Beletshachew Tadesse first met Dr Catherine Hamlin in 2009 when she was working for WaterAid. Soon after Beletshachew came work with Catherine at Hamlin’s Desta Mender as Hamlin Fistula Ethiopia’s first Rehabilitation and Reintegration Manager, she served in this role from 2011 to 2019.
I joined Hamlin Fistula Ethiopia in June 2011 as the Manager of Desta Mender, Hamlin Fistula Ethiopia’s rehabilitation, training and re-integration centre. I knew about the wonderful work of Dr Catherine Hamlin, the Hamlin Fistula Hospitals and the obstetric fistula injury before I joined Hamlin Fistula Ethiopia. I was always a fan of Dr Catherine and I admired her big heart and the love she has always shown to our poor women. She was a real gift for Ethiopia and to this world. I still find it difficult to believe that I actually worked with her.
Desta Mender was one of Catherine’s most ambitious schemes: an entire village where the women suffering from the worst fistula injuries, who could never be completely cured by her hospital, would always have a permanent home.
When I came in to work at Desta Mender or the ‘Joy Village’ as it’s known – a collection of 10 group homes with a community hall, teaching centre or chapel, a physiotherapy unit, and an injera cook-house among the eucalyptus trees opened in 2003 – I realised it wasn’t functioning as well as was hoped.
The three per cent of patients who couldn’t be cured were grateful to have somewhere to live with running water and close to the hospital as many had kidney and other health complications because of their fistula, but they just weren’t thriving.
For some it just felt like a gilded cage. They weren’t happy there. They said they felt like outcasts, invisible, and a number were suffering from depression.
It was heartbreaking. These women had a place to live, and be cared for, but they wanted more. They wanted to go back and have a life in the outside world, to re-engage with the community.
As one of the residents remarked sadly one day, “A woman isn’t a woman without a village.”
So I finally went to Dr Hamlin and told her that the village, usually home to about 25 women at a time, needed to change. I expected Catherine to argue for her original vision. But she didn’t.
She got it, she asked me questions, and then said, ‘Go ahead!’ So then we changed the strategy to community integration and Desta Mender refocussed to help provide women with the skills to make that happen. We started educating.
Once they have their health back, they might aim to be accepted back into their community or they might move into income-generation business roles. They learn there’s a lot they can achieve. Look at Mamitu! She’s become a surgeon. It’s now all about empowerment and reintegration then watching them reclaim their lives. And sometimes miracles do happen.”
When they’re ready, the women re-start their lives. One woman remarried and actually had a child. Another, who could never have one but who loved children, became a childcare worker instead. One applied for Government microfinance and now runs her own kiosk selling food and drinks, while her friend became a grain wholesaler. Still another retrained as a health worker, telling women about the need to go to clinics to have their babies. There are so many stories like this.
By the time I finished up at Hamlin in 2019, Hamlin’s Rehabilitation and Reintegration program comprised various vocational training, some business training, problem-solving, leadership lessons, how to apply for loans to start a business and we had many partnerships to support placement of former Hamlin Fistula Patients. Those partners included orphanages, textile weaving, hospitality and small business. I am so proud of what was achieved.
Every day at Hamlin, we saw the impact of empowering women at a community level. Our patients left cured of their injuries and thanks to our rehabilitation and reintegration team they are also equipped with a renewed self-belief, their heads held high.
When a woman leaves Desta Mender, she is no longer defined as a fistula patient. No longer an outcast. Rather, she is an empowered individual, ready to write a new chapter in her story. She will go on to benefit her family, her community and the world.
This reorganisation of Desta Mender from a residential centre into a training facility is celebrated as a huge success. I am so grateful to Dr Hamlin for being so open to change, while the women have, ever since, been powering ahead.
It’s just so wonderful to see.