Dr Hamlin’s Letter
My Dear Friends in Australia
I write sitting in my son and daughter-in-law’s new home in the beautiful County of Shropshire in England, recuperating from a recent operation for a new right hip. My left hip was done some years ago. So now both hips are new and, so far, working well.
An English Spring
This is a perfect spot to convalesce, with Spring beauty still so evident. Primroses and bluebells are still blooming on the banks of many lakes and, of course, the woodland areas are ablaze with them, especially the blue bells. While in hospital I saw an amazing coloured photograph in an English newspaper. It was of three huge lions resting in a bluebell wood, looking quite at home, and I am sure enjoying the scent and beauty. So different from the scrub of their African homeland! I expect the photograph was taken in a British game reserve.
I was quite a cripple when I left Addis Ababa several weeks ago so I hope that when I go back I shall be walking normally and not clinging to my recently installed path rail to go up to the hospital. It is good that my son, Richard, will be with me for a week, as there are some important Trustees meetings for us to attend.
In hospital I was well looked after and had visits from my grandchildren and other family and friends. I watched the
British election scenario on television and read about it in
the newspapers. I have had cards and many phone calls and messages from the hospital staff back in Addis Ababa. Some have been so touching. They have also sent encouraging news about patients with many special ones being cured and sent home whilst I have been away. I have also had many kind messages from people in Australia and I thank you for these. They have been very encouraging and thoughtful.
When I left Addis Ababa, Dr Tom Rassen was with us. He worked in Kenya for many years and now though retired from the Flying Doctor Service he is still living in Nairobi. He misses his fistula work especially and so he kindly comes up to help us from time to time. He is always welcome and he is an accomplished and excellent fistula surgeon.
A ‘rather special’ patient
Before I left Ethiopia a poor patient arrived with a fistula and a hare lip. Her name is Chuchu Sadi Daka. I cannot recall ever seeing such a deformity before among any of our patients. So she was rather special. She is 30 years old and came from the western part of the country almost as far as the Sudan border. Three years ago she had an obstructed labor with her first pregnancy. She was in labor for more than two days and her baby died at home. After discovering her incontinence her husband divorced her and she had been shunned till missionaries found her and brought her to our hospital in
Addis Adaba.
We were able to cure her fistula and a kind plastic surgeon from the CURE hospital in Addis Ababa treated this poor woman’s lip. He charged her no fees for her admission or the operation even though it is a private hospital. The surgeon was from South Korea originally but lived and trained in America before coming to Addis Ababa. We knew him from our church and all this was arranged after a Sunday morning service! Chuchu spent only a few days at the other hospital and was soon back with us. She stayed until her lip was perfectly healed – both top and bottom cured! We gave her a mirror and often saw her gazing into it and smiling for the first time! We sent her home, with mirror in hand, and hope that she may marry again and, perhaps, come back to us to deliver her first live baby. But this will probably depend on the mission who paid her original bus fare being able to send her back to us.
Committed staff
I left the Hospital in capable and committed hands with the staff really taking a much bigger part and being given more responsibility – often a nurse or post-graduate student gives a weekly short talk on some recent relevant topic or research they may have done. It is exciting to see them becoming confident in delivering a paper, and really taking pride in the Hospital and its work.
A joyful place
We have, as I am sure many of you know, a special 10 bed ward for any pregnant women who come back to us after previously having had their fistulas cured. We call this the Bethlehem Ward. It is a lovely sunny ward opening at one end on to a paved stone area where the young women can sit and knit or gossip as they wait for their labour to begin or to convalesce with their new babies after a safe delivery.
We don’t do caesarian sections at our hospital but send the women to another hospital for the procedure. They then come back to us with a live baby to convalesce and learn how to look after their new born until they are strong enough to make the often long bus journey home. So it is really always a joyful place to visit in our hospital grounds!
Occasionally we have to do a caesarian section if it is urgent, and on rare occasions we deliver a baby normally often in the Outpatient Department!
This ward is part of a 30 bed building many of you in Australia helped to pay for some years ago. We and the women who come to the Hospital continue to be enormously grateful for this as we are very grateful for so much else you have done and are doing to help us.
Special praise for midwifery training
Our Midwifery College is progressing well under the new Dean of the College Jacqueline Bernhard and Annette Bennett who is now the Vice Dean. To see our first batch of pupils graduating at the end of September will be a milestone for me especially as my late husband and I were originally employed by the Ministry of Health all those long years ago to start a Midwifery School for nurses – then through a lack of funds it was closed. But by then we had met the fistula sufferers who took over our interest and our lives!
The Tutors at the College have all been encouraged and excited by special praise from the Minister of Health, Dr Tedros, who said after a visit to the College and an interview with several students “This school should be the model for all future ones in this country!” What a great encouragement. Especially for the students who at first wanted to sink back into the methods taught here at other schools! We hope that some more of the new College buildings will be finished before “the rains” start at the end of June - although I hear the “small” rains are still dribbling on. These have kept the lawns emerald green and the garden looking its best.
