United Nations Population Award Acceptance Speech Dr. Catherine ...

United Nations Population Award Acceptance Speech
Dr. Catherine Hamlin
July 06, 2004
To have received this wonderful United Nations Award has filled me with great gratitude and
thankfulness. It is such an honour for me to stand here before you, as a representative of our
hospital and the work we do in Ethiopia for this long neglected maternal tragedy. This
recognition by such a prestigious and influential organization, as the United Nations, has warmed
my heart, as I know that because of your influence and power, these poor women and girls will
never now be forgotten or neglected. For centuries this has been the case - women tragically
injured from long unrelieved obstructed labour, living out their sad young lives in sorrow and
shame, hidden away alone in little dark huts all over the Developing World, separated from
family and society, and all that makes for happiness in this life.
Now at last, the World, especially the Medical World is awake to their needs. Their plight has
been brought to the fore with gynaecologists now seeking training, some at our hospital, and
after training going back to their own countries to set up fistula work there. The Federation of
International Gynaecologists and Obstetricians (F.I.G.O.) had a meeting last year in Santiago
Chile with special emphasis on the fistula problem and how to help these women. U.N.F.P.A. is
in the fore-front of this initiative, starting to set up embryo fistula centres in countries of Africa
and Asia and at the same time seeking in many ways to try and raise the status of women. This is
such encouraging and wonderful news for all who are scattered throughout the Developing
World, doing fistula repairs as best they can, many struggling to get the funds to do this, so to
know that now there is this U.N. project set up especially for such injuries is exciting. We all
pray that this project may prosper, and that many training centres will be established through
your efforts.
But we cannot afford to be complacent, so much so very much still to be achieved. Doctors to be
trained, able to repair these fistula injuries - this is, in my opinion what is still sadly lacking.
There are relatively few competent fistula surgeons in the world and training centres not yet fully
established to carry out this task. It is no use doctors thinking that just because they are
gynaecologists they can repair fistula injuries, long weeks, and months and even years are
needed to become competent to deal with the most difficult fistulae, and certainly up to half are
difficult! But being a gynaecologist is a good start and half the battle won!
Dedication and commitment is also essential, doctors and nurses motivated for humanitarian
reasons and not for financial gain and deep down a love for these girls - without this love work
for them will falter and not be sustained. However it is easy to love them, and every day our
hearts go out to them as they arrive at our hospital with nothing in this world except their faith
and hope in us, and their urine soaked clothes - young beautiful girls with a life shattered and in
ruins, how can one help loving them. Each one pulls at our heart strings and calls forth the
utmost compassion.

Childbirth should be a joyful occasion, but for these fistula girls it has developed into a
nightmare and a horror - to suffer the agony of days of labour, with nobody but the village
women to help and nothing to relieve the pain, to deliver their longed for child as a stillbirth, and
then to experience the awful consequences of this ordeal - incontinent now of urine and often
bowel contents as well. The whole picture is an unimaginable plight, and one which no woman
should be called on to endure, but one that is being repeated all over the Developing World,
where women have no access to any medical help. All these injuries are preventable, and this
surely is a task before all of us sitting here in this magnificent hall and building - to eradicate
appalling poverty, ignorance, lack of any opportunity for education, and to one day give every
mother the assurance and the right to have a safe delivery and a live baby.
Last month we celebrated the 60th anniversary of D-day in Europe, in the last world war, when
so many soldiers lost their lives, and yet every day as many mothers die - dying often alone and
with nothing to celebrate! But for every mother that dies there are many more left injured, and
the worst of these injuries and that most dreaded by obstetricians is the vaginal fistula. Often
these patients, so injured, wish they had died with their baby - some commit suicide, rather than
face a life of ostracism and shame, of loneliness and incontinence.
We are facing a challenge in this 21st Century - a challenge that is one we can together solve.
Money and buildings are useless unless we have personnel to fill the hospitals and health centers,
and engineers and labourers to build the roads and bridges, so that no woman is cut off by lack of
access when she needs urgent skilled help to deliver her baby and to prevent her being injured
and having a vaginal fistula to bear. There should be teams of midwives and doctors able to
predict obstetric complications, of which fistulae are the worst, and not just manage them and
cure them after they have occurred. So our focus should also be on predicting and preventing,
only then will this tragic condition be lessened, and hopefully eventually completely wiped out!
We at the Addis Ababa Fistula Hospital are aware of the enormous number of new fistula
patients every year. In Ethiopia alone estimated to be in the region of nine thousand - so we have
decided to set up five regional fistula centres in five strategic areas where we can admit these
women to a special unit, in the grounds of five existing Provincial Hospitals, where fistula
patients would be welcomed and treated with the same love and care that is shown by all our
staff at the Addis Ababa Fistula Hospital - in this way I am sure we can help many more women
- those too poor or too alone to journey to Addis Ababa. These centres will be run by us, and
from them we plan as well to try and do much towards prevention - visiting the surrounding
villages with a vehicle attached to each center, talking to Women's Associations, involving the
men, showing films and giving, and gathering information. Already one of these wards, with its
operating theatre, its own kitchen and laundry, has been built, and as soon as the equipment for
the theatre ordered from overseas arrives, we shall open it and start repairing these women.
Others we hope will soon follow, all are already planned and funds available to build three more
of these five centres. We hope they will be modeled on our Addis Ababa Fistula Hospital - using
ex-patients, trained as nursing aides under the supervision of one or two trained nurses, sending
our own doctors to operate and to train the gynaecologists already working at those hospitals in
this field of surgery. In this way we hope to help many more injured mothers, and to initiate
preventive measures in a really effective way.

The need is very great - as soon as this centre was built in Bahr Dar, in the Province of Gojam,
35 patients arrived thinking it was ready! We hope soon to be able to start work there, and are
excited by the prospect before us. As I said earlier in this speech we are facing a challenge - a
challenge at the beginning of this 21St century. We stand now, as it were, at a gate - a gate open
at last to reveal thousands of young women all over the Developing World, with their hands out
to us begging for help, let us together raise the needed funds, build the needed hospitals, and
most importantly train the needed fistula surgeons and nursing staff - and let us pray to our
loving, compassionate and powerful God for His help. Then we shall succeed.
Finally I quote words spoken by King of England George VI when he came to the throne at the
beginning of the Second World War:
I said to the man who stood at the gate of the year,
"Give me a light that I might tread safely into the
unknown"
And he replied, "Go out into the darkness and put your
hand into the hand of God, that shall be to you better
than light and safer than a known way.”