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Talking Heads -

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PETER THOMPSON: Dr Catherine Hamlin has turned around the lives of more than 30,000 women. Her work
at the Addis Ababa Fistula Hospital in Ethiopia, repairing injuries sustained in childbirth, has
seen her nominated for a Nobel Peace Prize. Catherine Hamlin has been operating now for 50 years,
and all of this is a far cry from a childhood of privilege in upper-class Sydney.

What's a fistula? Well, even Dr Hamlin had to reach for the textbooks when she arrived in Ethiopia.
There are still an estimated one million sufferers in that country who are outcasts in their own
society. Dr Hamlin, welcome to Talking Heads.

CATHERINE HAMLIN: Thank you, it's lovely to be here.

PETER THOMPSON: Would you explain what is a fistula?

CATHERINE HAMLIN: A fistula is just an opening between an internal organ and the outside of the
body. An obstetric fistula is between the bladder and the vagina or the birth passage, and between
the rectum and the birth passage or the vagina. And it's caused by long obstructed, unrelieved
obstructed labour.

PETER THOMPSON: When you first went to Ethiopia 49 years ago, you were told that the fistula
patients would break your heart.

CATHERINE HAMLIN: We've been told that by the previous gynecologist that we were replacing and it
was just what happened. We were appalled at their condition, we were saddened and they did break
our hearts and that's why we stayed home in Ethiopia.

PETER THOMPSON: When you treat these young women, what's their reaction? It completely changes
their life.

CATHERINE HAMLIN: Yes, it's wonderful. This is why it's so wonderful to be a fistula surgeon, the
joy that they display once they're cured is all in the world we need. Anyone looking after a
fistula girl's cure joins in this joy as they go home to a new life. We were not patching up old
women for a few more years, we're giving a new life to a young girl at the beginning of her life.
Women have been treated really in most of Africa as second-class citizens. But I feel setting up
the Fistula Hospital and devoting so much work to women - the poorest of the poor and most outcast
women - has made a difference.

I was born in 1924 in Sydney in the suburb of Ryde. I was christened Elena Catherine Hinkelson. My
mother cried when I was born because I was the second girl. (LAUGHS) I remember when my brother was
born she was all filled with joy. I had a very happy childhood. I was loved intensely by my
parents. I had an elder sister and lots of brothers and sisters later on and we had a wonderful
family life together in a big old house that was built by the convicts, lovely grounds, and my
mother was a great gardener. My father was fond of boats so we had a wonderful childhood with
horses and with ponies and dogs. We had a very privileged life as children. We had a maid and a
married couple, a gardener and the cook. And when we were little, we had a nurse. We didn't eat
with our mother and father, we ate in the nursery. My father was the most kind man - a sweet
temperament and very seldom got angry. My mother was a stricter person and she was very - she was
very kind and she was very loving too, but she was the one that would dole out the punishment if
we'd been naughty. Perhaps I was maybe the naughtiest, I'm not sure. We had a tremendous upbringing
as Christians. We had family prayers every morning, and we were very regular churchgoers. We knew
the Bible well, my mother would read us Bible stories and my father too. I think I was 12 when I
was sent to boarding school and I was very upset at the time of thinking of leaving my home.

PETER THOMPSON: You were a bit naughty as a child, weren't you?

CATHERINE HAMLIN: Well I was a bit rebellious, I think. I don't really think I was terribly naughty
but I was punished more than the others.

PETER THOMPSON: What did you do? Punished more?

CATHERINE HAMLIN: I think I might have been.

PETER THOMPSON: Or naughtier than the others? What did you get up to?

CATHERINE HAMLIN: We climbed trees and we threw hot potatoes onto cows' backs from our tree house,
all that sort of things. We threw manure over to the next house... (LAUGHS) pelting the children
there. And all sorts of things like that.

PETER THOMPSON: When you were punished - and you were punished by your mother, not your father,


PETER THOMPSON: When you were punished, hmm, you'd laugh.


PETER THOMPSON: Well, what was it about you that made you laugh?

CATHERINE HAMLIN: I don't know. I suppose I just wanted to show that I wasn't sorry. We'd be shut
in the bathroom too and things like that and I'd turn all the taps on and flood the bathroom.

PETER THOMPSON: Your family has a history of missionary activity on both sides.

CATHERINE HAMLIN: Yes. My husband's great great-grandfather lived England to be a missionary in the
Bay of Islands, he landed in New Zealand. And he became very committed to the Maoris and he
translated the Bible into the Maori language.

PETER THOMPSON: And on the other side of the family?

CATHERINE HAMLIN: Mother's ancestors were civil servants in India. And one of them became
converted, became a Christian at that time, he was upset because he had to go to the burning of
these widows. This custom of burning widows when the husband dies and he couldn't agree to this, so
he left. And finally went to New Zealand to farm.

