The Addis Ababa Fistula Hospital and its regional Hamlin Fistula Centres offer comprehensive care for women who suffer from incontinence, physical impairment, shame and marginalisation as a result obstetric fistula.
Patients undergo surgical repair by highly skilled Ethiopian and expatriate surgeons who have had extensive training in fistula surgery at the Hospital’s main facility in Addis Ababa. Around 93% of these patients are repaired successfully.
The average stay of patients whose injuries are not too severe and who arrive for treatment in reasonably good health is around three weeks.
Other women who have more severe injuries and complications often require a more extended stay and require more than just fistula surgery. The treatment of the patients is covered below.
1. Physiotherapy
Nerve damage during obstructed labour can result in a condition known as "dropped foot". Other women have contractures of tendons and muscles in their legs and hips due to long periods of lying in bed or on a mat hoping that by doing so they will stop leaking bodily wastes. Some women arrive unable to walk. It may take more than 6 months of physiotherapy before such women can regain the use of their legs and are ready for surgery.
2. Stress Incontinence Management
Some women have damage to the nerves and muscles that control the operation of the bladder and urethra. Some repair is possible but further treatment and exercise of the relevant muscles can make a difference. The Hospital has a special clinic devoted to this work.
3. Stoma Patients
Some women are so extensively injured that their bladders are almost completely destroyed. These patients can be offered further surgery to divert their urine into a bag through an opening in the abdomen. They need specialist counselling and training to enable them to live with this condition. Returning to a remote village in the countryside is difficult because of the increased risk of infection and the requirement for a supply of clean bags. The Hospital has established a purpose built village, Desta Mender, for these women. The village provides long term accommodation and special training programmes in life–skills and income–generation.
4. Psychological Counselling
Most of the women who come for treatment have suffered great loss (a child, husband, femininity and sense of worth) and may have been isolated from family life. These women need specialist care. The Hospital has a psychiatric nurse who assesses the needs of each patient and ensures that these are recognised and that appropriate treatment is provided.
5. Extended Medical Care
Many women arrive suffering from other medical ailments that may or may not be connected with their fistula and consequent isolation from their communities. The Hospital offers treatment and nursing care for malnutrition, anaemia, parasites, skin conditions and more serious problems such as TB, malaria or kidney failure. If necessary the Hospital pays for their referral to other specialised clinics. All the Hospital’s nurses aides are former patients, who because of their own experience, know and understand the condition and the suffering of the women for whom they are now caring.
6. Education
The Hospital has teachers who offer to patients literacy classes in the main languages of Ethiopia. They also give basic health education. All the women who come to the Hospital have the opportunity to learn embroidery, knitting, basket–making and other crafts. Their work can be sold or taken home with them. This keeps them active and gives them new skills. It also facilitates them to mix and socialise in beautiful and peaceful surroundings with the other women who have experienced similar trauma and this is an important part of the healing process.
