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Five Days Without a Midwife: Almaz’s story

Five days.

For five perilous days, Almaz endured an obstructed labour in her small Ethiopian village without a midwife. Without appropriate medical care, Almaz’s condition seriously deteriorated, and led to her suffering an obstetric fistula injury. The devastating impact of those five days without a midwife would be felt for ten long years.

A life upended by fistula

Born and raised in an isolated rural village in southern Ethiopia, Almaz grew up without access to basic necessities – including medical care and transport. Soon after getting married, Almaz was overjoyed to learn that she was pregnant. Like the rest of the women in her village, Almaz was unable to visit a midwife for prenatal check-ups during her pregnancy. Accessing the nearest health care clinic, a full day’s walk away, was unthinkable for a heavily pregnant Almaz. Like over 70% of women in Ethiopia, Almaz’s only option was to deliver her baby at home, without a midwife or any medical professional by her side.

For five endless days, Almaz suffered in obstructed labour. On the sixth day of her complicated labour, Almaz was taken to the closest hospital. At the hospital, Almaz’s baby was heartbreakingly stillborn. Her devastation was compounded when she realised that she was incontinent.

Almaz returned to her brother’s home, alone and inconsolable. “I had no support: I lost my family, and my brother was a poor farmer. I didn’t have the money to search for better treatment. I kept myself inside a small hut and would spend the day crying,” Almaz recalls. She would stay in that hut, incontinent, for a decade.

The power of Hamlin Midwives

Almaz’s story could have been so different. If a Hamlin Midwife has been in her village, she may never have suffered a fistula injury. When a Hamlin Midwife arrives in a community, cases of fistula drop to virtually zero in nearby villages. That’s because Hamlin Midwives bring expertise, experience, and compassion to their communities.

Moreover, through culturally sensitive advocacy work steeped in an understanding of the barriers that result in too many women experiencing labour without a midwife, Hamlin Midwives are educating communities about the importance of medical care during and after pregnancy. This vital work is helping ensure that no woman’s life is lost or devastated by the cruelty of fistula.

At the Hamlin College of Midwives, each student is attaining their Bachelor of Science in Midwifery degree on a full scholarship. During their degree, students cover the foundations of midwifery, anatomy, physiology, and pharmacology. They learn about newborn care, how to manage complicated pregnancies and labour, and gain advanced diagnostics skills and ultrasound training. Students also undertake practical placements in Hamlin-supported midwifery clinics around the country. This extensive training equips Hamlin Midwives with the skills to detect any abnormalities or complications during pregnancy and labour and prevent fistula injuries.

Almaz’s renewed hope

Depressed and ostracised, fistula was Almaz’s reality for ten slow years. Alone in that hut, Almaz came to believe it was her fate to suffer from fistula.

Earlier this year, Almaz’s life was renewed. Health officers found Almaz and she was brought to her closest Hamlin Fistula Hospital, in Mettu. The difficulty of her case required Almaz to be transferred to the global centre of excellence in fistula repair, Hamlin’s Addis Ababa Fistula Hospital. During her five-month stay at Hamlin, Almaz received holistic care and underwent surgery.

Today, Almaz is completely dry.

In addition to her treatment, Almaz stayed at Desta Mender, Hamlin Fistula's rehabilitation centre, where she was able to recover from her trauma physically and emotionally. The vocational training Almaz received at Desta Mender has equipped her to build a better future for herself back in her village. In her local language, Almaz’s name means ‘diamond.’ Healthy, hopeful, and dry, Almaz can now see a future befitting her beautiful name.

“My being cured is still a surprise. I never though it possible until it actually happened. Thank you for making this happen and for letting me be a woman again,” Almaz exclaims.

Hamlin Midwives save the lives of hundreds of mothers and babies every year. They can be the difference between joy and devastation. Midwifery education at the Hamlin College of Midwives is the answer to preventing – and eventually eradicating – obstetric fistula. But we need your help.

Without a midwife, too many women will continue to face the trauma of fistula. Together, we have the power to put an end to needless suffering, like Almaz endured. Click here to give in support of Hamlin Midwives.

Help us give hope to every woman.

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Hamlin Fistula NZ is committed to providing ongoing support for fistula surgery and for the preventive work of the midwives. The hospital in Addis Ababa has become a centre of excellence to which doctors from other countries come to learn and master the specialist skills of fistula surgery.

Photography credits to Mary F. Calvert, Kate Geraghty, Amber Hooper, Joni Kabana, Joli Wescombe, Natasha Meyer and Martha Tadesse.