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From isolation to independence: The journey of a fistula patient

3 minute read

For many women, arriving at a Hamlin Fistula Ethiopia hospital is the beginning of the end of what may have been a long period of suffering and the start of a new chapter in their lives.

Some women may have struggled alone with fistula for years before they are able to seek help, due to poverty or challenges in accessing health services in remote rural areas.

Through our regional fistula centres and patient identification programme we are working hard to reach even more women in need in remote areas across Ethiopia and provide life changing services at Hamlin Fistula hospitals, free of charge.  

So what happens when a fistula patient arrives at a Hamlin Fistula hospital? Join us on a journey to find out….

Arriving at Hamlin Fistula Ethiopia

Dr Betty and her team at Hamlin

On a patient’s arrival, our team of doctors are ready to receive them. At the Addis Ababa Fistula Hospital a patient’s first assessment is with general practitioner Dr Betty (pictured, right).

Dr Betty is a central part of Hamlin Fistula Ethiopia’s team of health professionals and works closely with specialists and surgeons to guide the initial care pathway for a new fistula patient, undertaking screening and lab investigations.

Hamlin operates a holistic model of care, and as well as assessing physical injuries, Dr Betty talks to women about how they are feeling to understand their counselling needs.

Preparing for surgery

Patients doing physiotherapy

For women who are diagnosed with fistula and admitted as in-patients, the next step in their journey is to begin the process of preparing for surgery with the support of our specialist team of practitioners.

In Addis Ababa patients will be seen by Urostomy Nurse Nina, who will support a patient’s assessment before and after surgery. Nina’s pre-surgery assessment includes examining the size of a patient’s bladder and the extent of their injury to share with the surgical team to inform healthcare decision making for the patient. You can read more about Nina’s work here.

Other pre-surgery support may include physiotherapy or other therapies, and for some patients this preparation can take time.

The day of surgery

Nurse with patient

Fistula surgery can be complex, and Hamlin Fistula Ethiopia has a team of talented Ethiopian surgeons leading work across our six fistula centres to ensure the best possible outcome for women.

One complex surgery for a woman can take up to 4.5 hours and typically the surgeons are joined by two to three theatre nurses.

Supporting the development of the next generations of surgeons is important to Hamlin Fistula Ethiopia and our chief surgeon Dr Yeshineh supports skills development programmes for practising gynaecologists in Ethiopia, and a number of Hamlin Fistula Fistula surgeons are undertaking research fellowships in advanced surgical techniques.

Recovery and rehabilitation

Education and training activities

One operation can repair a fistula. But that’s not the end of the story.

Beyond the physical mending of scars and injury, Hamlin Fistula Ethiopia provides rehabilitation programmes that help recovering fistula sufferers reintegrate into their community.

For these women who have been shunned from society, this Hamlin Model of Care is a critical aspect of rebuilding self-belief and empowering women to live independently, with dignity and choices.  

Following surgery, women receive physical therapy and livelihoods training, restoring their self-esteem and capacity to generate their own income after returning home to their communities. Like Elfinish, who successfully opened her first shop on returning to her village after surgery.

For women with complex fistula injuries who need more time to recover, Hamlin Fistula Ethiopia operates a rehabilitation centre called Desta Mender (meaning ‘Joy Village’) which gives women a place to heal with physiotherapy and counselling, and grow with education and training including farming.

Find out more below about our prevention, treatment and rehabilitation programmes:


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