This year the term ‘frontline warriors’ has become deeply embedded in the vocabulary around the world. As we show our respect and appreciation for these tenacious, dedicated health workers, here is a much older story of two remarkable women who saved and changed the lives of thousands of others. The story spans over 60 years, and starts from two different places.
It begins in 1959 when a young doctor couple in Australia, Reginald and Catherine Hamlin, saw an ad in The Lancet looking for gynaecologists in Ethiopia. With the zeal to do something useful, the idealistic couple flew across the oceans and continents to land in a tiny airport in Addis Ababa. They had plans to stay for 3 years, but they never went back.
Among the many gynaecological and obstetrics cases that they treated, the most common and most horrendous was a childbearing injury known as obstetric fistula. The condition is caused when prolonged labour opens a hole in the birth canal, leaving many women incontinent. For Ethiopian women, the injury often led to their being rejected by their husbands and ostracized by their communities.
When the Drs. Hamlin arrived in Ethiopia, there was little or no treatment available for such patients anywhere in the country, causing of thousands of women to barely survive, with life-threatening and life-changing injuries. Poring through medical books, journals and drawings of operations by other experts, the young doctors developed innovative surgical techniques to repair the damage.
One day in 1963, a 16 year-old girl was brought to them from a distant village, carried for twelve hours through mountainous terrain, on a primitive stretcher made from eucalyptus branches, and then on a bus to Addis Ababa. She had been in labour for four days, and her baby had died. She was in excruciating pain, and close to dying.
Her name was Mamitu Gashe. She was illiterate and terrified. She had never left her village, nor seen white people before; in her delirium she thought that they were angels. The agony, and the trust of the girl immediately touched the hearts of the doctors. Her injuries were the worst they had handled. It took months of repairs and treatment to heal her ravaged body. By then the innocence and indomitable spirit of Mamitu had created a special bond between the patient and her saviours.
As she gradually started her road to recovery, the young girl did not know how to show her gratitude to her doctors. Even while she was still in hospital, she started helping with chores like sweeping and changing sheets. Then as she regained her strength and confidence, Mamitu started to greet and comfort new patients, remembering her own terror when she first came. She refused to go back to her husband and village, and declared that she would stay and help the doctors. They in turn treated her like a daughter. She started calling them Emaye (mother) and Abaye father).
Over the next ten years Mamitu worked shoulder to shoulder with the Hamlins, helping out in the operating theatre, and then assisting in their operations; initially sewing up at the end of the surgery but progressing to learn all the steps in an operation. She learned to operate on fistulas by placing her hands over the surgeon’s and tracing her intricate incisions as she worked to save the women. In 1987, at the age of 40, Mamitu began operating on her own. She still could not read nor write, or speak English, but she had the gift of dextrous fingers, and just the right touch. Under the training and guidance of the Hamlins, Mamitu went on to be recognised as one of the finest fistula surgeons in the world. In 1989 she won the Gold Medal for surgery from the Royal College of Surgeons in London.
In 1993 Reginald passed away, but Catherine continued with her life’s mission, with Mamitu by her side. In 1995 they built another new hospital, one of a series that had started with their first in 1975–Addis Ababa Fistula Hospital. Today an estimated 60,000 women have been treated, and cured, by the Hamlins’ hospital and clinics.
Mamitu and her Emaye were inseparable companions for 57 years. In the later years, Mamitu became the caregiver of the one who once gave her a new life and purpose. The two were finally separated in March 2020, when Catherine Hamlin, passed away, aged 96. Seven months later, the still-grieving Mamitu has recently returned to the operating theatre. Now 74 years old Mamitu carries on her parents’ legacy, and continues to be a formidable frontline warrior.