Project Zero completes initial rollout in Didessa Woreda
The second pilot of Project Zero – Hamlin Fistula Ethiopia’s impactful programme to accelerate end of obstetric fistula in Ethiopia – completed its initial phase of work in 2024, with further success and learning generated.
In Didessa Woreda (district), Oromia region, which has an estimated population of 130,079, teams of Hamlin-trained community volunteers and health extension workers carried out a total of 24,855 house-to-house surveys.
Most household members (83%) had not heard about obstetric fistula before and were eager to learn more about it.
Through the house to house survey, and wider work to raise community awareness at markets, schools and through work with targeted local maternal health centres, 156 women with childbirth injuries were identified. This included 11 women with obstetric fistula and 145 with advanced pelvic organ prolapse.
All women were referred to Hamlin’s Metu Regional Fistula Hospital and most women have now received treatment.
One woman who received life changing support was Martha*.
Martha, a 70-year-old woman living near Didessa, endured nearly 40 years of isolation and pain due to obstetric fistula.
Martha had had an arranged marriage as a teenager, a decision made by her family that set the course of her life. At the start of her marriage, she happily raised three children, pouring her heart into nurturing them. However, it was her fourth pregnancy that changed everything.
Following an obstructed labour at home, she was left with a devastating fistula injury and incontinence. She withdrew from her community, avoiding social gatherings and the mosque for fear of judgment. For decades she lived a lonely, isolated life.
However, thanks to Project Zero, Martha’s life has been transformed.
Through the Didessa woreda house-to-house survey, Martha was identified by the Hamlin team, and referred to Hamlin’s Metu Fistula Hospital.
Successful surgery has restored her health and gave her hope. Surrounded by women with similar experiences, she found strength, healing, and a sense of belonging.
Upon her return to her village, Martha felt a mix of apprehension and excitement. With the encouragement of the Project Zero team, she decided to return to the mosque, ready to embrace her community once more. As she stepped inside, the familiar sounds of prayer filled the air, and she was greeted with warmth and acceptance. The women she once feared would judge her now surrounded her with open arms.
Her journey of healing and resilience helped break the silence around obstetric fistula, fostering a culture of compassion and understanding in Didessa.
How Project Zero is helping
House-to-house surveys are effective in raising communities’ understanding of birth injuries and the importance of antenatal care, institutional birth and maternal health care in general. By the end of the first phase of Project Zero in Didessa, awareness of childbirth injuries had increased from 17% to 79%.
A major component of Project Zero also includes assessing the woreda’s local maternal healthcare status using the Hamlin standard checklist in order to work on supporting local health care teams to develop and deliver improvement plans together over a subsequent three-year period, with continued mentorship from Hamlin.
Using learnings from our work in Didessa Woreda, and from our previous pilot in Ale Woreda, further expansion of Project Zero activity will take place in 2025, including rollout to Seharti Woreda in Tigray region and Fedis Woreda in Harar region.
