Hope and Healing for Ethiopian Women

A pioneering and globally renowned surgical technique

Dr Catherine and Reg Hamlin’s pioneering surgical techniques have been recognised globally by the American College of Obstetricians and Gynaecologists, the Global Health Council for Best Practices in Global Health, the Royal College of Surgeons of Edinburgh and the Australian Medical Association. Dr. Catherine Hamlin herself received the Distinguished Surgeon Award from the Society of Gynaecologic Surgeons in the USA.

Hamlin’s impact extends beyond Ethiopia’s borders, with surgeons from numerous developing nations visiting and training at the hospital. Pioneering new surgical interventions are being developed through Hamlin’s Urogynaecology Fellowship, which provides surgeons with advanced, specialised skills to treat complex, urogynaecology conditions to restore continence, achieve safe diversion, preserve renal function and improve quality of life.

Preventing Obstetric Fistula Through Midwifery

An estimated 31,000 women still suffer from untreated birth injuries, with around 1,000 new cases each year.

The root cause of fistula is a lack of access to quality maternity care. In rural Ethiopia, 50% of women give birth without a midwife or doctor present.

From the beginning, Dr Reg and Dr Catherine dreamed of training midwives as part of the program of prevention throughout Ethiopia. Catherine opened the Hamlin College of Midwives in 2007. Since then, 271 Hamlin Midwives have graduated and are making a significant impact in rural communities, drastically reducing rates of fistula and providing quality maternal health care.

The Hamlin College of Midwives recruits students from rural areas, puts them through rigorous training as midwives, and deploys them back to their villages where their skills are needed.

There are currently 92 Hamlin-supported midwifery clinics in rural health centers staffed by Hamlin midwives.

The downstream effects of a Hamlin midwife are remarkable; when a Hamlin midwife arrives, new cases of fistula drop to almost zero in nearby villages. These centers are key to prevention.

Hamlin Fistula New Zealand’s focus is on preventing fistula through increasing the number of dedicated midwifery centers and training of skilled midwives.

The introduction of a master’s postgraduate course in clinical midwifery course, launched in January 2022, is equipping senior midwives with advanced clinical practice skills, including the skills to perform emergency caesarean deliveries for complicated cases. This will empower midwives in preventing maternal death and injury among vulnerable rurally based women, who are unable to make the journey to a Hamlin Hospital.

In 2024 alone, Hamlin midwives provided safe birth care for 35,648 mothers and babies and antenatal care to over 47,000 women.

A Midwife Hero

Young Hamlin midwife Tisita, at 23, already exhibits the hard work ethic and heroic attitude inspired by her own heroine, Dr Catherine Hamlin.

Four hours and 86km of gut twisting 4-wheel drive travel away from the Hamlin hospital in Harar, Tisita is the sole midwife in a Hamlin midwifery centre in Dogu. There used to be two other midwives employed by the District Health Board (DHB), but they have moved on and the DHB has not replaced them.

We would never guess that she is managing 60-70 births a month on her own – as well as antenatal, postnatal, and family planning visits. Everything is basic but immaculate, with equipment carefully organised and blankets neatly folded on the beds. She proudly shows us around the delivery room recently equipped by Hamlin. Drawn on the wall above her head is a heart-felt motto to be shouted loud by any midwife or doctor, “Zero tolerance for death of mother.”

Although working in extremely challenging conditions, as most Hamlin midwives do, of sporadic water supply, irregular electricity, remote and isolated work-places and national shortages of drugs and equipment, we hear no complaints from Tisita.

Her eyes light up and her face shines as she tells us of her desire to perform more community outreach: providing health education in the community and encouraging young mothers to use the pregnancy and delivery services of the midwifery centre. She is bursting at the seams to share her knowledge. Travel out is frustratingly hindered by having no midwife to relieve her and by the distance limitations of travel by foot.

Tisita is just one of our many midwife heroes.

Project Zero

Hamlin Fistula Ethiopia is determined to accelerate the rate of change for the women of Ethiopia.

In a country of 130 million people, most of whom live in rural areas, finding and treating women living with obstetric fistula has always been a significant challenge. Project Zero is an ambitious yet achievable program that adopts a systematic approach to treatment and prevention.

Using a Woreda-by-Woreda (district) approach, Hamlin-trained teams will visit each and every household, in both rural and urban areas, to find women living with an obstetric fistula injury, and organise care and treatment.

At the same time, we will strengthen maternal healthcare services within Ethiopia, to reduce the incidence of birth injuries, and our national education campaign will give women the tools and knowledge they need to give birth safely. Project Zero encompasses a three-part approach:

Identification: Hamlin-trained health workers and patient identification officers will undertake community outreach and household surveys in all 800 Woredas (or districts) of Ethiopia to identify women living with fistula and transfer them for immediate treatment at one of Hamlin Fistula Ethiopia’s six hospitals. Women with long-term injuries will also be able to access the rehabilitation and reintegration services offered at Desta Mender.

Prevention: To improve maternal healthcare and outcomes for women, Hamlin Fistula Ethiopia will expand its prevention program, with the goal of establishing a midwifery clinic in every Woreda, staffed by Hamlin-trained midwives. The Hamlin College of Midwives curriculum meets the stringent standards of the International Confederation of Midwives, and the College will play an important role in training new midwives for Woredas around the country.

Education: A country-wide community education campaign will raise awareness on safe delivery methods, obstetric fistula and other birth injuries, and the treatment options available to women. We will highlight the importance of seeking professional medical care during pregnancy, labour, and after birth. Training will also be given to existing healthcare professionals, so that they have a deeper understanding of birth injuries and can advise their patients of treatment options.

How You Can Help

Together, we can ensure that no woman suffers needlessly from preventable childbirth injuries.

Here’s how you can make a difference:

Donate or become a regular giver to fund life-restoring surgeries and midwifery training.
Donate a Comfort Pack for patients arriving at a Hamlin fistula hospital.
Sign up to receive our newsletters and updates to stay informed and help spread the word.
Fundraise for Hamlin by hosting events like a High Tea for Hamlin, or participating in a Barefoot Walk.
For the more adventurous, experience our work first-hand by joining a 13-day Hamlin Ethiopian Adventure which departs every March and November.