Healing Hands of Joy: Developing a Solution

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Healing Hands of Joy is a newly formed NGO which assists Ethiopian women who have suffered from childbirth injuries (mainly obstetric fistula) in reintegrating back into their communities. It was founded by Allison Shigo, who co-produced the Emmy award winning documentary on obstetric fistula ("A Walk to Beautiful", 2007). The center opened its doors during my visit in November 2010.

Exhibited here are portraits of the first six graduates of the program.

Most survivors of fistula have suffered major emotional and psychological stress. After prolonged labor and delivering a stillborn, most are divorced by their husbands and discriminated against by their villages because of their unappealing physical condition. Granted they know that help is available and are able to find the funding to travel to a hospital from their remote village, the road to recovery is still long and arduous. Returning back home after surgery is sometimes difficult. Most are poor, illiterate and have little way of providing for themselves.

HHOJ is equipped to house up to six women at a time for the duration of the one month program. At the center they receive literacy classes, personal hygiene instruction, embroidery training and classes on microfinance, market skills, livestock maintenance and income generation.

Mulu's Story

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Mulu Shirfew represents a typical Ethiopian fistula patient. She is a young, 22 year old Tigrayn farmer girl with little education, given a large amount of physical household labor from a young age. She, like a vast majority of the 77 million people in Ethiopia, lives a rural village where transportation to and from her area is rugged and difficult. Also like most women in the country, Mulu's decision-making power and access to health care is minimal.

Most women in Ethiopia give birth on dirt floors with no health attendant and are accompanied only by family members in their hut. Most pray to Saint Mary to ensure a safe delivery, but when complications such as obstructed labor occur, many girls die, give birth to stillborn babies and if they survive, suffer from uro-genital fistula. This causes an uncontrollable stream of urine and/or feces (incontinence) often intolerable by family and friends. They are most often deserted from their husbands and isolated from their villages. Some commit suicide, emotionally destroyed and unaware that help exists.

Even after a 5 day obstructed labor, Mulu's husband and sisters refused to seek help, believing St. Mary would save her and control the labor. Village members notified a local health officer named Hezebalem Mengistu and a police officer was called in to assist. When Mulu was transported to the nearest (underequipped) health clinic, she delivered a stillborn under midwife Tiebe Yilema's care. Yet the pressure of a five-day obstructed labor left her with a tear between her bladder and vagina called an obstetric fistula. She is currently incontinent.

Despite her tragic story, Mulu is lucky.

The Hamlin Fistula Hospital: Treatment of Obstetric Fistula

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This story was shot at both the main Hamlin Fistula Hospital in Addis Ababa and at the Mekelle Fistula Center (about 772 km and a two day drive from Addis Ababa).

The Hamlin Hospital in Addis Ababa was founded by Drs. Reginald and Catherine Hamlin in 1974. The main hospital in Addis Ababa has the capacity for 140 patients at a time and provides free fistula repair surgery to approximately 2,500 women a year. The journey to Addis Ababa may be days and days for many women. It may also require the sale of precious livestock to get her onto public transportation. The Hamlin Fistula Hospital has therefore recently constructed five mini-hospitals throughout Ethiopia, including the Mekelle hospital in the Tigray region which is featured in this essay. The Tigray region is home to 4.1 million people. There are only 4 ob-gyn's for this entire area (1 per 1 million people).