© Lucy Perry

Walking between the trees, Catherine Hamlin approaches with a determined but friendly look on her face. She leans on a walking stick and stops to greet everyone she meets. Hamlin celebrated her 90th birthday this year; the hospital in Addis Ababa that she created with her husband Reginald has also reached a significant milestone, having opened 40 years ago.

In 1959, Hamlin moved from Australia to Ethiopia to start a midwifery school. Just days into her work at the Princess Tsehai Memorial Hospital in Ethiopia’s capital, she and Reginald met a 17-year-old girl with serious post-natal complications.

Having lain in her village in great pain during the last stages of pregnancy, she had given birth to a stillborn child, suffered from continuous urine leakage and had been left by her husband.

Meeting this girl changed the course of the Hamlins’ life and led them to set up the Addis Ababa Fistula Hospital to provide free treatment to all.

Fistula is an obstetric disease which affects two million women worldwide. It is caused by lengthy pressure against the pelvis, either because the baby’s head is too big, the mother’s pelvis too small or because the child is lying in a difficult position. Most of those who suffer from fistula live in countries with inadequate healthcare.

‘Pregnant women in the West get the help they need,’ says Hamlin. ‘If there are complications they can have a Caesarean. In the Ethiopian villages you have to walk for an average of two days to get to the nearest clinic. Many women die before they arrive at the hospital. It is immensely sad. The key to a fistula-free world lies in preventative measures.’

Hamlin and her husband had planned to return to Australia after three years in Ethiopia, but they stayed. In 1974 they opened the country’s first, and the world’s second, fistula hospital, which has now treated over 40,000 patients. Women come here by foot from as far away as Eritrea and Somalia and since the hospital was opened not a single bed has lain empty.

‘Reg didn’t have the heart to deny anyone help,’ Hamlin says of her husband, who died in 1993. ‘How can you turn your back on someone who is so desperate for help?’

This year, Hamlin was nominated for the Nobel Peace Prize for her lifelong commitment. But she is dismissive of her achievements, saying that she has ‘done nothing remarkable’.

It hasn’t always been easy, however. Around the same time that the hospital opened its doors in 1974, the Ethiopian monarchy fell. The next 20 years were characterized by constant unrest, when the communist military junta of Mengistu Haile Mariam ruled the country with an iron fist. The state took control of all private possessions and killed anyone they suspected of being anti-communist. Hamlin was scared of losing the hospital and feared for her patients’ lives.

She recalls a day in May 1991 when there was unrest on the streets outside the hospital. Hamlin was at home, knitting, when the telephone suddenly rang. She got up off the sofa and went to answer. As she did so, a bullet came in through the roof and hit a cushion where she had been sitting.

‘That conversation saved my life. God was with me in difficult times,’ she says now, while adding that she is sure no-one ever had ill-will towards her personally.

Today, there are five regional fistula centres across the country, established by the organization Hamlin Fistula Ethiopia with help from the authorities. Although 90 per cent of the population lives in the countryside, 90 per cent of Ethiopia’s gynaecologists work either in the city, or privately.

‘In 2007 the organization started a midwifery school,’ says Feven Haddis, deputy CEO of the hospital. ‘The students come from schools in the villages. The idea is that the girls, after completing the training, go back to their village to work. The challenge is to make this happen: very few doctors and trained health carers stay in the villages. They move to the large towns or establish themselves abroad.’

Hamlin operated every day until her 90th birthday in January. Now she is thinking about taking a well-deserved break and doing what she likes best: reading, knitting, weeding in the garden – and giving a good hug to her patients.

Sofi Lundin is a Swedish freelance photographer and journalist, based in Oslo.
This article is copyright and not to be reproduced under creative commons.

This article is from the December 2014 issue of New Internationalist.

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