April 14 - 20, 2013: Issue 106

Making a Difference in Ethiopia
By George Repin

Dr Reg Hamlin, an obstetrician/gynaecologist, who had been the Medical Superintendent of the Women’s Hospital, Crown Street,  Sydney and his wife Dr Catherine Hamlin, also an obstetrician/gynaecologist, who had married in 1950, arrived in Addis Ababa in 1959 under a contract with the Ethiopian Government.  The three year contract was to establish a greatly needed School of Midwifery at the Princess Tsehai Memorial Hospital but, after only ten  midwives had been trained the Government withdrew funding and closed the school.

Doctors Reg and Catherine Hamlin in the early days at the Princess Tsehay Hospital

In the meantime the Hamlins had become acutely aware of the high incidence of obstetric fistulae among very young women in the country. Obstetric fistulae are extremely rare in countries with adequate obstetric/midwifery care (with access to episiotomy and Caesarean section).  The Hamlins had never seen cases and it had been many years since operations for their repair had been performed in Australia. They set about learning the operative technique and in the first three years carried out about 300 operations.

There is no delicate way to describe an obstetric fistula. The following description is from an article by Nikki Barroclough in the Melbourne Age on December 1, 2008 following her visit to the Addis Ababa Fistula Hospital:

“….it’s a hole which develops between a woman’s vagina and her bladder, and sometimes between her vagina and her rectum, after days of obstructed labour without medical intervention, when the pressure of the baby’s head against the mother’s pelvis cuts off blood supply to delicate tissues.  The mother usually gives birth to a dead baby, and if the resulting intense grief isn’t enough to deal with, she’ll find herself leaking urine, and sometimes faeces as well, through her vagina. The leaking is continuous and uncontrollable.”

The women, because of their constant smell, tend to be abandoned by their husbands and they are often ostracised by their relatives who may build a small hut for them to live in, away from the rest of the family.

The Hamlins dedicated their lives to the repair of obstetric fistulae at first in the Memorial Hospital but ultimately, in 1974, in a purpose built facility – which is now the Addis Ababa Fistula Hospital.  This is the only medical centre in the world dedicated exclusively to fistula repair. 

 Dr. Catherine Hamlin with a young girl patient.

In a letter from Dr Catherine Hamlin in May 1983 she told me of her work:

“It is exciting and interesting and very worthwhile work – as our patients  are  all such young attractive women , who without this surgery would be  doomed to a lonely life of misery! So our reward is seeing the change from this wretchedness to women once again with assurance and self respect – and able to marry again and have a living child!  We get great joy therefore in our work! and  also living in this really beautiful country – very like Australia in some of its country scenery – and in its many eucalyptic trees.”

Reg Hamlin died in 2003.  Catherine Hamlin stayed in Addis Ababa to continue the work she and her husband started.  In an autobiography published in 2005 she wrote about their work and the hospital they established – weaving their story with the history of the hospital and of Ethiopia the country she adopted. The book is called The Hospital By the River.

Catherine Hamlin has received many awards recognising her work, including Companion of the Order of Australia (AC).

 Copyright George Repin 2013. All Rights Reserved. 

Addendum - Reflections: Dr Catherine Hamlin AC - 2018 NSW Senior Australian Of The Year

Obstetrician Dr Catherine Hamlin AC, was nominated for her work in Africa providing care for fistula patients.

The 2018 NSW Senior Australian of the Year has devoted more than 50 years to giving women in Africa a second chance at life. 

A surgical pioneer, Catherine and her late husband Dr Reginald Hamlin founded a network of six hospitals and a midwifery college in Ethiopia. The hospitals provide free fistula repair surgery to poor women suffering from horrendous and preventable childbirth injuries. The midwifery college trains midwives to prevent the injuries.  

When Catherine arrived in Ethiopia in 1959, there were almost no resources for expectant mothers. Since then she and her team have treated more than 50,000 women, restoring their health and dignity. Catherine’s organisation is a global centre of expertise in fistula repair and she trains surgeons from around the world. Through her foundation, Hamlin Fistula Ethiopia, Catherine is tackling a new fistula frontier, Uganda. 

Now 94 years old, Catherine  remains active in her day-to-day work at the hospital, healing women through surgery, rehabilitation and counselling, so they can be whole again. 

