VCU news

By Michael Ford
University News Services

The Virginia Commonwealth University School of Medicine presented one of the world's leading experts on obstetric fistula, a debilitating birth injury among young women in the developing world, caused by the lack of medical intervention during prolonged, obstructed labor.

A fistula is an abnormal connection or opening between two organs or parts of the body that are not normally connected, like a part of the intestine and another organ (such as the bladder or vagina).

A specialist in obstetrics and gynecology, Dr. Catherine Hamlin is co-founder and director of the Addis Ababa Fistula Hospital in Ethiopia, where she has devoted 44 years of her life to the treatment of poor, rural women who have suffered devastating childbirth injuries. Dr. Hamlin's special lecture at the VCU Medical Center followed a moving 15-minute video presentation shot in Ethiopia and featuring many women left injured and essentially shunned from society before successful surgery.

"This is a labor of love to me, to be able to cure young women who have been devastatingly injured in labor, " Hamlin said. "If they're not cured, they become social outcasts forever. There is no way for them to get better without the surgery."

In June 2003, Dr. Tilahun Adera, professor and chair, preventive medicine and community health in the VCU School of Medicine, visited Hamlin and toured the Fistula Hospital while in Ethiopia and invited her to address the VCU community on this issue.

"Dr. Hamlin, with her late husband and since his death, has been instrumental in bringing thousands of women and girls out of shame, isolation, and despair into hope for a brighter future," said Adera, a native of Ethiopia. "Furthermore, she has multiplied her efforts by training hundreds of physicians from developing countries to perform the procedure thereby giving more women a much better chance of being reintegrated into society and live productive lives."

The World Health Organization estimates more than 2 million women and girls currently live with this condition worldwide. Health experts say it typically occurs when a young teenage girl cannot deliver a baby because her pelvis is still too small causing obstructed labor. After several days of labor, the baby is stillborn and the girl is left with a hole between her bladder, vagina and sometimes rectum. In some cases she is left crippled from nerve damage.

During her lecture entitled, "Obstetric Fistula: The Horrors and the Opportunities," Hamlin spoke about the lives of shame and despair that is led by Ethiopian obstetric fistula victims, and the successes that she and her staff have had in repairing their injuries. The hospital has mended more than 20,000 girls and women of their fistulas to date, and has trained more than 200 surgeons from across the developing world in the Hamlin procedure.

Hamlin said the injury could be prevented, if women had better access to doctors and hospitals during childbirth. She said money is badly needed to provide medical facilities but also better roads so rural patients could travel more rapidly. According to Hamlin, it would take more than two days on foot for the average pregnant Ethiopian woman, from a rural village, to reach a health care facility.

"This is a preventable injury and we need doctors to come to Ethiopia to teach the general practitioners how to deal with a woman in obstructed labor, "said Hamlin, a 1999 nominee for the Nobel Peace Prize. "If the young general practitioners could be trained to do a safe Caesarian section, a safe delivery for a woman in obstructed labor, we could prevent this injury. But we need new hospitals, we need new roads, we need new clinics."

Following her remarks at the VCU Medical Center's MCV Alumni House, Dr. Hamlin departed for a New York City fundraiser. Later this week she is to be inducted as an honorary fellow of the American College of Surgeons.

For more information about Dr. Catherine Hamlin and the Addis Ababa Fistula Hospital, go to www.fistulahospital.org.