The Addis Ababa Fistula Hospital is an innovative non-for-profit hospital in Addis Ababa, Ethiopia that treats obstetric fistula, a humiliating and unsanitary condition caused by prolonged or obstructed labor.
What Is Obstetric Fistula?
Cesarean sections have become so common in industrialized societies that many patients, doctors, and other health professionals consider them to be overused. However, in about 5% of all labors, the mother is unable to give birth without assistance. A normal labor lasts about 12 hours. Thanks to the widespread availability of Cesarean sections, many women living in industrialized societies have forgotten that troubled labors can stretch on for a week or more of agonizing pain. If the woman survives this ordeal, she will finally give birth to a baby that is already dead, and she will have a high risk of developing an obstetric fistula. An estimated 2 million women live with obstetric fistula worldwide, with another 100,000 new cases every year.
Obstetric fistulas occur when the baby’s head presses against the tissues of the birth canal during prolonged or obstructed labor, cutting off blood circulation to the region. If this lasts for more than a day or two, the tissue will die, rot, and fall out, leaving a fistula, or hole, between the birth canal and the bladder and/or rectum. Urine and/or feces will pass uncontrollably through the hole. The condition is not only unsanitary, it also frequently results in social ostracism for the victim due to the unpleasant odor and uncleanliness associated with the condition. In many cases, victims are abandoned by their husbands and families. In others, the may spend long periods curled up on a mat waiting for urine to dry up. Over time, this can lead to muscle atrophy and other health problems.
Obstetric fistulas are easily preventable with good maternal care, but most of its victims are the rural poor, who may live hours or days from the nearest hospital. Fistulas are also more common among child brides and other pregnant teenagers, and women whose bodies and pelvic development have been stunted by poor nutrition or overwork. Most fistula victims give birth attended only by another woman from their village, and may not even be aware that medical assistance is possible.
How The Addis Ababa Fistula Hospital Helps
Fortunately, fistulas are also easily curable in more than 90% of cases. A simple surgery is all that is required. The Addis Ababa Fistula Hospital, founded in 1974 by Drs. Reginald and Catherine Hamlin, is one of the leading hospitals worldwide for treatment of fistulas. Its innovative programs restore health and dignity to fistula patients, and provide a comfortable and productive life for women suffering from incurable fistulas.
The hospital’s main program is the treatment of fistula patients – more than 6,000 every year. In addition to the basic fistula repair surgery, the hospital also offers physical therapy for women who have difficulty walking due to contraction of the tendons and muscles, stress incontinence management therapy for women whose bladders have become weakened as a result of the condition, psychological counseling, and more. The hospital also treats patients for existing illnesses and other health conditions that are not related to the fistula, such as malnutrition, parasites, and even tuberculosis. A patient who is otherwise healthy may leave the hospital in as little as three weeks; more serious cases may take six months or more.
The hospital is dedicated to improving its patients’ lives in other ways as well. Before their operation and during their recovery period, women have the opportunity to take classes in basic literacy, embroidery, knitting, basket making, and other skills that will help improve their income or quality of life. These classes help keep them active and give them something to focus on besides their injury. They are also provided with some basic health education to help them educate other girls and women in their village about fistula prevention, maternal health, and other issues, as well as being more prepared for any future births they may experience themselves.
Women with the most serious and incurable cases are offered a place in the hospital’s long-term care facility, and are given food, shelter, and education. Many of the women are trained to become nurse’s aids or to perform other duties around the hospital, and all of the hospital’s more than 100 nurse’s aids as well as several other staff members of various types are long term patients. The hospital also operates a 60 acre long term care facility outside of Addis Ababa that can house up to 100 long term care patients. The women tend gardens, orchards, poultry, and dairy cows, or do crafts or cooking. The profit from these income generating activities is enough both to cover their living expenses and provide them with an income of their own to do with as they see fit.
Some of these long term care patients have been able to return home in recent years due to the five mini-hospitals now built around Ethiopia, which allows them to receive fresh urostomy or colostomy bags and other supplies they may need closer to home. These mini-hospitals also expand the number of women the hospital is able to treat and aid fistula prevention by offering care to expectant mothers at high risk of obstructed labor, as well as health education and training to surrounding communities.
Other programs include training doctors and other medical professionals in fistula care and prevention, researching and developing new clinical techniques in fistula treatment, and training midwives to assist with births.
How You Can Help
The Addis Ababa Fistula Hospital accepts donations through a number of different partner trusts, including Hamlin Fistula UK, Hamlin Fistula Relief and Aid Fund (Australia), and The Fistula Foundation (US). The Fistula Foundation also supports the work of a number of other fistula hospitals around the world, including hospitals in Afghanistan, Bangladesh, and the Congo. Like Dr. Catherine Hamlin and the late Reginald Hamlin, Dr. Denis Mukwege of the Panzi Hospital in the Democratic Republic of Congo has become recognized as an international leader in the treatment of fistulas due to his work curing the physical and psychological wounds of traumatic fistulas sustained by war victims in Congo, where women are commonly gang-raped with objects such as sticks, machetes, or guns. The Fistula Foundation accepts regular or recurring donations, and also offers a “Dignity Gifts” catalog of jewelry and other items that help support the work of fistula hospitals around the world.