Hamlin Fistula Impact Report 2022

The extraordinary journey of our founders, the late pioneering surgeons Dr Catherine Hamlin and Dr Reg Hamlin, started with an initial three-year posting to Ethiopia. Today, over sixty years later, our work continues to provide life-changing treatment to some of the world’s most marginalised women. Since I joined Hamlin two years ago, I have been blown away by the dedication of our colleagues in Ethiopia, and this year was no different.

Their hard work at Hamlin hospitals across the country has shown impressive results. They delivered 2,584 operations for women with childbirth injures – including surgeries for obstetric fistula, pelvic organ prolapse and other obstetric and gynaecological conditions.

This figure was slightly below our target due to the continuing impact of the pandemic and civil unrest in Ethiopia’s northern Tigray region. However, it remained a 50% increase on the previous year’s results and is testament to the hard work and dedication of our team in Ethiopia.

This has also been a year of highlights for Hamlin and some which stand out for me include congratulating 23 fourth year midwifery students at the Hamlin College of Midwives who worked hard to complete their final modules and graduate with a 100% pass rate, and the launching of a

brand new Masters in Clinical Midwifery course – the first of its kind in Ethiopia. The unwavering commitment of our UK supporters and partners have been vital in making this work possible and changing the lives of so many women. From marathon running, to cake sales, to knitting blankets for patients, your generosity and commitment has helped us to achieve these results.

Your support is especially appreciated at this time of increasing economic challenge. Many of us are feeling the impact of the cost of living crisis and household budgets are stretched. However, the need in Ethiopia is still great with 70% of women giving birth without a midwife present and around 1,000 new fistula injuries each year. None of our vital work could happen without the support of our generous donors who ensure we can continue to help as many women as possible.

I would like to say a heartfelt thank you for your commitment to helping women in Ethiopia.

Thank you

Helen Marriott CEO, Hamlin Fistula UK

£412,276 raised in the UK through donations, legacies, grants and other income.*

*2021-22 UK financial year

Hamlin Fistula UK

Every woman matters

Our vision is to realise

Dr Catherine Hamlin's dream for every Ethiopian woman to be free from devastating childbirth injuries and to gain access to quality maternal healthcare. We are part of the Hamlin global family of charities and our mission is to support the treatment and prevention of childbirth injuries in Ethiopia.

In 2022, thanks to the work of Hamlin Fistula Ethiopia. . .

18,090

2,584 operations

1,253 patients completed numeracy and literacy education

310 women completed livelihoods training

You helped us deliver vital services across Ethiopia. Our nationwide network is formed of six fistula hospitals, a rehabilitation centre, the Hamlin College of Midwives and Hamlin-supported rural midwifery clinics.

Hamlin College of Midwives and Desta Mender rehabilitation centre Hamlin Midwifery Clinics

Treatment

The impact of our treatment services

Hamlin’s team of health professionals welcomed women to 6,867 outpatient appointments across the year, ensuring they got the help they needed across Hamlin fistula hospitals in Addis Ababa, Bahir Dar, Harar, Metu and Yirgalem. Women in need of surgery for childbirth injuries were admitted and our surgeons delivered 2,584 operations for women with childbirth injures including obstetric fistula, prolapsed uterus and other obstetric and gynaecological conditions. This figure is an impressive 50% increase on the previous year.

Community outreach

Community outreach to raise awareness of fistula and other childbirth injuries and identify women in need of support is a vital part of our programme. Some outreach had to stop for a period of time due to Covid-19; however, these activities fully resumed in areas where it was safe to do so this year. Each Hamlin hospital has a resident Patient Identification Officer who is dedicated to undertaking regular outreach activities. These include one on one and group education sessions, door to door outreach, as well as leading mass and local media campaigns, to dispel misconceptions about fistula and empower women to reach out for support.

Hirut’s Story

After suffering the loss of her baby following an obstructed labour, Hirut sadly developed a fistula. At home in her village, she initially thought the incontinence was normal after labour. However, it did not stop. Gradually her life became harder and harder.

“Our way of living deteriorated in time. My husband and I spent two protracted years full of stress and agony”. She told us.

Thankfully, a Hamlin Patient Identification Officer visited the area Hirut lives in to train local health workers in fistula identification.

Soon after, Hirut was found during a home visit and referred to Hamlin’s Yirgalem Regional Fistula Hospital. After successful surgery she said:

“This might be routine work for the hospital but for me it is the biggest

Pictured: Hirut, after receiving successful fistula surgery

Pictured: Patient Identification Officer. Mohammed

Rehabilitation

Childbirth injuries can have a devastating impact on a woman’s life. For fistula patients, not only have most suffered the tragedy of a stillbirth and a traumatic injury, in many cases women are then divorced by their husbands, abandoned by their families and even cast out by their communities.

Repairing a woman’s obstetric fistula injury is therefore not the end of her story. Having lived in social isolation for months or even years, re-entering the community can be daunting, and few women have an income that allows them to live independently.

Physical therapy, counselling, numeracy and literacy training are provided to women at all our hospitals. For those that need more support, our specialist rehabilitation centre Desta Mender offers three month residential rehabilitation and life skills training.

