The fight to eradicate Obstetric Fistula

College Dean Zelalem Belete believes the more complex the cases students are involved with, the better prepared they’ll be when they finally return to their home areas.

“In Ethiopia, there are so few gynaecologists, a midwife has to serve as a gynaecologist, an obstetrician and a GP as well as a midwife,” he says. “So they have to develop the kind of skills they need to handle all sorts of problems.”

Hamlin Fistula Ethiopia
(Hamlin) recruits students from rural areas, puts them through rigorous
training to become midwives, and deploys them back to their villages where
their skills are needed.

A vital part of Hamlin’s mission is to ensure that women in Ethiopia have access to qualified midwives, so they no longer suffer for days on end with an obstructed labour. Tblets is training to be a midwife.

22-year-old Tblets is from Tigray in the north of Ethiopia. She is in her fourth and final year of training at the Hamlin College of Midwives. When Tblets graduates, she will return to the Tigray region to work as a midwife, as a way of preventing fistula and other childbirth injuries.

The Hamlin College of Midwives is a centre of excellence for the training of midwives. Each student undertakes a four-year degree in Midwifery and commits to working as a Hamlin midwife for a minimum of four years following their graduation.

Tblets is one of 95 students currently studying at the college and has already delivered 32 babies.

“I wanted to do this work to reduce the amount of maternal mortality and childbirth injuries in my country,” Tblets says. “Here it is a very high rate, too high. I want to help and it is thanks to Catherine that I am able to learn how to.”


In 2018, 145 Hamlin Midwives were able to provide skilled delivery services to 11,897 labouring women.

In 2018, alongside clinical midwifery activities, Hamlin rural midwives were also able to provide home-based antenatal services to 18,475 pregnant women and a total of 93,405 women received culturally sensitive and appropriate contraceptive advice across all regional the health centres.

There are now Hamlin midwives at 65 rural government health centres. The long-term effects of a Hamlin midwife are enormous – when a Hamlin midwife starts at a clinic, new cases of fistula drop to virtually zero in nearby villages.

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