Pioneers saved thousands

Rachel Pindar
Catherine Hamlin could be hailed as a new Mother Theresa.
Dr Hamlin , 82, and her Napier-born obstetrician husband, the late Reg Hamlin, pioneered the development of fistula surgery in Ethiopia, saving thousands of women from pain, exile and even death.
The couple went to Addis Ababa in 1959 on a three-year contract to establish a training school for midwives. But the plight of women who had severe problems giving birth touched their hearts so deeply that they found themselves unable to leave.
Pregnancy and childbirth in developing countries presents a far higher risk to women than in the West. Some women are married very young, with an underdeveloped and small pelvis, so the risk is increased.
Many areas of the country are extremely remote and often inaccessible. Antenatal care is seldom available, and if problems occur during labour, swift transport to hospital or for medical assistance is almost impossible.
A mother with a small or malformed pelvis or a badly positioned child may be in labour for five days or more without help, before a stillborn child is delivered. In most cases, the traumatic birth results in a hole, or fistula, in the bladder and at times a similar fistula in the rectum. These problems are unknown in New Zealand because of good ante-natal care, easy access to hospitals, and the use of caesarean sections or other interventions in the case of difficult births.
But in developing countries, the lack of education and lack of access to medical facilities, especially in rural areas, results in hundreds of thousands of women experiencing a fistula every year.
In Ethiopia alone, the number is estimated at 9000 new cases each year. The consequences for the women are horrendous. They smell because they are unable to control their urine and have a constant leakage of waste material from their bladder or bowel, or both.
The women are often abandoned by their husbands and driven out by villagers. They become outcasts and are forced to live in huts at a distance from their families. Life for them is so devoid of hope that some opt for suicide.
Dr Hamlin said that, in 1959, she felt an overwhelming compassion, along with a professional challenge to develop surgical techniques to relieve their suffering.
"Specialist surgery can successfully repair a fistula in about 90 percent of cases, restoring the women with the prospect of marriage, children and a normal life," she said.
"However, the difficult nature of the surgery and the lack of hospital facilities in developing countries mean only a minority of fistula patients receive treatment. Alongside the need for enhanced surgical facilities to treat existing cases is the need to develop health-education programmes and good natal care to minimise the number of new cases."
At first, she worked with Reg from the Princess Tsehai Memorial Hospital in Addis Ababa, where they carried out fistula repairs to 32 women in the first year. By the third year, they had healed 300 women. They perfected the delicate surgical procedure, which takes one to three hours.
In Ethiopia, as word spread that there was a cure for this condition, more and more patients arrived, but there were not enough beds at the hospital.
Dr Hamlin explained that at that point, she and her husband agreed they must find another hospital.
"This new hospital would be a sanctuary and a haven, where women would be welcomed, and because they were so poor, they would not have to pay," she said.
Permission was granted by Emperor Haille Selassie to buy land, but money was needed for it and to construct a hospital.
The Hamlins set out on a world fundraising tour and after receiving a £10,000 grant from the New Zealand-based Council of Relief Services Organisation (CORSO) in 1968, the Fistula Hospital finally became a reality in 1974.
Their work continued uninterrupted, despite political upheavals and civil war.
More than 30 years later, women continue to make amazing journeys to be operated on at the Fistula Hospital. One woman crawled on hands and knees 15km from her village.
The hospital has greatly expanded and outreach hospitals have been set up to serve remote areas. The number of patients now being treated each year is 1200-1400, while preventative health-education programmes are also being developed. The success rate is 93 percent, and it is estimated that more than 27,000 women have now been treated.
Dr Hamlin is currently staying in Napier with her niece, Cynthea Greene. Her son, Richard Hamlin, has also flown over from London for her visit. Cynthea, president of the Taradale Club, had not seen Dr Hamlin since 1989, and picked her up from Hawke's Bay Airport on Tuesday.
"I'm absolutely elated and overjoyed ... it is wonderful to see her for the five days she is in Napier," she said.
Reg Hamlin died in 1993, but Catherine continues her involvement.
"The need will continue for years, until all Ethiopian women in labour have easy access to a hospital for medical assistance," she said.
Dr Hamlin will speak at Hawke's Bay Hospital today at 5.30pm. Open to public, $5 entry.