Dr Catherine Hamlin AC and the late Dr Reg Hamlin OBE

Dr Catherine Hamlin, née Nicholson, was born in Sydney Australia and graduated from the University of Sydney in 1946. She met and married Dr Reginald Hamlin, a New Zealander, when they were both Senior Medical Administrators at Crown Street Women’s Hospital, Sydney.

In 1958 they answered an advertisement in the Lancet Medical Journal for an obstetrician and gynaecologist to establish a Midwifery School at the Princess Tsehay Hospital in Addis Ababa. They arrived in Addis Ababa in 1959 on a three year contract with the Ethiopian Government.

They began working in the hospital and training midwives. However, after a short while the Ethiopian Government advised the Hamlins that it would not be able to afford to pay the higher salaries of the trained midwives. Only about 10 midwives had been trained before the the Government closed the midwifery school.

By then, however, the Hamlins had seen women arriving at the hospital who were incontinent and smelling. They were outcast even by the other patients. No one at the hospital knew how to treat these women.

The Hamlins had never seen an obstetric fistula before. “To us they were an academic rarity,” Catherine recalls in her book, The Hospital by the River.

One fellow gynaecologist told them that the “fistula patients will break your hearts”. And this is exactly what they did. In response the Hamlins set about finding a cure.

Developing surgical techniques for fistula patients in 1960s

The Hamlins studied what they could from the writings of earlier fistula surgeons such as Dr Marion Sims (the Father of Modern Gynaecology) and from doctors who were still operating in places such as Egypt.

Obstetric fistula was virtually eradicated in the United States by the Twentieth Century due to improved obstetric techniques such as Caesarean section.

The Hamlin’s refined the surgical technique to close obstetric fistulae, while continuing to treat a broad range of obstetric cases. They were able to develop a delicate surgical technique to successfully repair fistulae caused by obstructed childbirth in 93% of cases.

As women returned to their villages cured, and word spread that a cure for this condition was possible more and more women arrived seeking help.

In their first year in Ethiopia, the Hamlins treated 30 fistula patients. By the third year 300 women had been healed.