News Archive - September 2004

From Dr Catherine Hamlin AC
Addis Ababa Fistula Hospital , Ethiopia

Five new 'Hamlin Fistula® Centres' will be built over the next 5-10 years
September 2004

"We are embarking on the most extensive development program since 1974. We want to be able to cure many more fistula patients and to help prevent this dreadful problem occurring" It is estimated that 8,000-9,000 women in Ethiopia suffer obstetric fistulae every year. At present, our Hospital in Addis Ababa is able to treat only 1,400 of them.

Overview of the Hospital's progress

1959
Dr Reg and Dr Catherine Hamlin arrived in Ethiopia from Australia. Began working at the General Hospital in Addis Ababa and became aware of the plight of the fistula patients.

1961
A 'fistula clinic' was built in the grounds of the Princess Tsehai Hospital to treat patients. The 'Hamlins' developed a surgical procedure to successfully cure fistula patients in 93% of the cases.

1970-1974
The 'Hamlin Fistula® Research and Welfare Trust' in Ethiopia was registered. Land for the Hospital was purchased.

1974
The first Addis Ababa Fistula Hospital was opened.

1975-1993
Despite two major civil wars and an oppressive regime, about 15,000 fistula patients were treated and cured during this period.

1993
Dr Reg Hamlin OBE died in Ethiopia. Dr Catherine Hamlin pledged herself to continue the work they had started.

1993-1995
A house for a new resident doctor was built. The Princess Anne Ward, the pathology laboratory and the library were also built. A more intensive program to train doctors and nurses in fistula surgery was commenced.

1997-1999
The Fistula Hospital building complex was restructured and major extensions were made. A new operating theatre, an x-ray room and physiotherapy centre was built. Accommodation for resident nurses and for overseas doctors in training, were constructed. A bore for water was sunk.

1998
Because of the extreme difficulty patients have to reach Addis Ababa, a mobile Medical Team was established, to travel to remote areas of Ethiopia, to do fistula operations in regional hospitals. A land Rover was given by Rotary Clubs in Australia..

2001
Dr Andrew Browning from Australia joined the staff at the Hospital.

2003
The self-help Rural Village 'Desta Mender' was opened. It will accommodate 100 patients who cannot be completely cured and will require ongoing medical care.

2004
An additional 30-bed Ward was built in the grounds of the Addis Ababa Fistula Hospital.

Most of cost of the recent building improvements has been donated by generous friends from Australia.

The Broad Plan to cure more fistula patients

Why is there a need?
The countryside in Ethiopia is mountainous with deep ravines. Roads are few. A destitute fistula patient has extreme difficulty reaching a bus. Then she may not be able to travel on the bus because she is 'smelly' and leaking urine. To make the trip to Addis Ababa on foot or being carried on a stretcher is a marathon epic.

Of the estimated 8,000 to 9,000 women who suffer an obstetric fistula each year in Ethiopia, only about 1,400 are able to get to the Fistula Hospital for treatment. The question is, 'what happens to the others?' Do they live with the problem? Or do many die of infection?

What is the plan?
It is intended, over a period of five to ten years, to build a 'Hamlin Fistula® Centre, in the grounds of The 'Hamlin Fistula® Centre' at Bahr Dar is at present being equipped and furnished. Staff has been enlisted and have received training at the Fistula Hospital to run the Centre.

At Harer
The Hamlin support Fund in the USA, known as 'The Fistula Foundation', has agreed to provide the funds required to construct the 'Hamlin Fistula® Centre' at Harer and to fund the running costs of that centre.

At Yirgalem
There is land available at Yirgalem, that was previously a missionary centre operated by a Norwegian Lutheran Mission and now controlled in part by the Norwegian Government's aid agency, NORAD. NORAD has agreed to finance the construction of the 'Hamlin Fistula® Centre' in Yirgalem.

These centres are north, south, east and west of Addis Ababa in areas where it is known that numerous fistula cases occur.

The mobile medical teams from the Fistula Hospital, have for the last 4-5 years been visiting the centres that have been chosen. In most of the towns there is a doctor who has had some training at the Fistula Hospital.

Where are the five selected towns?

