The Anglo-Ethiopian Society

Lecture - Tuesday 13th February 2007

20 years of visiting the Fistula Hospital in Addis Ababa - an illustrated talk

Given by - Prof Gordon Williams

Reviewed by - Julian Kay

“Mourning the stillbirth of their only child, incontinent of urine, ashamed of their offensiveness, often spurned by their husbands, homeless, unemployable, except in the fields, they endure, they exist, without friends and without hope. They bear their sorrows in silent shame. Their miseries, untreated are utter, lonely and lifelong”. These were the words of Reg Hamlin read in Amharic before the Emperor when he received the Haile Selassie humanitarian prize in 1972.

For over 20 years Professor Gordon Williams of the Department of Urology at the Hammersmith Hospital in London has been visiting the Fistula Hospital in Addis Ababa. There once, and sometimes twice, a year he voluntarily gives his time and skills operating on many poor fistula pilgrims as well as teaching the doctors. The young girls who reach the hospital have taken weeks, months and in some cases years to get there, hence the soubriquet ‘fistula pilgrims’ which Reg Hamlin called them.

Gordon Williams has done, and continues to do, valiant work for this very special hospital. It was he who in 1992 persuaded the BBC that it should make a documentary about the hospital and the work of Reg and Catherine Hamlin who have cared for the young victims of unattended childbirth since their arrival in Ethiopia.

The talk on the 13th February is the second time that he has addressed the Anglo- Ethiopian Society and it was illustrated by some very graphic slides. It was moving, at times harrowing, but left the audience with some hope and optimism for the future.

He shared with the audience the holistic approach to the care of these girls taking account of the whole patient - body, mind and spirit, not merely the physical part needing to be repaired. The patients mainly have ruptured bladders, but sometimes also ruptured bowels as a result of trying to give birth before the body is physically capable of doing so and without well-trained birth attendants. The patients who can be operated upon successfully leave the hospital after convalescence in a condition completely opposite to the one in which they arrive.

The enormity of the problem in Ethiopia and the wide distances that young girls with this condition have to travel to get treatment has led to outreach centres being set up in different parts of Ethiopia where many girls can be treated. They are overseen by the Fistula Hospital in Addis Ababa, and patients are referred to the capital only if necessary.

Despite the worldwide acclaim given to the Fistula Hospital (“Dr Catherine Hamlin is the new Mother Theresa of our age” proclaims the New York Times) there is still no-one in the rural areas trained to support women/girls in childbirth. Additionally, young girls, some hardly in their teens, are married too early even though this is now against the current Ethiopian government law. It will take many heroic priests and community leaders to urgently begin to speak out about this ongoing practice.

However, in the course of his work Gordon Williams has met a number of young women who have not had a formal education but who have been trained to undertake surgical procedures, some even better than himself!

Having witnessed this he envisages a situation where local people from the rural areas can be trained in a limited number of surgical techniques that would not only avoid fistulae in the future but also help to decrease both the infant and maternal mortality rates. Gordon Williams is about to become dean of a new medical school in Addis Ababa and he will be seeking people with technical skills that require hand, eye and foot coordination who can be trained to carry out emergency surgery (he jokingly mentioned bus drivers as they have such skills and at the heart of their work is a concern for the safety and well-being of their passengers). This would provide a large cadre of people similar to the bare-foot doctors in other developing countries.

So the challenge is on to wean people away from harmful traditional practices such as early marriages and to train new healthcare workers from outside of the existing professional groups to live and work in the rural areas. He leaves to begin this challenge later in 2007.

To learn more about the Fistula Hospital, or to support its work, the easiest way is to contact the English support arm:

The Hamlin Churchill Childbirth Injuries Fund (HCCIF)
Broadfield House
Popes Lane
W. Midlands
B69 4PA
Tel: 0121 544 7772
Website: HCCIF

First Published in News File Spring 2007

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