Hamlin has been recognised by the United Nations agency UNFPA as a pioneer in fistula surgery for her development of techniques and procedures for obstetric fistula treatment. The Hamlins, together with the hospital staff, have treated more than 60,000 women to date for obstetric fistula. She died in Addis Ababa on 18 March 2020.
Three trainee midwives with Catherine Hamlin at the Hamlin Fistula Hospital in 2009
In 1958 the Hamlins answered an advertisement placed by the Ethiopian government in The Lancet medical journal for an obstetrician and gynaecologist to establish a midwifery school at the Princess Tsehay Hospital in Addis Ababa. They arrived in 1959 with their six-year-old son, Richard. The Hamlins had never seen an obstetric fistula before — they were an "academic rarity" having been virtually eradicated in the United States in 1895. (The first fistula hospital closed its doors in New York City in 1925.) Seeing many cases arrive at the school, they decided to create a dedicated hospital. Fifteen years later, in 1974, they founded Addis Ababa Fistula Hospital which is the world's first modern-day fistula hospital. Over the years, the Addis Ababa Fistula Hospital and Hamlin Fistula Ethiopia's five regional hospitals have treated more than 60,000 patients.
Between 2003 and 2010 Catherine Hamlin established five strategically-placed regional fistula hospitals in addition to the Addis Ababa Fistula Hospital. Hamlin and the Hamlin Fistula Ethiopia organisation decided to build fistula facilities in remote parts of Ethiopia due to the higher rates of fistula cases there as a result of limited access to prenatal and perinatal care. The five hospitals, located in Bahir Dar, Mekele, Yirgalem, Harar and Mettu, act as regional centres for fistula patients.
Hamlin lived in her cottage on the grounds of the Addis Ababa Fistula Hospital and remained very active in the day-to-day work of the hospital and patient care up until her death in 2020. Reg Hamlin was actively involved in the activities of the hospital and was a member of its Board of Trustees until his death in 1993.
Fistula prevention and rehabilitation programs
Hamlin’s efforts to end fistula saw her lead a program of preventing obstetric fistulas through Ethiopia; she believed that midwifery was key to preventing fistulas from occurring in the first place. Hamlin argued that "to put a well trained midwife in every village would soon eradicate obstetric fistulae." In 2007 she founded the Hamlin College of Midwives. Hamlin Fistula Ethiopia recruits students from rural areas, provides a full four-year scholarship for students as they gain their Bachelor of Science (Midwifery) degree. Upon their graduation, students are deployed back to their communities where their skills are needed. As of November 2019, 170 midwives have graduated form the College; 92 are currently studying. Hamlin Fistula Ethiopia has partnered with the Ethiopian government to provide resources and midwives who have graduated from the Hamlin College of Midwives, to 80 government midwifery clinics across regional Ethiopia.
As part of the whole patient approach she advocated, Hamlin opened a rehabilitation and reintegration centre for fistula patients in 2002. Called Desta Mender (Amharic for 'Joy Village'), the facility was built on land donated by the Ethiopian government. The location of the site is approximately 10 kilometres from the Addis Ababa Fistula Hospital. Desta Mender has 10 houses which accommodate patients suffering chronic long-term injuries which require further care. Patients at the rehabilitation and reintegration centre undergo literacy and numeracy classes, counselling and vocational training.
On 1 January 2001, she was awarded the Centenary Medal for "long and outstanding service to international development in Africa". She is the author of the best-selling book, The Hospital by the River: A Story of Hope, first published in 2001. A second ion was published in 2016 with a foreword by Dame Quentin Bryce. She has been described as a modern-day "Mother Teresa" in an orial by Pulitzer Prize–winning writer Nicholas Kristof of The New York Times.
Aged 80, Hamlin appeared on Oprah Winfrey's television show in January 2004. The episode was included in Winfrey's 20-year anthology collection. Winfrey travelled to the hospital and filmed another episode for her show, broadcast in December 2005. The 2007 documentary, "A Walk to Beautiful" featured five Ethiopian women who were treated and cured by Hamlin and her team at the Addis Ababa Fistula Hospital.
In 2019, Hamlin celebrated the 60th anniversary of her arrival in Ethiopia at a ceremony at the Addis Ababa Fistula Hospital. The Ethiopian Prime Minister, Abiy Ahmed, gave a speech recognising Catherine’s great impact on Ethiopia and presented her with a prestigious Eminent Citizen Award on behalf of the Government of Ethiopia. She is one of three people to ever receive this accolade.
The Sydney ferry Catherine Hamlin
Both Hamlin and her hospital received numerous awards. Known for her dedication and humility, Hamlin said of the plaudits she received that "I'm doing what I love doing and it's not a hardship for me to be working in Ethiopia with these women".
^Awards and Culture Branch, Department of Prime Minister and Cabinet (26 January 1983). "Its an Honour". itsanhonour.gov.au. Canberra: Commonwealth of Australia. Archived from the original on 29 June 2011. Retrieved 20 June 2010.
^Awards and Culture Branch, Department of Prime Minister and Cabinet (26 January 1995). "It's an Honour". itsanhonour.gov.au. Canberra: Commonwealth of Australia. Archived from the original on 4 June 2011. Retrieved 20 June 2010.
^Awards and Culture Branch, Department of Prime Minister and Cabinet (1 January 2001). "It's an Honour". itsanhonour.gov.au. Canberra: Commonwealth of Australia. Archived from the original on 29 June 2011. Retrieved 20 June 2010.