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The impact of community outreach: Medanit’s story

Many women in rural Ethiopia don’t routinely have access to professional maternal care. They may never see a midwife during their pregnancy. When they enter labour they do so with women of their community at their side, but with no medical professionals to care for them. This situation leaves countless women vulnerable to childbirth injury and trauma. 

This is Medanit’s story:

I still feel the unbearable pain that I was in during the labour,” Medanit told us, “All traditional medications known in the village were given to me, but none pulled me out of that pain”.

It’s not easy for Medanit, 25, to remember that time, but thankfully we are meeting on a happier occasion – the birth of her first daughter by safe caesarean section at Hamlin’s Yirgalem Regional Fistula Hospital.

Medanit grew up in a remote rural village in Ethiopia’s Oromia region, the eldest of eight siblings. With the nearest schools and clinics, and even electricity, over an hour’s walk away, this distance and her family’s poverty meant she and her siblings did not have the opportunity to go to school.

She spent her childhood looking after the family’s small farm and animals and supporting her mother in the home. When she was 18, she had an arranged marriage, as was the custom in her village and happily set up her own home.

Setting up home

It wasn’t long before Medanit became pregnant for the first time, and she and her family began to prepare happily for the baby’s arrival.

However, during her pregnancy due to the distance to the local health centre she did not have any midwifery support and her family encouraged her to give birth at home in the village with traditional birth attendants.

When the time came for her delivery at home, it soon became clear that something was not right. Medanit’s baby did not come, and her labour lasted an agonizing five days – when she became unconscious her family decided to carry her to the nearest health clinic for help.

The tragedy of a fistula injury

She told us,By the time I woke up I found myself lying still on the clinic bed, with my baby gone and feeling a strange wetness down my thighs. Tragically Medanit had lost her baby and developed a fistula, leaving her incontinent.

When the nurses told me that I was incontinent I felt ashamed and hopeless…it was the hardest time of my life.”

The clinic Medanit had attended was not aware of services for fistula and she returned home, incontinent, for three years. Fistula took away everything from me,” she explained.My married life was suspended, I relied completely on my family and spent a protracted, lonely three years.”

The impact of community outreach

Thankfully, one market day Medanit and her father heard an announcement from Hamlin’s community outreach activities about services at Yirgalem Regional Fistula Hospital.

Community outreach to proactively identify patients in need takes place in areas surrounding Hamlin fistula hospitals across Ethiopia, led by our patient identification officers, including Mohamed, pictured. This includes regular activities in marketplaces, churches and schools, door to door outreach, as well as local media campaigns to raise awareness.


In Sidama region alone last year, alongside Medanit, 23 other women living with fistula were identified and referred for treatment – highlighting the impact of outreach.

Fistula can be cured

After hearing the announcement at the market, Medanit’s father didn’t waste any time and immediately sold one of his cattle to pay for someone to take them to Yirgalem Regional Fistula Hospital, a full day’s bus drive away from their village.

Medanit was admitted as an inpatient, and provided with fistula surgery free of charge, which was a success: My cure was like a miracle!” she told us.

Medanit explained that she felt she had been given her life back, and she returned home with her family to resume life, armed with advice from our team that if she became pregnant again she should return to Hamlin for a safe caesarean section.

Which brings us back to today, with Medanit at Yirgalem for the safe delivery of her baby girl. As we wish her all the best with her new baby she tells us, I can’t thank you enough for what you are doing for women like myself”.

Medanit with her baby at Yirgalem

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