Physiotherapy at the Hamlin Fistula Hospital, Addis Ababa

Author(s): G. Brook - Pages: 36–40

Abstract

An obstetric fistula occurs when an obstructed labour leads to the baby’s head causing prolonged pressure within the mother’s pelvis, which results in ischaemic necrosis of the soft tissues. In most cases, the baby dies. A vesicovaginal fistula forms, resulting in severe urinary incontinence. Women who also experience a rectovaginal fistula suffer faecal incontinence as well. It is estimated that more than 2 million women world-wide live with an obstetric fistula. In Ethiopia, as many as 9000 women per year will develop a fistula, and many factors contribute to this. The country is large and mountainous, and only 10% of women have access to a skilled health worker during labour. With little or no access to adequate sanitation and no pads, many fistula sufferers live in isolation. Doctors Reginald and Catherine Hamlin established the Addis Ababa Fistula Hospital (AAFH) in 1974, which has since developed into an internationally renowned centre of excellence. Physiotherapy services were introduced in 2003. The AAFH and its outreach centres treat several thousand women each year. Many arrive with considerable rehabilitation needs before they are fit for surgery, while others
remain incontinent despite a successful fistula repair. The physiotherapy team offers a range of treatments both pre- and post-operatively.

Keywords: obstetric fistula, physiotherapy, urinary incontinence.