Previous Reflections by George Repin 

The Nineteen Thirties  Remembering Rowe Street  The Sydney Push  Saturday Night at the Movies  Shooting Through Like A Bondi Tram  A Stop On The Road To Canberra  City Department Stores - Gone and Mostly Forgotten  An Australian Icon - thanks to Billy Hughes  Crossing The Pacific in the 1930s  Hill End  The Paragon at Katoomba  Seafood In Sydney  How Far From Sydney?  Cockatoo Island Over The Years  The Seagull at the Melbourne Festival in 1991  Busby's Bore  The Trocadero In Sydney  Cahill's restaurants  Medical Pioneers in Australian Wine Making  Pedal Power and the Royal Flying Doctor Service  Pambula and the Charles Darwin Connection  Gloucester and the Barrington Tops  A Millenium Apart  Have You Stopped to Look?  Gulgong  Il Porcellino   Olympia   Durham Hall  Sargent's Tea Rooms Pie Shops and Street Photographers The Ballet Russes and Their Friends in Australia  Hotels at Bondi  Alma Ata Conference - 1978 Keukenhof - 1954 The Lands Department Building and Yellowblock Sandstone  The Goroka Show - 1958  A Gem On The Quay  Staffa  The Matson Line and Keepsake Menus Kokeshi Dolls  The Coal Mine At Balmain  The Hyde Park Barracks  The Changing Faces Of Sydney From Pounds and Pence to Dollars and Cents Nell Tritton and Alexander Kerensky  Making A Difference In Ethiopia William Balmain  J C Bendrodt and Princes Restaurant Azzalin Orlando Romano and Romano's Restaurant   Waldheim  Alcohol in Restaurants Before 1955  King Island Kelp  The Mercury Theatre   Around Angkor - 1963   Angkor Wat 1963   Costumes From the Ballets Russe Clifton at Kirribilli  Chairman Mao's Personal Physician  The Toby Tavern The MoKa at Kings Cross  The Oceaographic  Museum  in Monaco  The Island of Elba  Russian Fairy Tale Plates  Meteora  Souda Bay War Cemetery Barrow, Alaska  Cloisonné  Tripitaka Koreana Minshuku The Third Man Photographs and Memories  Not A Chagall!  Did You Listen? Did You Ask?  Napier (Ahuriri, Maori) New Zealand  Borobudur  Ggantija Temples Plumes and Pearlshells  Murano  University of Padua  Ancient Puebloe Peoples - The Anasazi   Pula  The Gondolas of Venice Cinque Terre  Visiting the Iban David The Living Desert Bryce Canyon National Park   Aphrodisias   The Divine Comedy Caodaism  Sapa and local Hill People  A Few Children   Cappadocia  Symi Jean-Marie Tjibaou Cultural Centre   Aboriginal Rock Art on Bigge Island    ANZAC Cove (Ari Burnu) 25 April, 1997  Hotere Garden Oputae  Children of the Trobriand Islands  Page Park Market - Rabaul  Rabual   Kotor, Montenegro   Galleries of Photographs I   Lascaux  Galleries of Photographs II   The Cathedral of St. James – Šibenik, Croatia  Ivan Meštrović  - Sculptor   Delphi   Gallery of Photographs III  The Handicrafts of Chiang Mai Raft Point  San Simeon - "Hearst Castle"  Floriade - The Netherlands - 1982  Russian New Year   Mycenae   "Flightseeing" Out Of Anchorage Alaska  The White Pass and Yukon Route  Totem Poles  Tivkin Cemetery  Krka National Park - Croatia   Tavistock Square and the BMA  Orthodox Easter  Wieliczka Salt Mine  A Walk on Santorini   Indonesian Snapshots Ephesus - The Library of Celsus  Ephesus - Some Places Of Interest  Waimea Canyon and the Kalalau Valley United Nations Headquarters 1958  A Miscellany of Flower Images Gardens Bath St. David's In Wales   Zion National Park Nicholas Himona - Artist   Kraków  Lilianfels   Collonges-La-Rouge  Gingerbread Houses   Cape Sounion   Delos  Wroclaw  Colonial Williamsburg  Gruyères   Strasbourg  Coventry Cathedral  The Roman Theatre at Aspendos  Turkish Carpets The Duomo of Orvieto  Rovinj  The City Walls of Dubrovnik Monaco - Snapshots   Bonifacio, Corsica  Autumn in New England USA  The Great Ocean Road  Pompeii  Didyma  Lawrence Hargrave 1850-1915  The Corinth Canal  Malta  Snapshots of Amsterdam Café Central - Vienna