Elinor Catherine Hamlin (1924- )
Keywords: Reproduction, People
Elinor Catherine Hamlin founded and helped fund centers in Ethiopia during the twentieth century to treat women affected by fistulas from obstetric complications. Obstetric fistulas develop in women who experience prolonged labor, as the pressure placed on the pelvis by the fetus during labor causes a hole, or fistula, to form between the vagina and the bladder (vesicovaginal fistula) or between the vagina and the rectum (rectovaginal fistula). Both of those conditions result in urinary or fecal incontinence, which often impacts women's social status within their communities. Hamlin co-founded a hospital to treat fistulas and helped fund health clinics, a rehabilitation center, and a midwife school. Her work in Ethiopia helped to help train the next cohort of midwives to treat women with obstetric complications and has contributed to the health and social well-being of Ethiopian women.
Hamlin was born Elinor Catherine Nicholson on 24 January 1924 to Elinor Nicholson and Theodore Nicholson in Sydney, Australia. She grew up in Ryde, a suburb of Sydney, as one of six children, including two sisters, Sheila and Alisha, and three brothers, Peter, Donald, and John. Hamlin lived on her family's estate, called the Hermitage, during her childhood. In 1936, when Hamlin turned twelve, she was sent to an all girls boarding school called Frensham in Mittagong, Australia. During her time at Frensham, Hamlin later said, she decided to become a doctor.
Hamlin graduated with a degree in medicine from the University of Sydney Sydney, Australia, at the age of twenty-two in 1946. After graduating, Hamlin completed two internships at different hospitals in Sydney. She interned at St. Joseph's Hospital in the suburb of Auburn, and later at the St. George Hospital in the suburb of Kogarah. Hamlin applied for a resident's position at the Crown Street Women's Hospital in Sidney.
After her interview with the medical superintendent, Reginald Henry James Hamlin, Hamlin chose a career in women's medicine and specialized in obstetrics. She became senior resident medical officer at the Crown Street Women's Hospital. Hamlin worked in the labor ward at the Crown Street Women's Hospital, where she learned to treat abnormal obstetric conditions. In 1950, she married Hamlin, the hospital superintendent who was fifteen years her senior. They continued to work at Crown Street Women's Hospital until 1952.
In 1952, the Hamlins moved to London, UK, where Hamlin's husband was offered a position at the Samaritan Hospital for Women. During Hamlin's stay in the UK, she had a son, Richard, in 1953. In 1956, the Hamlin family returned to Australia when Reginald Hamlin tried to become a consultant at the Crown Street Women's Hospital. However, due to a professional dispute with fellow obstetrician Thomas Dixon-Hughes, Reginald Hamlin was ultimately denied the position. In the interim, Elinor Hamlin accepted an obstetrics position at The Adelaide Children's Hospital in Adelaide, Australia. During that time, she found an advertisement in the Lancet soliciting humanitarian work for physicians in Ethiopia, to which she and her husband applied.
When Hamlin and her husband were offered the positions in Ethiopia, she later reported feeling like she was answering the call to help people in underdeveloped countries. Hamlin writes in her memoir that during her fifth year at the University of Sydney she wanted to become a missionary, and nearly ten years later she had finally achieved that goal. The Hamlin family relocated to Ethiopia in 1959. Hamlin and her husband worked at the Princess Tsehai Memorial Hospital in Addis Ababa, Ethiopia. A board of trustees in England managed the hospital, and hired the Hamlins. Hamlin and her husband worked as gynecologists and established a midwifery school that would function out of the hospital.
The Hamlins initially contracted with the Ethiopian Government to work at the Princess Tsehai Memorial Hospital in Addis Ababa, Ethiopia, for three years. They were contracted to help with the maternal ward, but many of the cases they received were obstetric fistulas that arose primarily among rural women. Though Hamlin had dealt with obstetric abnormalities as a result of her work in Australia, she had never treated obstetric fistulas. Hamlin and her husband talked with friends and experts on the subject of treating and preventing fistulas. As obstetric fistulas were not common in Australia, the Hamlins had no experience with the surgery required to repair fistulas.
Hamlin credited the 1928 work of Heinrich Martius in Germany, and his procedure called the Martius fat pad graft, with helping to increase the success rate of the fistula operations that she and her husband performed at the Princess Tsehai Memorial Hospital. The high success rates of the fistula operations performed by Hamlin and her husband attracted attention from other specialists on obstetric fistulas. John Chassar Moir, an obstetrician and gynecologist from the UK who had published about vesicovaginal fistulas, visited the Princess Tsehai Memorial Hospital and received training from the Hamlins on how to treat difficult cases of obstetric fistulas. According to Hamlin, Moir was taken aback by the level of injury sustained by some of the women, and he considered many of those extreme cases to be inoperable.
