Natalie Imbruglia Visits Ethiopia, Pledges to Help Fistula Sufferers

ADDIS ABABA, Ethiopia – Seventeen-year-old Tegest (name has been changed) doesn’t recognize the beautiful young woman, whose face has graced dozens of magazine covers around the world. Nor does she know her from the countless television programmes, movies or music videos in which she has performed.

The teenager shyly averts her eyes away from the Australian actress/musician Natalie Imbruglia,who has traveled to Ethiopia and Nigeria to see for herself how UNFPA and its partners assist young women like Tegest who have suffered from obstetric fistula and how they ultimately reclaim their lives after successful operations.

“Fistula is not something that [these girls] are able to talk about,” says Imbruglia. “It's a very shameful thing. How do you speak about the unspeakable? They need a voice, and I'm happy to do it.”

Imbruglia listens attentively as Dr. Catherine Hamlin – one of the founders of the Addis Ababa Fistula Hospital – discusses Tegest’s case. The young woman, who is dressed in the traditional style of northern Ethiopia with tattoos outlining her delicate features, was in labour for five days before losing her baby. A hole developed in her bladder and rectum, causing chronic incontinence.

“Her husband left her, because of the smell of urine and feces,” explains Dr. Hamlin, her arm cradling the young woman who can’t control the flow of urine that pools beneath her. “These girls are rejected by society and are often living alone in a shed in their villages, sometimes languishing until death, unless someone tells them they can be cured.”

Imbruglia spent a total of five days in Nigeria and Ethiopia visiting UNFPA-supported fistula projects. While in Ethiopia, she also paid a visit to the "Good Samaritan Training Center for Street Girls," which provides vocational training to young
women and a safe haven off Addis Ababa's streets.

"We take for granted how easy it is for us to have children – the antenatal care, the help we get during a difficult labour. These women have none of that, " said Imbruglia after meeting with patients at the Fistula Hospital in Addis Ababa.

Obstetric fistula is a childbirth injury that is usually caused by several days of prolonged obstructed labour without timely medical intervention. In nearly all cases, the baby dies. An estimated three million women in Ethiopia become pregnant each year, of which approximately 9,000 will develop fistula.

Natalie shares a smile with a patient and her baby at the Addis Ababa Fistula Hospital. Photo: Angela Walker/UNFPA

Dr. Hamlin came to Ethiopia with her late husband Reginald, also a gynaecologist-obstetrician, in 1959. They established the Addis Ababa Fistula Hospital specifically for women with childbirth injuries in 1974. Five outreach centres are currently being established to serve women in outlying regions who may not have the means to make the arduous journey to the capital. The UNFPA country office has donated two land cruisers, a coaster bus, and surgical equipment to assist the centres in Mekelle and Metu.

"The women suffering from fistula in these remote regions of Ethiopia are among the most vulnerable in the country," said UNFPA Representative Dr. Monique Rakotomalala. "UNFPA is proud to be a part of the Fistula Hospital's efforts to reach out to these women and support their repairs."

Additionally, UNFPA has supported the work of the Addis Ababa Fistula Hospital through the donation of surgical equipment, including operating tables, mobile lighting units and an autoclave for sterilizing operating instruments.

“UNFPA is now doing a tremendous amount of work all over the world to help these women – not only in Ethiopia, but all over the developing world,” said Dr. Hamlin.

About 1,200 operations are performed at the hospital each year, with two to three weeks on average needed for recovery. Physical therapy is also available to the women, many of whom need to relearn how to walk normally due to nerve damage plus prolonged immobility after delivery when they lie for days, weeks and months trying to stop the urine from leaking. Six obstetrician-gynaecologists and ten nurses assist the patients. Another 50 former patients serve as nursing aides. Hospital staff also train doctors from other countries, including Tanzania, Kenya, Chad and Somalia, on fistula repair, as well as all post graduate doctors from the Department of Obstetric and Gynaecology of the Addis Ababa University.

Dr. Hamlin and Dr. Ambaye Wolde Michael, herself Ethiopian, both said that working on fistula cases is more than a career – it is a vocation. “It’s like giving back their lives to them,” explains Dr. Ambaye, who came back recently to Addis Ababa with blisters on her hands after performing 36 operations over a two-week period in Kenya.

Not only young women are affected by fistula. Dr. Hamlin recalls a woman of 60 that she treated who had delivered her first child at 20. The baby was stillborn. The woman suffered silently for 40 years before her fistula was repaired at the hospital.

“She told me, ‘I’ve been sitting alone for 40 years with no one to talk to me. To think I could have been cured and had more children and a normal life,’” said Dr. Hamlin. “After ten days, she recovered from the simple operation. She kissed my shoes before she left and said ‘I love you next to God.’”

Angela Walker/UNFPA