Catherine Hamlin

Obstetric fistula: a neglected maternal health crisis

Born in Sydney in 1924, Hamlin left Australia together with her husband in 1959 in response to an advertisement to work as obstetricians and gynaecologists at a hospital in Addis Ababa.

Hamlin was horrified by the prevalence of obstetric fistula, which often made women with the condition live as social outcasts amidst the most miserable conditions. Obstetric fistula, formerly common throughout the world, is now almost non-existent in industrialised countries thanks to better obstetric care, however, it is still prevalent in low- and middle-income countries.

Pioneering fistula treatment

When the couple started their work in Ethiopia, there was little treatment available for the condition anywhere in the world, but the Hamlins developed surgical techniques, began to operate on their patients and eventually achieved a 93 per cent success rate. Soon, women started arriving at the hospital from all over the country hoping for the operation. Small hostels were built on the hospital’s grounds to accommodate them as they awaited their turn. All treatment was – and still is – free of charge.

Addis Ababa Fistula Hospital

As more and more women started arriving for treatment, the Hamlins realized the need to open their own hospital dedicated to treating obstetric fistula. In 1975, the Addis Ababa Fistula Hospital was opened. The hospital soon became a global centre of expertise and training in fistula repair. Additionally, five more regional hospital centres have also been opened across Ethiopia to make the treatment more widely accessible.

Now, their doctors treated thousands of women per year. The Hamlins’ dedication and vision have allowed 60,000 women in Ethiopia to receive treatment over the past decades.

They have also established Desta Mender, or “Village of Joy,” a rehabilitation centre for women so badly injured that they need long-term care.

Hamlin also focused on the important area of fistula prevention with the establishment of the Hamlin Midwifery College in Addis Ababa. The midwives trained there are placed in rural health clinics around the country in order to prevent obstetric fistula in the first place, to raise the quality of care in childbirth generally and to lower the high maternal death rate.

Hamlin, while still also operating on patients, spent a lot of time travelling the world to raise awareness about the condition and its disastrous effects on the lives of its victims, and to fundraise for her clinics and midwifery school.

Honours and books

Hamlin was awarded many medical honorary fellowships, and a number of civil honours, including Companion of the Order of Australia (1995) and the Rotary Award for Understanding and Peace (1998). She received an honorary degree from the University of Addis Ababa in 2010. In Australia, her book The Hospital by the River became a bestseller.