The main message I send you is that all is well at the Hospital – our staff, both medical and administration are all working well, and also at our four other functioning Fistula Centres. Metu, our fifth regional hospital will be opened soon. It will have two gynaecologists from the general local hospital. They are now trained in this special surgery and they are already aclimatised to the isolation of such a far away location!
My prayer is that we shall all continue to work with the love and compassion we need, and that God will bless this work as He has ever done in the past.
With love to you all,
Hospital update from Mark Bennett, CEO, and Professor Gordon Williams, Medical Director
The time it takes for a woman with a fistula to reach our hospitals varies enormously. It can range from just a few months to around forty years.
Patient survey
The Hospital has been surveying the women who come to it in order to better understand the factors which affect the ability of women to seek help.
Two thirds of the patients surveyed had been suffering from obstetric fistula for between five months and five years. The remaining women surveyed had suffered from six to 36 years. A third of patients said that the delay in arrival was for financial reasons and a quarter of the women said that it was due to social reasons. Some patients thought that the fistula would heal spontaneously; with one woman having been told this by another hospital. Others said they had been told that fistula is incurable.
Seasonal variations are also important. Ethiopia has a rainy season which usually starts towards the end of May and goes through to the end of September or early October. The rains often make the dirt roads impassable. Planting and harvesting is also a busy time when women find it difficult to travel as there is usually no one available to help them make the long arduous journey to the nearest fistula centre or Addis Ababa. In 2009 the rains seemed to go on forever and merge into the harvesting season. This may explain why our hospitals were relatively quiet in the last three months of 2009. However more recently in Addis Ababa we have had our busiest months ever, particularly February and March with patients often having to share a bed!
Most patients surveyed heard about our hospitals from friends and relatives. Others hear about the help we can provide from former patients or through our regional radio broadcasts. Many need financial assistance to make the long journey to our hospitals and our new brochures and referral cards will state that the Hospital will reimburse travel costs. Radio broadcasts need to be widened to cover the whole country and we have hired unemployed girls as focal fistula persons in Tigray. They will seek out women who are leaking and let them and others know where they can be helped. Already this is resulting in significant increases in patient numbers at the Mekelle Centre.
In recent months over 700 procedures have been conducted by the Hospital. We are also planning to expand education about fistula amongst health extension workers, women’s associations, traditional birth attendants and many other groups that come in contact with fistula patients.
Other projects
We recently visited the new Hamlin Fistula Centre which is being built in Metu, in the west of the country. It is coming along well. The Hospital is also working with the Norwegian Lutheran Mission on a fistula treatment project in Arba Minch in the far south of the country. There we are sponsoring treatment through USAid and supplying training and follow up.
We are also delighted with the new physiotherapy and patient education centre which has been opened at the hospital in Addis Ababa. This will give more space and attention to handling foot drop and contractures, and it will allow us to focus more on exercises to aid in improving continence.
Other projects continue to expand our work including the new classroom and administration building at the Hamlin College of Midwives and the maternal health expansion in Bahir Dar. Plans for extending our fistula treatment in Bahir Dar are almost complete and should commence soon. These two projects should bring significant benefits for improved maternal health to women in the Amhara region which has a population of around 20 million people.
Our training programmes are in full swing and recently we received two trainee doctors and nurses from Sudan. We are keen to have an ongoing partnership to develop the capacity to treat injured women in the South of that country. We hope to follow up this training with a visit later in the year.
We hope that with all these activities and others the amount of time a woman remains incontinent with obstetric fistula is significantly reduced and that we can continue to improve the care the Hospital provides and, of course, prevent these tragic injuries.
Mark Bennett – Hospital CEO
Professor Gordon Williams - Medical Director
Fund News
In recent months the Australian Fund has assisted the Hospital by providing funds: to purchase the medical equipment for the new centre at Metu; to construct the new classroom and accommodation buildings at the Midwifery College; to purchase ambulances as part of the midwifery deployment strategy; to purchase filtration equipment to improve the water supply at two of the Hospital’s regional centres and to acquire and install new computer equipment for the Hospital’s administration.
This assistance has been made possible through the generous support of the Hospital’s Australian supporters. On behalf of the Hospital, the Fund sincerely thanks all those who have contributed to assisting the Hospital’s work in these ways.
New website
The Fund recently launched its new website at www.hamlinfistula.org.au
The Fund expresses its grateful appreciation to Lucy and Bruce Perry for donating the services of their company Pure Graphics, to design this new look website. The Fund also thanks their graphic designer, Adam Dipper, and the Fund’s publicist Alexandra Cordukes who collaborated to develop the new look.
Hamlin Fistula® International Foundation
Dr Catherine Hamlin AC and the Trustees of the Addis Ababa Fistula Hospital have established the Hamlin Fistula® International Foundation with the aim of ensuring that the work of the Addis Ababa Fistula Hospital can continue well into the future. The income earned on funds which are conservatively invested by the Foundation is used to assist in paying some of the Hospital’s running costs.
If you would like your tax deductible donation to be directed towards supporting the Hospital through the Hamlin Fistula® International Foundation then tick the relevant box on the attached donation slip or complete the message box when making a donation via the website www.hamlinfistula.org.au .
