Hamlin Fistula Ethiopia; Light in Hell

By Muluken Tariku

“These women are the poorest of the poor. They are alone in the world with out hope, with out friends. They bear their sorrow in silent shame. Their miseries, untreated, are utterly lonely and life long.” Dr Catherine Hamlin, Hamlin Fistula Ethiopia.

After being given to a 35 years old husband, the 17 years old Yewubdar Assefa, became pregnant. Every thing went well until the day of the delivery. She had never been examined by a doctor, nor does she know what an obstetrician is. All she knew was that she is going to give birth at the mercy of a traditional midwife in her village.

She said she had been pushing for three days before she finally gave birth to a dead child. The traditional obstetrician, her mother, her husband and her parents at all were all shocked when they discovered Yewubdar had given birth to a dead kid, for such things are considered as eternal punishment. The whole family treated her nicely for few days until they feel she had finally recovered from her loss.

As days passed, Yewubdar found herself wetting her bed. She couldn’t control both her urine and stool. Her husband felt that his wife couldn’t recover for good. He took her to her parents, for he felt he no longer should stacked to a smelly and wetly wife. Besides, most people in the distant rural feel that such a pain is not natural but God’s punishment for being cursed. So who wants to be with the one who is cursed?

Anatomically speaking, women are born with a circular shaped pubic bone, which while giving birth makes the delivery easy. Men have triangular pubic bone. Unfortunately some 10-15% of women are born with a triangular pubic bone. And 5% of kids are born having unusually big-sized skull. These two are natural barriers of giving birth, which in turn would potentially cause obstetric fistula.

Yewubdar is one of the unfortunate 10% mothers who were born with a triangular pubic bone. Even worse she is from the very distant part of the country where no sufficient health centers are found. Mothers like Yewubdar, as an obstetrician from Fistula Hospital in Addis said, must give birth under a very critical follow up by doctors, for they require minor oppression to save the lives of both the infant and the mother. However, lack of knowledge, and sometimes health stations, heightens the extent by which women encounter obstetric fistula.

While traditional obstetricians try to bring out the infant through the narrow pubic opening of the mother, damage on a soft wall like structure that serves as a frontier between bladder and the lower part of the large intestine would occurs. Such a wounded opening is what professionals call an obstetric fistula. Due to the damage on this part of the woman organ, she couldn’t control herself from wetting her bed and herself.

An obstetric fistula might not be worse than brain tumor or heart failure. It might in fact be easier to mention that other fatal diseases. In agrarian community like Ethiopia, obstetric fistula is not just a physical pain, but both emotional and spiritual. One’s the woman encounters the fistula, she will be induced to unwanted person by her community. In any traditional society, abnormalities like fistula which occurs ones in a blue moon are not welcomed nor treated well.

Fistula patient, except the very few lucky ones, will not be given the desired treatment, nor they will be kept in the society. They will rather be marginalized, deprived of their dignity, outcasted, alienated, imprisoned, forced to flee and even pushed to commit suicide by the people who ones were their mothers, fathers and husbands.

“Mothers should not die while giving birth. Nevertheless when you see the survivors in our hospital, you feel the pain and the agony of the unlucky ones who passed away after giving birth to probably a dead kid,” says Feven, senior Public Relations officer for Fistula Addis. As Feven puts it, what profoundly affects the patients is not the physical pain but the emotional; instability and posttraumatic disorder they encounter.   

The pain is dual; emotional and physical. As the women couldn’t control their urine and stool and wet their beds, they feel ashamed of what is happening to them. The women then start to isolate themselves from the family. Most patients, As Feven said, think that there is no other patient of their type. It is only after they see some hundred of their type that they would start feeling better.

Some call Dr. Catherin Hamlin “The Light in Hell”, for she is the only place for the desperate ones to retreat. She has been serving these deprived mothers for several years now. Her work in Ethiopia has repaired several broken hearts. She, more importantly, has helped hundreds of thousands to feel that they are important to themselves.  The village gives them a new hope of living. The village is fully occupied by the obstetric fistula patients. The 300 beds in the wards have always been busy. Patients are grouped based on the localities they come from. Such proximity would help the women to recover sooner.

During the interview on April 2012, Yewubdar Assefa has almost recovered from her injury. Nevertheless, she hasn’t yet recovered from the emotional and posttraumatic strains she has encountered after giving birth to a dead kid. As Feven said, most women would recover in few months time from their physical injury. Most victims found it very difficult to go back to the society that deprived them of love and care

To cleanse her posttraumatic disorder and make her ready to join her society again, Yewubdar is being given continuous psychiatric treatment. As the obstetrician puts it most women fully recover after a long on going treatments. Even when they seem to feel nice, they still don’t want to go back to their place, for the old scare bounces back to them.

Hamlin Fistula hospital is currently striving to give an end to obstetric fistula in Ethiopia. For this, the institute is doing its level best in undertaking preventive projects.  Currently, the institute is operating in 9 different stations in Ethiopia. As being the only specialized obstetric fistula hospital in the whole world, the institute is taking off to the level of being a study and research center. To this end, the institute is working in collaboration with several international and domestic universities. It is giving training for post graduate students of Gondar, Addis Ababa and Jimma universities.

Hamlin Fistula Hospital in Addis is the clean, well –lighted, green village which helps the patient recovers soon. In addition to the fulfillment of medical materials, the physicians and administrative workers in the hospital is all life giving.  The free medication along with the post medication transport and other costs are all covered by the hospital. The workers treat their patients well enough until they fully recover. Such is a village of hope; such is a place of retreat; such is a person who gives a light for the forgotten and isolated ones; such is LIGHT IN HELL.