Friday, 4 May 2012

Fistula Hospital

There are lots of hospitals in Addis, but probably the most famous is the Hamlin Fistula Hospital, which is where Dr D and I spent our last afternoon in Addis.

The basic story is that many years ago the Hamlins came to Addis intending to improve the care of pregnant women. They found women with fistulae who no-one else was caring for and devoted the rest of their lives to trying to fix this problem.

The basic issue is that many Ethiopian women are under-nourished and then have children when they are too young. The babies get stuck, and without any access to obstetric care, after several days the baby dies and the mother suffers injuries to her bladder and bowel, which leave her leaking urine and/or faeces. This makes her a smelly outcast, rejected by her husband and family, left alone in a basic shelter with nothing to do but wait for death.

Thanks to the fistula hospital many of these women can be fixed, and return to their families in good health. The hospital provides comprehensive care, including preoperative nutrition and physiotherapy for those who are too undernourished and deformed to be ready for surgery. They can do urodynamics to assess patients, and if necessary they will do a urinary diversion and create an ostomy if no other solution is possible. Women who do not wish to return to their families are considered for positions as nurses aides.

The enterprise has been wildly successful, with supporters from around the world, notably including Oprah Winfrey who built a new wing. They have now developed smaller hospitals to do the simpler cases in cities across Ethiopia, have set up some small businesses for their ex-patients, and have just now graduated their first class of midwives. Fistula is a preventable problem, which hardly exists in developed countries. If women have decent care in childbirth and can be referred to a hospital early for a CSection, the problem can be avoided.

We were shown around the beautiful grounds, and the spotlessly clean wards, where we met Catherine Hamlin, who was a very gracious host and spent quite some time talking to us about the hospital.

Photographs are not allowed, but you can learn more about the hospital and make a donation at

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