NICHOLAS D. KRISTOF

Give her a Nobel at 90

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We journalists tend to cover disasters, corrupt officials and loathsome criminals with gusto, but let’s take a break and applaud a hero.

Catherine Hamlin, an Australian gynecologist who has spent most of her life in Ethiopia, is a 21st-century Mother Teresa. She has revolutionized care of a childbirth injury called obstetric fistula, which occurs when a baby gets stuck in the birth canal and there is no doctor to perform a cesarean section. As many as 2 million women worldwide suffer from fistulas. The babies die, and the woman is left incontinent with urine and sometimes feces trickling through her vagina. She is stigmatized. She smells. She is ashamed.

Dr. Hamlin and her late husband, Reg, set up a fistula hospital in Addis Ababa, Ethiopia, and their work proves that it is possible to repair the injuries cheaply. Their hospital has trained generations of doctors to repair fistulas and provided a model replicated in many countries.

At a 90th birthday party for Dr. Hamlin in January, former patients cheered as she blew out 90 candles. Her son Richard declared: “Catherine has one son and 35,000 daughters.”

Dr. Hamlin gave the crowd a pep talk about the need to improve maternal care. “We have to eradicate Ethiopia of this awful thing that’s happening to women: suffering, untold suffering, in the countryside,” she said. “I leave this with you to do in the future, to carry on.”

Ethiopia this month nominated Dr. Hamlin for the Nobel Peace Prize, and she deserves it. I hope she gets it, along with other extraordinary leaders in women’s health such as Denis Mukwege of Congo, Hawa Abdi of Somalia and Edna Adan of Somaliland.

One striking feature of Dr. Hamlin’s work is the way she empowers recovering fistula patients to help others.

Mahabouba Muhammad was sold at age 13 to be the second wife of a 60-year-old man. She became pregnant, delivered by herself in the bush and suffered a severe fistula. Villagers, believing Mahabouba to be cursed, left her for the hyenas. But she fought off the hyenas and — because nerve damage from labor had left her unable to walk — crawled for miles to get help. At Dr. Hamlin’s hospital, she underwent surgery and now is a nurse’s aide there.

Another former fistula patient is Mamitu Gashe, who helped doctors during her recovery and was soon recognized as a great talent. Mamitu was illiterate but learned to perform complex fistula repairs and, because the hospital does so many, has become a world expert in fistula surgery. When distinguished professors of obstetrics from around the world come to this hospital for training in fistula repair, their teacher often is Mamitu.

Dr. Hamlin has had difficult moments, including upheavals in her organization, but has relentlessly focused on helping rural women. She also trains midwives and posts them in underserved areas — because 85 percent of births in Ethiopia take place without a doctor or nurse present.

Lack of medical care makes reproductive health in poor countries a human rights catastrophe. One fistula sufferer told me how her husband abandoned her and her parents built a separate hut for her at the edge of the village so that no one would be bothered by her smell. She barely ate or drank because everything she consumed would soon be trickling down her legs. She fell into deep depression. “I just curled up for two years,” she said. Finally, her parents heard about Dr. Hamlin’s hospital and she was repaired.

The cost of a fistula surgery? About $500 to $1,000. Dr. Hamlin’s hospital is supported by Hamlin Fistula USA, while the Fistula Foundation supports fistula repairs worldwide.

In much of the world, the most dangerous thing a woman can do is become pregnant, and 800 die daily in childbirth. Many more suffer injuries. Liberals and conservatives joust over abortion policies, but the basic task of making childbirth safer never gets adequate attention or resources. Bravo to Rep. Rosa DeLauro, D-Conn., for preparing legislation that would support efforts to prevent and repair fistulas.

Dr. Hamlin put the issue on the global agenda, and she’s not stopping: “We’re trying to prevent these injuries and wake up the world,” she told me. So for just a moment let’s take a break from covering villains and celebrate a doctor who has saved the lives of vast numbers of women — and now counts some of them as colleagues.

Nicholas D. Kristof is a syndicated columnist for The New York Times.



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