame and neglect.

We soon took her to Addis Ababa where tests were carried out for any underlying disease but all were clear. She was just a girl in deep depression who was slowly starving to death. Some six months later Wotate was ready to go home, now with a lovely smile, excited to be cured and normal again.

Watching our medical staff care for such patients and seeing the joy of the cured patient reflected in the faces of our surgeons and nurses as they realize the privilege of seeing, and being the means of this transformation, turns the work into a labour of love for them.

MANY COLOURED SHAWLS
Just before leaving for England, many cartons of beautiful knitted shawls arrived from our British Trust. Many of you in Australia make these shawls too and send them across to us. They are really appreciated.

They are almost now a uniform and add colour and warmth for our mobile patients!

I see little colourful figures wandering across the lawn to our small sewing and craft room with its verandah and benches where they spend much of the day, drinking coffee supplied by our kind sewing teacher and other staff.

This has become quite a social area now; this little informal group provides healing for the mind and gives to each patient a feeling that she is once again a normal woman!

Our literacy and numeracy teaching, Bible classes, films and basket weaving also do wonders. We see such changes in so many of our patients who now know that they are truly accepted and loved and no longer outcasts.

I send my love and again my sincere thanks for all your past great help.



Dr Catherine Hamlin AC

MASKAL DAY – FINDING THE ‘TRUE CROSS’
Maskal Day, to which Dr Hamlin refers in her letter, has been celebrated in Ethiopia for over 1,600 years. ‘Maskal’ means ‘cross’. The feast commemorates the discovery of the Cross - upon which Jesus was crucified - by the Empress Helena, the mother of Constantine the Great and is celebrated on 27 September each year.

The celebration has a particularly Ethiopian flavour because of the belief that a piece of the ‘True Cross’ was found in Ethiopia at the remote mountain monastery of Gishen Mariam in Wollo. In this monastery is a massive volume called the “Tefut”, written during the 1400’s which records the story of how a fragment of the cross was acquired.

The festival begins by planting green trees in town squares and village marketplaces. Around these trees, tall bundles of branches are tied together and yellow daisies or maskal flowers are placed at the top. Eucalyptus twig torches are used to light the bundles of branches.

The branches are ignited to symbolise the Empress’s search for the Holy Sepulchre, which she did by lighting incense and praying. Where the smoke drifted she dug and found three crosses. To one of them, the ‘True Cross’, many miracles were attributed.

As evening darkens the flames glow brighter. It is not until dawn that the burning pyramid consumes itself and the big tree at the centre finally falls.
During the celebrations each house is stocked with tella, the local beer, and strangers are made welcome.

DR MELAKU ABRIHA - MEKELLE
The Hamlin Fistula Centre at Mekelle, built with funds provided by Australian donors, is in Tigray, the northernmost regional state of Ethiopia.

Tigray covers 54,600 square kilometres. The total population is 4.1 million with nearly a quarter being women between 15 and 49 years of age. It is estimated there are about 184,000 pregnancies each year in Tigray. Obstetric fistulas occur in about 1.6% of cases which is well above the estimated national average of 1%.

The region has one obstetrician for every one million people, and one midwife per 33,713 people, compared to the WHO standard for midwives of 1:5,000.

The Centre has 28 beds, and 26 happy staff. Since opening in February 2006, it has attended to over 500 patients.

We have hired a health officer whose primary responsibility is finding hidden fistula patients and promoting health education to prevent fistulas occurring. Our centre works with the regional health bureau, international and local NGOs in the prevention of obstetric fistulas, averting maternal morbidities and reducing maternal mortality.

Tsehay – Tragedy and Recovery
Tsehay was brought to the Mekelle Centre by her uncle. She was born in a small village near to the ancient town of Axum. She developed febrile illness at the age of six which resulted in her becoming deaf and dumb. Because of this she did not marry at the age of 13 (or less), unlike many of the other girls in her village.

She lived with her mother. By the time Tsehay was 27, her mother wanted Tsehay to have the pleasure of her own baby and continue the family tree.

So the mother arranged with a married man in the neighbourhood who is a father of four, to make Tsehay pregnant. He spent every night with Tsehay until her mother was sure Tsehay was pregnant. The mother assured the man that nobody would know that he was the father of the baby. Without her consent, Tsehay became pregnant. The mother then told the man to stop visiting her daughter.

Poor Tsehay did not know what was happening to her. To keep the birth secret the mother conducted the delivery at home. The baby became obstructed in Tsehay’s uterus and died after three days labour. Then after three more days urine began to leak through the vagina and Tsehay began to smell badly. She remained in this condition for another twelve months until her uncle made a visit and discovered Tsehay’s pitiable condition.

The mother was too ashamed of what she had done to come to our centre, as other mothers do. So the uncle accompanied Tsehay to our centre.

After taking a thorough history from Tsehay’s uncle and some examination, we did fistula surgery and cured Tsehay.
When she was recovered she was discharged with a new dress, a good local hair style and a warm smile.

We cannot ever forget Tsehay’s warm smile of thanks.

Dr Melaku Abriha

SOME CHRISTMAS IDEAS
If you are looking for ideas for presents this Christmas and how you could support the work of the Hospital, then here are three suggestions to do both at the same time.

quid and harmony
‘quid and harmony’ by Tasmanian author Allan Smith is the first book of the Earth and Sky trilogy. Written for mature teenagers and above, this thoughtful and very imaginative adventure story tells of a young woman who enters another world where the struggle of good and evil is fought through music, song and dance.

Whilst some may find parts of this novel challenging, perhaps a little confronting, it is possible you will never think of song and dance in quite the same way again. A good read for the Christmas holidays.

Copies can be purchased through www.smithysbook.com. Allan is donating the funds he receives for the book to the Hospital through Rotary International, and has raised some $10,000 since mid-August.

Raw Silk and Pearls
Readers of our September newsletter will recall that Dr Sarah Thompson has recently published her second book, ‘Raw Silk and Pearls.’

The book has over 70 poems “celebrating life” and is beautifully presented. Sarah is donating the proceeds from the sale of the book to the work of the Hospital and it can be purchased for $29.95 (includes $5 postage) from Peribo, 58 Beaumont Road, Mt Kuring-Gai NSW 2080 or by emailing info@peribo.com.au, phone 02 94570011

A ‘friendship gift’ this Christmas?
If you would like to support the work of the Hospital as a Christmas gift to a family member or friend, then complete the attached slip and we will forward with your receipt, a card which you can send to the family member or friend for Christmas. Donations will need to be received at the Fund office by Monday 17 December in order for you to receive the card before Christmas.