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The impact of fistula on mental health

The long read: 3 minutes

The start of October marked World Mental Health day, a chance to raise awareness and advocate against social stigma around the globe.

While obstetric fistula is inherently a physical injury, its consequences for mental wellbeing can be grave and this is why at Hamlin a holistic approach is taken to supporting patient recovery.

Through our Rehabilitation and Reintegration Programme in Ethiopia we help women regain their self worth, trust in their bodies and the confidence and empowerment to move forward in a new phase of their lives.

A doctor supporting a patient

The impact of fistula on mental health

For women suffering the effects of obstetric fistula in Ethiopia, having suffered a traumatic birth they are all too often misunderstood, stigmatised and excluded from their communities.

Due to superstitions surrounding the causes of fistula injuries, women may even be outcast by their husbands and families which can have devastating effects on their emotional wellbeing and ability to earn a living or live a normal life.

For some women with no means of supporting themselves, they will endure a poor quality of life, frequently suffering from depression.

Research has found that almost 97% of women living with fistula experience depression, a truly alarming figure.

Fistula surgery – repairing more than just physical injuries

Hamlin’s surgical teams at hospitals across Ethiopia are performing vital work in repairing the injuries of fistula sufferers. Such surgeries not only repair the physical injuries but, according to recent evidence, mend emotional scars too.

2019 research by the University of South Africa’s Addis Ababa campus found following successful fistula surgery at Hamlin’s hospitals, the prevalence of depression among patients reduced hugely, to 27%.

This suggests that medical complications of a fistula are only half the story. It is necessary to help women regain their sense of worth and rebuild their lives.

A pioneering and holistic approach to recovery

This is why at Hamlin Fistula Ethiopia we had long recognised the physical and mental health implications of a fistula, and through our Rehabilitation Programme we successfully helping women regain their confidence and livelihoods.

The Hamlin Model of Care

Desta Mender: Amongst friends

Desta Mender, Hamlin’s peaceful and purpose-built recovery centre allows long-term fistula patients to continue to heal. Amongst friends who share an understanding of what it means to have endured fistula, women find themselves immersed in a caring community.

Women are offered counselling, helping them to better understand their injuries and the subsequent trauma, as well as literacy and numeracy classes and vocational skills training. This programme gives women the confidence and expertise necessary to become independent members of their communities and is central to them regaining a sense of self-worth.

As one patient Wubanchi told us: “in those four years with fistula I led a distressed and isolated life, taking myself away from mixing with the community and suffering a lot in concealing my case to relatives. It was a kind of hard to live with injury. I gave up hope”.

Wubanchi at Desta Mender

Wubanchi, pictured, was just 14 when she gave birth for the first time. Tragically she suffered an obstructed labour and struggled for three painful days at home before falling into a coma. Seeking help, her family carried her on a stretcher for five hours to the nearest health centre, where still unconscious, she delivered a stillborn child.

After the death of her baby, the loss and mental trauma were only intensified by the double fistula she was left with after her protracted delivery.

Four long years later, having undergone a fistula repair and a number of surgeries at Hamlin’s Mekele Fistula Hospital, Wubnachi was able to join the rehabilitation programme at Desta Mender and complete a life-changing programme which equipped her with the emotional skills and resilience for a better life.

“You have given me life again, confident and dreaming to continue my education and became a strong woman with successful future. I found nothing strong enough to describe my heartfelt thanks to you”


It is only with your help that we can continue providing a safe and nurturing environment at Desta Mender and all Hamlin Fistula hospitals across Ethiopia for women like Wubanchi.

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