Wednesday, February 26, 2014

Dr. Catherine Hamlin

At 90, This Doctor Is Still Calling

Photo
Dr. Catherine Hamlin set up a hospital in Addis Ababa, Ethiopia, years ago to repair fistula injuries in women. Dr. Hamlin, seated center, was given a party for her 90th birthday last month and was honored by colleagues and former patients. Credit Joni Kabana
We in journalism tend to cover airplane crashes, corrupt officials and loathsome criminals with gusto, but let’s take a break and applaud a hero.
Catherine Hamlin, an Australian gynecologist who has spent most of her life in Ethiopia, is a 21st-century Mother Teresa. She has revolutionized care of a childbirth injury called obstetric fistula, which occurs when the baby gets stuck in the birth canal and there is no doctor to perform a cesarean section. As many as two million women(and often young teenage girls) worldwide suffer from fistulas. The babies die, and the woman is left incontinent with urine and sometimes feces trickling through her vagina.
She is stigmatized. She smells. She is ashamed.
Dr. Hamlin and her late husband, Reg, set up a fistula hospital in Addis Ababa, Ethiopia, and their work proves that it is possible to repair the injuries cheaply. This hospital trained generations of doctors to repair fistulas and provided a model that has been replicated in other countries.
At a 90th birthday party for Dr. Hamlin in January, former patients cheered as she blew out 90 candles on a cake. Her son, Richard, referring to the patients she has helped, declared: “Catherine has one son and 35,000 daughters.”
Dr. Hamlin gave the crowd a pep talk about the need for a big push to improve the world’s maternal care. “We have to eradicate Ethiopia of this awful thing that’s happening to women: suffering, untold suffering, in the countryside,” she said. “I leave this with you to do in the future, to carry on.”
Ethiopia this month nominated Dr. Hamlin for the Nobel Peace Prize, and she deserves it. I hope she gets it along with other extraordinary leaders in women’s health such asDr. Denis Mukwege of CongoDr. Hawa Abdi of Somalia, and Edna Adan of Somaliland.
One of the most striking features of Dr. Hamlin’s work is the way she empowers recovering fistula patients to help in the treatment of others.
Mahabouba Muhammad was sold at age 13 to be the second wife of a 60-year-old man. She became pregnant, delivered by herself in the bush and suffered a severe fistula. Villagers, believing Mahabouba to be cursed, left her for the hyenas. But she fought off the hyenas and — because nerve damage from labor had left her unable to walk — crawled for miles to get help. At Dr. Hamlin’s hospital, she underwent surgery and now is a nurse’s aide at the hospital.
Another former fistula patient is Mamitu Gashe, who helped doctors during her recovery and was soon recognized as a first-rate talent. Mamitu was illiterate but learned to perform complex fistula repairs and, because the hospital does so many, has become one of the world’s experts in fistula surgery.
When distinguished professors of obstetrics from around the world come to this hospital for training in fistula repair, their teacher has often been Mamitu.
Dr. Hamlin has had difficult moments, including upheavals in her hospital organization, but through it all has relentlessly focused on helping rural women. She also trains professional midwives and posts them in underserved areas — because 85 percent of births in Ethiopia take place without a doctor or nurse present.
Lack of medical care makes reproductive health in poor countries a human rights catastrophe. One fistula sufferer told me how her husband abandoned her and her parents built a separate hut for her at the edge of the village so that no one would be bothered by her smell. She barely ate or drank because everything she consumed would soon be trickling down her legs. She fell into deep depression.
“I just curled up for two years,” she said. Finally, her parents heard about Dr. Hamlin’s hospital and she was repaired.
The cost of a fistula surgery? About $500 to $1,000.
Dr. Hamlin’s hospital is supported in the United States by Hamlin Fistula USA, whilethe Fistula Foundation supports fistula repairs worldwide.
In much of the world, the most dangerous thing a woman can do is become pregnant, and 800 die daily in childbirth. Many more suffer injuries. Liberals and conservatives joust over abortion policies, but the basic task of making childbirth safer never gets adequate attention or resources. Bravo to Representative Rosa DeLauro, a Democrat from Connecticut, for preparing legislation that would support global efforts to prevent and repair fistulas.
It was Dr. Hamlin who first put the issue on the global agenda, and she’s not stopping. “We’re trying to prevent these injuries and wake up the world,” Dr. Hamlin told me this week.
So for just a moment let’s take a break from covering villains and join in celebrating a doctor who has saved the lives of vast numbers of women — and now counts some of them as colleagues.

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