At Hamlin Fistula Ethiopia, good nutrition is recognised as an essential foundation of healing for women with childbirth injuries. It is an integral part of the Hamlin Model of Care, a holistic approach to obstetric fistula treatment that supports each woman’s physical, emotional and social recovery.
Many women arrive at any of the six Hamlin hospitals with complex health needs. After years of living with obstetric fistula, they may be experiencing muscle weakness from long periods of immobility, chronic skin irritation, internal infections, and the ongoing physical effects of incontinence and poor hygiene.
Research shows why nutrition matters
Sister Tigist Debebe, who has a master’s degree in public health and nutrition, has undertaken research into the nutritional status of women with obstetric fistula, published in the Millennium Journal of Health. The research found that more than one-third of women presenting at the Addis Ababa Fistula Hospital in Ethiopia were underweight, with women in rural areas five times more likely to be malnourished than women in urban areas.
In the paper, Sister Tigist and her co-authors note that the findings “emphasise the importance of implementing comprehensive interventions to improve nutrition and well-being in this population”.
Sister Tigist says micronutrient deficiencies are also common among patients with obstetric fistula. “At Hamlin Fistula Ethiopia, we conduct individualised nutritional assessments using the NCES approach — Nutrition Assessment, Counselling and Support,” she explains. “Through proper diagnosis and treatment, we can address the specific nutritional needs of each patient.”
Genet’s story
For Genet*, who lived with obstetric fistula for almost two decades before receiving treatment, the impact of poor nutrition was part of daily life.
Before her injury, Genet, a widow, earned a small income by doing labouring work in neighbours’ homes. But the constant leaking, pain and shame caused by fistula eventually made it impossible for her to continue working.
Her family became reliant on the kindness of neighbours for food. There were many times when there simply was not enough for Genet, her daughter and her elderly mother.
“I used to earn a living by doing labouring work in neighbours’ homes — scraping enset for them and doing other tasks,” Genet says. “I supported my family with the small income I earned from these jobs. Then, because of the problem I faced, I was forced to stop the work I used to do.
“After that, we began living on the edge. We ate when food was available, and when it wasn’t, we just went to sleep.”
Care begins from the moment of arrival
At Hamlin, nutritional care begins from the moment a woman arrives at hospital.
Before treatment begins, each patient receives a thorough health assessment, including an assessment of her nutritional status. A personalised care plan is then put in place to help build her strength before surgery. Nutritious meals, rest and targeted support help prepare women physically for treatment and can support a stronger recovery after surgery.
Sister Tigist adds: “When we improve the nutritional status of women, this has a positive impact on their physical and mental health. It also improves the outcome of obstetric fistula surgery, reduces the likelihood of repeat surgeries, and supports each patient’s overall recovery.”
For Genet, nutritional care began on her very first day at Hamlin’s Addis Ababa Fistula Hospital.
“I took a shower, changed my clothes, and rested in my bed,” she says. “After that, they brought me lunch. That was the first day I was able to sleep well.”
For women who have lived for years with pain, hunger and isolation, nutrition is more than a meal. It is part of restoring strength, dignity and hope — and one of the first steps on the journey to healing.
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*Patient names have been changed to protect the identities of those we help.
