The Hamlin Fistula Hospital

As part our health workshop in Addis the VSO team arranged for us to visit the Hamlin fistula hospital.  It is a world famous hospital that specialises in the management of obstetric fistula. These are abnormal connections between the bladder, bowel and uterus which usually occur as the result of prolonged obstructed labour.  Essentially, if the baby isn’t delivered fairly promptly after labour starts, the pressure of the head on the bladder and bowel walls, inhibits good blood supply and the tissue thins and dies, and abnormal connections develop. The woman becomes incontinent and is often ostracised from her family because of this.  She almost invariably loses her baby too and it’s all made worse because so many of the women who this affects are actually girls having babies at 14, 15 and 16 years before their pelvis is fully developed.

So in 1959 two Australian obstetricians called Catherine and Reg Hamlin came to Ethiopia initially just for a 3 year period to help develop obs and gynae services in the country. They found such need that they ended up staying, and 50 years later the Hamlin Fistula Hospitals are the fruits of their labour. Their story is told in the book The Hospital by the River, which is a really good read about Ethiopia and obstetrics in general.

The hospitals (there are now 6 in total) are fascinating because they really are a shining example of how development work should be.  They started with the Hamlins operating on the few women that found their way to their hospital, but they trained some of their ex patients how to do the surgery, and things have grown and grown so that the 6 fistula hospitals now provide a comprehensive holistic approach to fistula treatment including the initial surgery, psychological support and counselling,  physiotherapy and rehabilitation, and the teaching of new skills such as handicrafts to the women so that when they leave the have a way to make money for themselves. The whole project is now run by local people and they train people from all over Africa how to do fistula surgery.

Our visit was really interesting. Unfortunately (but understandably) you are not allowed to take photos at the hospital so I can’t show you what it’s like. Instead I just have to say that I feel really privileged to have visited such a great place.