At Bahr Dar
The Builder who has done all of the Hospitals work in recent years, has built and given the Bahr Dar building to the Fistula Hospital. Mr Varnero has done this in memory of his father and in order to assist the work of the Fistula Hospital. The Regional Ministry of Health has made the land available to the Hospital without charge.

The Norwegian Lutheran Mission will be monitoring the project on behalf of their Government.

At Mekelle
The Board of Directors of the Australian 'Hamlin Fistula® Relief and Aid Fund' has indicated that it is prepared to raise monies in Australia to provide the funding for the construction of the 'Hamlin Fistula® Centre' at Mekelle. It is also willing to take the responsibility for the running costs for a period of years.

At Metu
No progress has yet been made. Dr Ambaye and the mobile medical team visited the regional hospital in March. They operated on 30 patients and a further 21 patients were transferred to Addis Abba Fistula Hospital, for surgery.

A doctor from the hospital at Metu wrote to Dr Hamlin:
"I hope the dream to open a satellite fistula unit (at Metu) will be materialised soon...."

Dr Catherine Hamlin writes:

Dear Australian Friends,

It is exciting for me to write and tell you briefly how we are progressing with our Outreach Program.

Already one Centre, at Bahr Dar, is built and almost fully equipped. Nursing staff have already completed 3 months' training at the Fistula Hospital, so are now ready to commence work at the Centre. This will be our pilot Centre and we hope very soon to open it. The need is very great. Recently 37 patients turned up hoping to be admitted!

Now we are anxious to start building our truly Australian Centre at Mekelle. This will serve the large and populous Province of Tigray and the northern area of the adjoining Province, from which many of our patients come.

Early marriage, difficult communications (few roads and mountainous country) and poverty play a large part in the prevalence of fistula sufferers. At present we have four patients in the Addis Ababa Fistula Hospital from Tigray. There are usually many more, but the rainy season is still with us, preventing travel because of flooded rivers and roads. The tracks are washed away. Soon many more patients will arrive from the Tigray Province.

To have a Fistula Centre in the chief town of Tigray will benefit so many poor patients who will be able to reach the new centre more easily. This will save them the long, difficult and expensive journey to Addis Ababa. We know the need is very great.

The enormous need in this area is confirmed by the gynaecologists who are working at the Mekelle Regional Hospital, who tell us how common this tragic injury is and how important and welcome is our planned Centre.

We have enthusiastic support from all the medical personnel in that town. As I write this letter, one of our patients from Tigray is in the theatre having her operation, performed by Dr. Andrew Browning, our Australian doctor, who is now an expert fistula surgeon. This poor woman lost her longed for baby after 4 days of labour and was left with a fistula in her bladder and rectum. This double injury occurs in about 16% of our patients, making their plight a horror to endure.

Andrew has a special interest in Mekelle, because it is being built with funds from Australia. Perhaps one day he may be in charge, making it a truly Australian Centre.

Recently, we had a big meeting with the World Bank who are interested in improving road connections to small villages. The lack of roads makes it impossible for a woman in obstructed labour to easily get medical help and is one great cause for women to have fistula injuries. Most villages are remote and it is a long walk to a main road, and even then it is not always possible for her to get onto a bus.

The World Bank is concerned about these injured mothers and the enormously high maternal mortality in Ethiopia. We were encouraged by this meeting, and although it is just a start, it may bring some positive results.

Our new 30-bed ward at the Fistula Hospital is occupied. What a difference this has made for the women waiting for surgery. They no longer need to be sent 'up the road' to sleep on a dirty floor in an overcrowded village house nearby!

A week ago, I had the exciting news that a number of schools in Australia have been raising money for us. Two schools in particular, Loreto at Normanhurst and Abbotsleigh at Wahroonga, have done wonders by raising large amounts and sending it to our Trust for the Mekelle Centre.

It touches my heart that girls in my own country are helping other girls here. Many are the same age as our patients and so they are really helping their 'sisters' in another country and from a very different background. When our patients are cured, they are like any other girl, looking forward to a new start in life and returning to the familiarity and the comfort of their own village society.

Thank you for all that you have done

In my next letter, I hope to be able to tell you that the building of our Mekelle Fistula Centre is under way!

In my next letter, I hope to be able to tell you that the building of our Mekelle Fistula Centre is under way!

With my love and appreciation,

(Dr.) Catherine Hamlin