Ethiopia has millions of people who eke out an existence from subsistence farming in difficult locations, or struggle to keep animals in desert areas. The rugged terrain and huge distances make accessing maternal healthcare a challenge.

Maternal death and disability is among the highest in Africa. A sizeable proportion of women suffer from a condition known as Obstetric Fistula. This is an injury resulting from long unrelieved obstructed labour leading to an abnormal opening between the birth passage and bladder and/or rectum. If the mother survives, her baby is usually stillborn. Following this traumatic experience, the woman becomes incontinent, offensive to those around her and a social outcast in her own community.

 Entrance to The Hamlin

In 1959 the husband and wife team of Drs Reg and Catherine Hamlin went to Ethiopia, initially for a three-year period, to address the shortage of maternal health services. They soon became pioneers in performing surgery for women suffering from Obstetric Fistula. In 1974 they established the Addis Ababa Fistula Hospital.  This amazing place turns away no woman with these horrific injuries. Space is always found for her and she is charged nothing; she is gently examined by one of six specially trained doctors supported by 40 qualified nurses and other staff including counsellors and 150 former patients. Clinical treatment is planned covering all aspects of her care, including surgery, physiotherapy and psychological counselling to assist her regain not only her health, but also her self-esteem, find meaningful employment and reintegrate to village life.

 Geoffrey Marshall with Zenebe, The Chaplain

The Hamlin now undertakes over 3000 procedures every year in Addis and its five outreach centres across the country. Women are taken (not sent) home, sometimes hundreds of miles, after weeks in the hospital, to a new life with smiles on their faces, new dresses and even new skills – like being able to read or sew. The surgery is now 95% successful, but some women will need lifelong post-operative stoma and other care; and all will need the Hamlin to provide a Caesarean section at the end of any future pregnancies.

 Meeting Dr Catherine Hamlin

With its Vision of “A world without maternal death, birth injuries or obstetric fistula”, their Desta Mender (Joy Village) for chronically injured women who find it impossible to return home and their College of Midwives, the Hamlin is now the leading obstetric fistula hospital and training facility in the world. Employing over 500 Ethiopians, Hamlin relies on the generosity of donors and visitors to continue its work in treating and preventing obstetric fistulas, ensuring Ethiopian women have holistic and compassionate healthcare.

Although her husband died some years ago, Dr Catherine Hamlin is still in Addis and is still operating. At 94 she is one of the most remarkable people I’ve ever met. Close to her I would count Zenebe Mesfin, the hospital’s full-time Chaplain, a deacon in the Ethiopian Orthodox Church.

 Zenebe welcoming McCabe Pilgrims

Zenebe has twice shown my pilgrims around this wonderful institution. He once came to Cardiff for a week’s training, but he and the Hamlin Hospital would love him to come to the UK for a year’s training in Chaplaincy, which I am trying to arrange as I write. This will no doubt cost money, which supporters of the MET might be approached to help with in future, but Zenebe’s main request from pilgrims visiting Ethiopia is that we take clothes for new-born babies – those born alive start their lives with nothing more than a desperately sick and ostracised mother.

You can learn more about the work of the Hamlin at hamlinfistula.org.

 Pilgrims on a tour of the hosptial