Empowering women at Desta Mender

At Desta Mender, each woman is given a tailored programme to suit her needs and interests and the Hamlin team continues to support women to find sustainable employment upon reintegration back into their communities. In some cases, this also includes providing start-up grants to establish their own business, enabling these women to generate an income and live independently.

Over the past year, our specialist staff provided 1,253 women with literacy and numeracy training. Additionally, 310 women were also supported to complete livelihoods training at Desta Mender in a range of skills from farming and pottery to catering and business skills and 150 women were re-integrated to their communities with seed funding to start a business.

Tigist Aman, Hamlin’s Rehabilitation Manager, highlighted the impact training has had on patient Aselefech:

“Aselef (pictured below) is a very brave woman with a talent that could change her life. Our role in this training was to channel this talent into a succesful business. She has even become a trainer for other women interested in pottery.”

women received seed funding to start a small business

Research and training

Since 2014, Hamlin Fistula Ethiopia has been working with the International Federation of Gynaecology and Obstetrics (FIGO) to increase the number of fistula surgeons around the world.

Selected surgeons train at Hamlin for six weeks to acquire knowledge of the Hamlin Model of Care and best-practice advanced fistula surgery techniques. During the year, five visiting surgeons from Afghanistan, Somalia and Nepal trained at Hamlin’s Addis Ababa Fistula Hospital.

Hamlin’s clinical team is proud to share knowledge and skills with surgeons beyond Ethiopia in the fight to end fistula.

Development and refinement of surgical techniques is important in maintaining the highest levels of care. Over the past year Hamlin’s medical specialists participated in the development of six research project proposals, which it is hoped will start in the year ahead.

Prevention

The Hamlin College of Midwives continues as a centre of excellence for the training of midwives in Ethiopia.

Our prevention programme focuses on the training and deployment of Hamlin midwives to rural health centres across the country, to help meet our goal to end fistula in Ethiopia, forever.

We are growing the number of trained midwives in Ethiopia through training students in a BSc degree in Midwifery and a brand new Masters in Clinical Midwifery at the Hamlin College of Midwives.

Over the past year, the College taught 84 BSc students and congratulated the graduating class with a 100% pass rate. In January 2022 the Hamlin College of Midwives also launched Ethiopia’s first ever Masters in Clinical Midwifery with the first class seeing 31 practising midwives take their skills to the next level.

Lasting two and a half years, the Masters course will train midwives in advanced clinical practice, including the skills to perform emergency caesarean deliveries for complicated cases. This will be hugely impactful, saving the lives of women and their babies.

This year, we also welcomed Konjit Kassahun as the incoming Dean of the

College and Head of Hamlin Fistula Ethiopia’s nationwide Prevention Programme encompassing the health centres and midwives. Konjit was formerly the Matron and Head of Nursing at Addis Ababa Fistula Hospital and worked alongside Catherine for many years.

Practising Hamlin midwives

Since 2007, 234 Hamlin midwives have graduated from the college and been deployed back to their local areas across Ethiopia to provide quality maternal health care.

Hamlin midwives support, nurture and empower women to be informed about their reproductive health and the available care services.

Over the year, Hamlin midwives at supported government health centres in rural Ethiopia vastly improved health outcomes for expectant mothers and families - they delivered 18,606 babies and prevented countless fistula injuries and neonatal deaths. Over the year there was not one maternal death in a clinic where a Hamlin midwife was placed.

“I am interested in studying health sciences and when I found out I had been awarded the Hamlin midwifery scholarship it was like a dream come true.”

Student midwife

A huge Thank You

The support of generous donors is what makes our work possible.

Thank you to everyone who has supported us, including individuals who organised fundraising events, took part in sports challenges, made monthly donations, or who pledged a gift in their will.

We also want to thank our volunteer knitters who enabled us to send an amazing 2,142 blankets to Ethiopia to give patients a warm welcome to our hospitals, and others who have given their time to support our work.

Our key supporters:

Patron

Baroness Tessa Blackstone

Trustees

Greg Morris - Chair

Libby Grundy MBE

Hewete Haileselassie

Sarah Hewitt-Clarkson

Alison Murray

Emnet Yadeta

Trusts and Foundations

Band Aid Charitable Trust

Eleanor Rathbone Charitable Trust

Ericson Trust

Evan Cornish Foundation

Hodge Foundation

Kirby Laing Foundation

Oakdale Trust

Peter Stebbings Memorial Charity

Roughley Charitable Trust

Stanley Grundy Foundation

Sulney Fields Charitable Trust

The Big Give and EthiopiAid

Thornton Charitable Trust

Key supporters

Mark B

Helene and Martin Hayman

We would also like to thank all donors who wish to remain anonymous.

How your donations were spent in 2021-2022

For every £1 raised, 85p supported our programmes in Ethiopia

Childbirth injury treatment and prevention

Administration of charitable activities

Raising Funds

Become a monthly donor

Our monthly donors make a huge difference to our work, through providing regular, dependable support for women in Ethiopia. Giving monthly can be an affordable and flexible option, enabling donors to spread their donation out across the year. It is also highly effective, providing us with a reliable base of support for our programmes.

Find out how to become a monthly donor at hamlinfistulauk.org/donate

“A monthly gift can make a life changing difference to women who have remained desperate and uncared for, often for years. Will you join me?”

Sue Aldridge, monthly donor