Cover Story

National Treasure

Casey-Ann Seaniger | DECEMBER 2008 / JANUARY 2009

At 84, Australian gynaecologist, Catherine Hamlin, is running a women’s hospital in Ethiopia. This Nobel Prize nominee and Oprah Winfrey guest has been described as a modern day Mother Teresa by the New York Times. Yet few Australians know about their national living treasure. Casey-Ann Seaniger sets out to discover more.

Every once in a while, a story or experience touches you in a profound way. The life of Australian gynaecologist Dr Catherine Hamlin OAM is one of those unforgettable stories.

While many doctors are lured to western countries for better money and lifestyle, Dr Hamlin has done the reverse. Catherine journeyed to Ethiopia in 1959 to fill a three year placement with her late husband Dr Reg Hamlin to treat women suffering from the debilitating childbirth injury known as fistula. The World Health Organisation has called fistula "the single most dramatic aftermath of neglected childbirth".

They founded the Addis Ababa Fistula Hospital and nearly 50 years on Catherine has operated on more than 25,000 African women.

In her mud house located on the hospital grounds, Catherine lives a quaint and fulfilling life. Aside from her work as a surgeon, she and her team have built four other hospitals across the country and founded a midwifery college.

She has become a hero for tens of thousands of African women and been hailed as a modern day Mother Theresa and a living national treasure.

Catherine’s work has also been documented in the 2008 film, A Walk to Beautiful.

For Catherine, the journey just keeps getting sweeter. At the age of 84 she still wants to do more. Dr Hamlin is on a mission to eradicate fistula injuries in Ethiopia by the end of this century. That’s heart for you. Her story captures the true meaning of what life is all about. And that is love.

Firstly, can you explain what a fistula is and how women receive these injuries?

The fistula we are treating is the hole between the bladder and the vagina, and often between the rectum and the vagina. So imagine a beautiful young girl having her first baby and she gets into obstructed labour, as 5 per cent of all women in the world do, and she needs some skilled help to get that baby delivered. If they haven’t got that skilled help, they labour day after day for up to five or six days. I had one woman who was in labour for 10 days so you can imagine the suffering. And then the baby comes out but it’s dead and she has to wait until it is smaller until she’s able to push the baby out as a stillbirth. Now she’s lost her baby. Badly damaged fistulas cause a constant stream of urine and sometimes faeces to drip wherever she goes. As a result the women are treated as social outcasts.

When you finished medical school, what made you want to go to Ethiopia?

We didn’t really plan to. I was married then and my husband said why don’t we just go and help in a developing country for a few years before we return to Australia to settle down. My husband died in 1993 but at the time we were both gynaecologists and obstetricians. We answered an advertisement for gynaecologists to found a school of midwifery in Addis Ababa, Ethiopia. We were appointed to a three year contract. We thought after three years we would go back to Australia but when we started to meet the fistula patients our hearts were broken by their conditions so we stayed on.

What’s the most rewarding part of what you do?

The reward is to see them cured and to give them some joy in their life again and reason to be alive. They are reduced to abject poverty, they’re ostracised by their societies and often deserted by their husbands because of the nature of their injuries. But when they get through our gate, their whole attitude of rejection and despair disappears and they have hope. I’ve got a fairly wonderful life among these poor women and we can do so much to help them. The terrible thing is that it’s a preventable injury and these women have been neglected over the centuries. Here we are in the 21st century and nothing worldwide is being done for these women. It is a terrible blot on our affluent societies and I’m really upset that no-one has taken this on in a big way to help.

How are the plans for the hospitals and the midwifery college going?

It’s growing enormously. We now have four regional hospitals in the country and one more being built in the south-west corner of the country. We want to do something about prevention so we have started a midwifery college to train girls from the countryside to go back as midwives into their villages. This college is going to be special because the girls will be trained to diagnose as well as be birth attendants so they can diagnose before labour starts to see if a woman is going to get into obstructed labour.

Is there any one particularly memorable patient that sticks with you?

One girl, who is now one of our good workers, was first carried to us on a goat skin. She had terrible injuries at the age of 16, delivering a stillborn baby. She’s stayed on at the hospital and learnt to do surgical procedures and has been with me for over 40 years now. The transformation in this girl is amazing. She is very special, I love her very much and she’s like a daughter to me.

What have been some of the challenging parts over the years?

We went through the Communist era for 18 years when the Emperor was deposed. It was difficult to get water, we weren’t allowed to travel and we had to get permits to even go to church. It was a pretty nasty time.

Your husband Reg, who died in 1993, was a big inspiration to you especially since this was his plan. After he died did you consider leaving Ethiopia?

Well he was the one who set everything up and inspired everyone to work for this cause. So when he died, I wondered how I was going to cope. But I had wonderful staff around me who were so supportive and I couldn’t just walk out and leave them. Patients and staff said to me “don’t leave us, we’ll all help”. There was a great spirit of comradeship in our hospital. So although I did feel depressed and that I could not carry on, I soon recovered.

So you see Ethiopia as home?

Yes, I have my house here. I have a beautiful site on the hill here and a lovely garden. I live in the hospital grounds. But I do love Australia and love going back of course and I have a son in England with four grandchildren.

You’ve been on Oprah and nominated for a Nobel Peace Prize - is that humbling?

I really don’t like receiving so much adulation from people. But I am very grateful because I know it is drawing attention to these women. After I spoke to Oprah, I got a tremendous amount of money, around $3 million, just from her viewers. Oprah also gave me a personal cheque from herself for the hospital and she came and filmed us for her show so that was a great occasion.

How is the funding for the hospitals progressing?

Australia’s provided wonderful support. The federal government has given us $2 million this year. We’ve also got a wonderful Trust in Sydney, the Fistula Trust, and they are so dedicated. We have Trusts all over the world. I would like to thank the people of Australia for their generosity and all they’ve done for these women.

And you still perform surgeries now?

Yes. We have other doctors here but I do like to get into the theatre once a week usually. But I also love doing the rounds and meeting the patients.

Do you have a motto that you live by?

I’m a Christian and I believe that God is behind this work and that’s why I’m confident it won’t fail. For me, this is everything and I just feel the spirit of God in here. The love that the staff have for these women is rare in any hospital. And this is something that keeps me going.

Do you have much more to achieve in Ethiopia in regards to prevention and awareness?

Oh yes, very much more. As more students from the midwifery college graduate, we want to send them out to their villages so they can work in the countryside. To do that, we need enormous funding. We need to provide housing and build more ante-natal clinics. In this way we hope to eradicate this terrible scourge by the end of the century. This is my dream, my passion, to deploy midwives into the countryside and for them to look after these women and get them to hospital before their labour starts.

To donate to the Fistula Foundation go to www.fistulafoundation.org/donatenow.

Dr Catherine Hamlin’s story, Catherine’s Gift (Macmillan), by John Little is available in all good book stores. RRP $32.99