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Ayana lived alone with the debilitating pain of fistula for 60 gruelling years. In March 2020 she underwent life-changing fistula repair surgery. Read her incredible story of resilience through tragedy – and finding hope.

Ayana is one of 24 patients found in the initial phase of Hamlin Fistula Ethiopia’s Patient Identification Programme, funded by UNFPA, which launched at the start of this year.

Ayana at Yirgalem Regional Fistula Hospital

Ayana grew up in rural Southern Ethiopia, in a remote village where access to health services is limited. In the 1950’s Ayana was pregnant with her second child. Having already given birth to a healthy son, Ayana did not expect anything to go wrong with her second pregnancy; unfortunately, Ayana experienced an obstructed labour. Without a trained midwife by her side, Ayana suffered for five agonising days until she eventually delivered a stillborn baby.

Beyond the sorrow of losing her baby, Ayana also suffered a fistula injury. The incontinence from her fistula started immediately after the birth. Unaware of the nature of her injury, Ayana was told by elders that the injury would repair itself after a few days. In reality, Ayana would suffer from her fistula injury for six decades.

When the leaking failed to stop, Ayana began to withdraw from everyone in her village; she lived alone with the debilitating pain of fistula for 60 gruelling years. Ayana thought that her problem was a curse and was untreatable. It was not until she was approached by Workee, a Hamlin-trained health worker, that Ayana learnt of a solution to her nightmare.

Ayana was one of the first women identified in Hamlin’s Patient Identification Programme. As part of the programme, Workee, the health officer who found Ayana, received specific training from Hamlin Fistula Ethiopia; this training helped Workee and other health officers identify fistula patients, talk to the women with empathy and sensitivity, and offer counselling to them.

Ayana was taken to Hamlin’s Yirgalem Fistula Hospital, which Is fully funded by Hamlin Fistula UK. When she arrived she was severely malnourished, weighing only 32 kilograms. After a comprehensive health-check Ayana was given pre-operative physiotherapy sessions in preparation for her fistula repair surgery.

In March 2020, Ayana underwent life-changing fistula repair surgery. Her post-surgical compassionate care has included counselling, physiotherapy, good nutrition and education to help her make a full recovery – physically and emotionally.

Reaching every woman

Like Ayana, too many women suffering the debilitation of fistula are ignored and ostracised by their communities. Like Ayana, too many fistula sufferers are unaware that there is a cure for their condition. Like Ayana, too many women in remote and regional Ethiopia are too poor to access the healthcare they so desperately need. This is why the Hamlin Fistula Ethiopia team launched the Patient Identification Programme, funded by UNFPA, to find and treat women who have suffered from fistula for too long.

The first phase of the programme identified 24 fistula patients, including Ayana and Tita, and provided care for them at Addis Ababa Fistula Hospital and Yirgalem Fistula Hospital. The second phase of the programme will train local health officers in four targeted areas and already Hamlin Fistula Ethiopia has trained 569 health professionals and community health officers from relevant regions.

There is so much more we want to do – will you help us treat women like Ayana suffering from fistula?


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