Award Winner CATHERINE HAMLIN (Ethiopia)

Posted on by October 13, 2009 by Karin Styrenius

Catherine Hamlin (Ethiopia), the 2009 Right Livelihood Award “…for her fifty years dedicated to treating obstetric fistula
patients, thereby restoring the health, hope and dignity of
thousands of Africa’s poorest women”.

Catherine Hamlin came to Ethiopia from Australia in 1959 to work as an
obstetrician and gynaecologist at a hospital in Addis Ababa. With her husband
Reginald she pioneered the surgical treatment of obstetric fistula. The Hamlins built
their own hospital in Addis, where women are treated free of charge. The facilities
include reception hostels for the women, who come from all over the country, and a
rehabilitation centre for the badly injured. They have also established regional
centres to make the treatment more widely accessible and a midwifery school to
help prevent obstetric fistula occurring in the first place.
Catherine Hamlin was born in Sydney in 1924. In 1959, she left Australia together with
her husband Reginald in response to an advertisement to work as
obstetrician/gynaecologist at a hospital in Addis Ababa, Ethiopia. The couple was
horrified by the prevalence of obstetric fistula, a condition arising from prolonged
obstructed labour that leaves the affected woman incontinent of urine, with 20% suffering
bowel incontinence as well. Permanently leaking bodily fluids, they often become social
outcasts, without hope, and live in the most miserable conditions. Obstetric fistula,
formerly common throughout the world, is now almost non-existent in industrialized
countries, thanks to better obstetric care, but is still prevalent in developing countries.

Pioneering fistula treatment
At the time the Hamlins started their work, 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% 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
Recognising that they needed their own hospital, the Hamlins went fundraising abroad.
Eventually, in 1974, Addis Ababa Fistula Hospital was opened. Since then, it has become
a global centre of expertise in fistula repair and also trains surgeons. In addition to the
main hospital in the capital, there are now, in 2009, five regional hospital centres in other
Ethiopian cities to make the treatment more widely accessible. Their doctors treat 2,750
women per year – about 29% of new fistulas in Ethiopia – and have treated over 32,000
women in total. They have also built Desta Mender – ‘Village of Joy’ – a rehabilitation
centre for women so badly injured that they need long-term care.

Hamlin also focuses on the important area of fistula prevention with the establishment of
the Hamlin Midwifery College in Addis Ababa. The midwives will be 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.
The hospital and associated activities have about 400 staff and cost more than EUR 1
million per year to run. Catherine Hamlin, while still also operating on patients, spends 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.
Funds come from eight international partner organisations (that in Sweden has 70,000
members) and major charities. The Australian Government is also a key supporter.

Honours and books
Hamlin has been 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). In Australia, her book The Hospital by the River
became a best-seller.

Quote
Catherine Hamlin chose to quote the British fistula surgeon, Professor Chassar Moir of
Oxford, who summed up the ethos of fistula treatment:
“Nothing can equal the gratitude of the woman, who wearied by constant pain and
desperate with the realization that her very presence is an offence to others, finds
suddenly that life has been given anew and that she has once again become a citizen of
the world.”