Originally published in The Herald, Fall 2002 #26
The Hospital by the River: A Story of Hope
by Dr. Catherine Hamlin with John Little
Pan Macmillan Australia, illustrated
308 pages
No price listed.
(Available in the US through the American Friends Foundation for Childbirth Injuries, www.fistulahospital.org.)

Reviewed by Hayward Allen (Harar 62–64)

RIC HAAS (Dembidolo/Addis Ababa, 1967-69) handed me this book at the E&E Country Update session of the 40+1 Conference. I told him I would review the book because I believe that his foundation’s assistance to the fistula hospital in Addis is a worthy cause. There was no way of knowing what a goldmine of the author’s personal experiences and contemporary Ethiopian history The Hospital by the River would be.
     In my 30-odd years of book reviewing, one of my methods is to crimp page tops and bottoms at places I will re-locate as I write. If I were to go back to the plethora of page crimpings, I would produce a chapter-by-chapter extrapolation and review.
So, I will do the opposite. I will simplify matters by noting two dimensions of The Hospital by the River. No, I’ll note three, if not more. But I will keep this short because I believe that any and all members of E&E RPCVs should find a way to get this book, to read it, and to act upon their own conclusions.
     That may sound like a reviewer’s cop-out, but isn’t that exactly what a reviewer is supposed to do? Inspire folks to check out the book for themselves?
     That posited, here are the points I wish to briefly illuminate.
  1. Fistula obstetrica is a horrible condition women face when they cannot have their babies delivered safely. No, that’s not really what fistula is. Fistula means that a child-bearing woman can have her guts torn apart, literally. Imagine a mother-to-be carrying a still-born fetus, or a woman who cannot deliver a normal child vaginally. And the woman cannot get to a hospital or clinic to help her.
  2. What happens is that the baby ruptures the mother’s tissues between the vagina and the bladder or rectum. The woman, if she doesn’t die, is condemned to a fate worse than death. She will never bear children. She will be constantly incontinent. She will reek of urine and feces. She will be an untouchable, an outcast.
  3. In Third World countries, young girls are impregnated, inadequate diets are legion, and medical facilities might as well be on the moon. Ethiopia is one of those moon-distanced nations.
  4. Enter Drs. Reg and Catherine Hamlin, doctors of obstetrics and gynecology. In 1959, he was 50-years-old; she was 35-years-old. They went to Ethiopia because they answered, from Australia, an advertisement in the British Medical Association’s The Lancet: "Gynaecologist wanted to set up a school of midwifery for nurses in the Princess Tsehai Memorial Hospital in Addis Ababa." It was a three-year contract. It became a lifelong commitment. It because more than midwifery. The assignment became the creation of a hospital dedicated to women sadly aflicted with fistula.
  5. The conditions, situations, and individual stories of fistula are vibrant and heart-rending.
  6. The descriptions of the two doctors’ lives, their work, their fund-raising, their family problems are humbly delivered, honest, and full of pluck. Dr. Catherine Hamlin is an indefatigable optimist, a woman who actually looks "on the bright side of life." She is, ultimately, amazing.
  7. For readers of The Herald, her account of the Red Terror and the Degue is explicit and fascinating. Although not so knowledgeable of the Mengistu Era histories in print, I would measure her descriptions and experiences as invaluable to understanding the on-the-ground conditions faced by service-providers in Ethiopia during that horrific reign.
  8. Not once does she mention the Peace Corps, and that kind of surprised me, but then maybe her and Reg’s 24/7 commitment did not include relations with the incoming, short-termers from the US. She does relate fond memories of various British ex-pats and recalls with gentle glee the Order of the British Empire that Queen Elizabeth presented to Reg, in person, in Ethiopia.
  9. There are few accounts, as I have read, of the last days of Haile Selassie and his family, his death and their imprisonment. The good doctors obviously loved the Emperor, loved and had intimate contact with his family, and did as much as possible to aid them in their long imprisonment and detention by the Dergue. There is the story of the VW Bug in which H.E. was carted away to his death, for example, as well as the detective work to find his remains, which it seems were beneatha slab under Mengistu’s desk.
  10. If there is a tribute, besides the BBC and Australian TV films honoring the Hamlins and their hospital, it is the undying devotion to a cause by a couple who left "civilization" and went where their religious teachings took them. Their mutual devotion to each other, and their exceptional humility, are both worth considering through The Hospital by the River.
  11. It is no wonder why Ric Haas has taken on a new task.
NOTE: Learn more about the hospital at www.fistulahospital.org
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