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From Helplessness to Hope: New Beginnings for Obstetric Fistula Survivors in Ethiopia

New beginnings for fistula patients

I first traveled to Ethiopia in 2010 as a photographer with the organization SalaamGarage to profile the childbirth injury of Obstetric Fistula. During that trip we spent time at Hamlin Fistula Hospital and heard the harrowing and heartbreaking stories of the fistula patients. Obstetric Fistula is caused by prolonged, obstructed labor and results in a hole between the birth canal and another organ, as well as death of the baby. Women are left incontinent of urine, feces, or both. Adding to their grief and humiliation, these women are frequently rejected by their families, isolated from their communities, and banned from public transportation. They have little, if any, support or hope for their future.

I learned about a 22-year old woman named Ajayibe (“Amazing”) who had hung herself from a tree in a suicide attempt in a remote western village. Her husband and family rejected her, and she’d run out of options. Through a serendipitous encounter with a man named Tsega (“Grace”,) she was brought to Hamlin Hospital for a fistula repair surgery. That surgery, as well as two subsequent ones has been, tragically, unsuccessful.

When I heard the story of Ajayibe I was moved to tears. For a woman of childbearing age in the USA, there are so many options available! She can choose to have children or not, to adopt or use fertility drugs, to deliver vaginally or by C-section. Women in so many parts of the world lack these options.

I met Tsega in the parking lot of Hamlin Hospital after he and 2 other men had brought 3 women, including Ajayibe, for treatment. Tsega has an engineering background and a workshop that manufactures and installs hydro-powered turbines. These turbines can run small machines, generate electricity, and operate mills that grind grain for women in rural areas. One such water mill helps about 800 families (3,200 people) and keeps women from having to do the backbreaking work of grinding wheat, corn, barley, and tef by hand. Tsega is a strong advocate for women, and especially fistula patients.

I asked Tsega if it would be possible to build a mill so that the proceeds could benefit women like Ajayibe. He replied that it had never been done, but that it seemed like a good idea. In 2011 I returned for a month-long solo trip to Ethiopia to research, interview, and fact-find about this idea. I met Ajayibe and other fistula patients like her. I went back to Hamlin Hospital. I traveled out to Begi and met organizers of the existing fistula transport program. The idea of a mill project was well received, so I came home to Seattle and began fundraising for the $10,000 needed.

Over the next year I created a film, showed photographs, and told stories about Ajayibe and Obstetric Fistula to whoever would listen. The money was raised, and the mill is now completed and operational. In 2012 I returned on a donor trip to see the mill, a nearby clinic, and a training program for fistula patients which is located in a different part of the country. I wonder about creating a similar training program in Begi with the components of increased support and self-esteem, basic maternal health, and economic empowerment. This will take more time and more funds.

Today, the first fistula survivors, including Ajayibe, have received flocks of sheep for their first income-generation projects from the proceeds of the mill. They have new hope, and a means to support themselves. I will be returning for a 4th trip to Ethiopia on May 20th to determine next steps.

While I’m proud of my own small involvement in helping to create new hope and possibilities for a few women in Ethiopia, I’ve been humbled beyond belief at the generosity of others and at the courage of the women and the men whom I’ve met along the way. This story of Amazing Grace continues to unfold, and all of it feels worthwhile when I consider the transformation of Ajayibe’s shattered life to her now radiant smile.

mill on the Chandi River
Kristie and Ajayibe
First women at the mill!
hydro-powered turbine
Local excitement over the new mill!
Tsega and Kristie
The mill house
Local clinic


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