The Hamlins struggled to treat fistula patients at The Princess Tsehai Memorial Hospital because the government could not fund the operations, and patients were often too poor to pay their admission fees. Hamlin and her husband often paid the admission fee for those patients from their own salaries. When Haile Selassie, Emperor of Ethiopia, was deposed in 1974, The Princes Tsehai Memorial Hospital was relocated and turned into a military hospital.
The Hamlins founded the Addis Ababa Fistula Hospital in Addis Ababa, Ethiopia. The hospital only treated women with fistulas. The Hamlins built the facility after receiving a donation of 10,000 pounds from a donor in New Zealand. On 24 May 1975, Hamlin and her husband opened the newly built hospital and christened it the Addis Ababa Fistula Hospital. After founding the Addis Ababa Fistula Hospital, Hamlin and her husband dedicated their time as surgeons to helping women with fistulas. After the death of her husband in 1993, Hamlin continued her work at the hospital.
By 2015, The Addis Ababa Fistula Hospital had treated more than 30,000 fistula patients. Operations were funded through Hamlin Fistula Ethiopia, a charitable organization that raised funds for the Addis Ababa Fistula Hospital, for the Hamlin College of Midwives, established in 2007, and for Desta Mender, established in 2010. The Hamlin College of Midwives trained midwives, who then worked in rural communities. Desta Menda became a rehabilitation center where long-term obstetric fistula patients lived and worked. Hamlin continued to live in Ethiopia as the chair of the board of trustees of Hamlin Fistula Ethiopia and as senior consultant in surgery at Addis Ababa Fistula Hospital. The Addis Ababa Fistula Hospital also functioned as a training center for visiting doctors from Africa, Europe, Asia, and North America. Students completing postgraduate work in Obstetrics and Gynecology at the Addis Ababa University often received further training at the hospital.
Hamlin received many awards for her humanitarian and medical work in Ethiopia. The Ethiopian government awarded her The Haile Selassie Humanitarian Prize in 1971. The Australian government appointed her as Companion of the Order in 1995, the highest civic honor awarded for service to Australia or the betterment of humanity globally. In 1999, she was a Nobel Peace Prize nominee. In 2009, she received the Right Livelihood Award for her practical and exemplary treatment of fistulas in Ethiopia. Hamlin has also been awarded many honorary medical fellowships. She was named an Honorary Fellow by the American College of Surgeons in 2003 and received an honorary doctorate in medical sciences from the University of Addis Ababa in 2010. Into the early decades of the twenty-first century, and into her nineties, Hamlin continued to operate on patients and run the hospital.
- Arrowsmith, Steven, E. Catherine Hamlin, and L. Lewis Wall. "Obstructed labor injury complex: obstetric fistula formation and the multifaceted morbidity of maternal birth trauma in the developing world." Obstetrical and Gynecological Survey 51 (1996): 568–574.
- Browning, Andrew. "Obstetric fistula in Ilorin, Nigeria." PLOS Medicine 1 (2004): e2. http://www.plosmedicine.org/article/info%253Adoi%252F10.1371%252Fjournal.pmed.0010002 (Accessed November 10, 2014).
- "Dr. Catherine Hamlin." Interview by Peter Thompson. Talking Heads. Australian Broadcasting Corporation. ABC1 (2008) Television. Transcript. http://www.abc.net.au/tv/talkingheads/txt/s2297982.htm (Accessed February 10, 2015).
- Hamlin, Catherine, and John Little. The Hospital by the River: A Story of Hope. Oxford: Monarch, 2001.
- Hamlin, Catherine. "The treatment of rectovaginal and vesicovaginal fistulas in women with childbirth injuries in Ethiopia." Journal of Wound, Ostomy, and Continence Nursing 24 (1997): 187–9.
- Hamlin Fistula Ethiopia. http://hamlin.org.au/ (Accessed February 10, 2015).
- Ijaiya, Munir'deen, and P. A. Aboyeji. "Obstetric urogenital fistula: The Ilorin experience, Nigeria." West African Journal of Medicine 23 (2004): 7–9.
- Martius Heinrich. "Die operative Wiederherstellung der collkommen fehlenden Harnrohare und des Schliessmuskels derselben." [The surgical restoration of the completely missing urinary sphincter and urethra.] Zentralblatt Gynäkologie [Central Journal of Gynecology] 52 (1928): 480–6.
- Mellor, Lise. "Hamlin, Elinor Catherine." Faculty of Medicine Online Museum and Archive, University of Sydney. http://sydney.edu.au/medicine/museum/mwmuseum/index.php/Hamlin,_Elinor_Catherine (Accessed November 10, 2014).
- Moir, John Chassar. "Vesicovaginal fistula: thoughts on the treatment of 350 cases." Proceedings of the Royal Society of Medicine 59 (1966): 1019. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1901091/pdf/procrsmed00178-0096.pdf (Accessed February 5, 2015).
- World Health Organization. 2014. "10 Facts on obstetric fistula." http://www.who.int/features/factfiles/obstetric_fistula/en/ (Accessed February 8, 2014).