PETER THOMPSON: Doing missionary work, which was to be the path you took eventually, was that ever
a talking point at home?

CATHERINE HAMLIN: Yes. When I did medicine, I thought perhaps I might go and be a missionary at one

PETER THOMPSON: Often boarding school demands of the children that they become quite resilient,
quite self-sufficient. Did that happened to you?

CATHERINE HAMLIN: I think so. I think they do give you a support, especially Frensham because it
was rather an unusual school. We had a lot of outdoor activities and we had a chance to do things
on our own, and it was quite that sort of a school. We weren't regimented I don't think as much as
other schools might have been. It was a rather unusual school. It was a boarding school in the
countryside of Mittagong. We would have what they would call holting - I think it must be an
English word - We'd go and chop up wood or gather wood or pull up weeds, and just generally work in
the bush.

I wasn't a very good witness of my faith at that time because I was ashamed of sitting down and
reading the Bible in front of all the other girls, and I would do it rather in secret. It took a
long time before I felt at home doing that. It was until towards the end of my time at school that
I decided I'd like to be a doctor. I was only 16, 17 actually, when I started university. I went
straight into medicine because of the war years and we all had that idea at school that we'd be
able to help during the war years. I went to church one night and there was a famous preacher
called Hugh Paton. And he was preaching on Jesus' talk with Peter after the Resurrection. It
affected me very much in the church and I came home and I kneeled down and I said, well really I'm
putting myself in the place of Peter because I have often denied Christ and I've denied Jesus at
school and lots of things in my life. So then I committed my life to God. I made a decision to do
something for him in my life. Well, I asked God, really, to forgive my past neglect of him and to
become a true follower of Jesus in my life.

I was going to be accepted at Sydney Hospital or the North Shore and then I failed - and I really
didn't think I was going to fail. We went up to the university and my name wasn't on the list, so I
came home and I said, "I failed". However, I settled down and I did the post a few months later and
I got through. Of course I'd lost my position at these good hospitals, then I went to Crown Street
after that.

PETER THOMPSON: What made you decide to become a doctor?

CATHERINE HAMLIN: I just got a feeling that I'd like to help women and children and I wanted to
just excel in that, really.

PETER THOMPSON: Why, given the vast number of choices, do you think that appealed to you?

CATHERINE HAMLIN: When I first got there, I wasn't completely convinced that I wanted to do this,
but I got very involved as soon as we got into that hospital. It was so busy and it was so exciting
bringing babies into the world and learning all the abnormal things that can happen and also doing

PETER THOMPSON: And Crown Street of course was the women's hospital.

CATHERINE HAMLIN: Yes, it was a very prestigious one. Especially because it was in the slums of
Sydney in those days and so we got every training in abnormal obstetrics at that hospital.

PETER THOMPSON: And the superintendent there was Dr Reginald Hamlin.

CATHERINE HAMLIN: I was the only woman to begin with because we had lots of post-war men coming
back and they were in Crown Street, so I was rather spoiled. I had a lot of attention from Reg
especially training me how to do difficult deliveries, how to rotate a head from a bad position to
the right position, how to deliver a breach, and how to give an anesthetic. And he taught me a lot.
I think I became one of his favourite pupils. He would ring up and say, "I've just been reading a
nice psalm." He would just quote the verses to me and we'd talk about that. We got fond of each
other. We were in his office and he just asked me to marry him from the other side of the desk. He
came over and gave me a kiss and then I said, "Well, I can't tell you at the moment because I'm
just about to go to England", and I said "I let you know when I get there". So I sent him a cable
that I would accept him. (LAUGHS) He sent me the ring over to England, when I came back we got
married soon after that. My mother had a reception at the Hermitage for me, and we had a marquee on
the tennis court. Then, Reg presented me with a beautiful little red Morris Mini car and we spent
our honeymoon traveling about in that.

But then we decided to go and accept an appointment that he got in Adelaide as a medical
superintendent of another maternity hospital - the Queen Victoria, and we were there for some
years. We saw this advertisement in The Lancet and it's said "Gynecologist wanted to found a
midwifery school in Addis Ababa, Ethiopia". And so I said, "Why don't we go to Ethiopia?" And Reg
said, "Well, why not?" Then of course, we set off and went to Sydney, got a ship and then the

PETER THOMPSON: Well exciting Ethiopia awaits, but let's go back to that initial job interview with
Reg. Your mother attended and she told Reg that you were fragile.

CATHERINE HAMLIN: (LAUGHS) Yes, she did. She embarrassed me enormously.

PETER THOMPSON: Was it true?

CATHERINE HAMLIN: No, of course not. I don't know why she said such a thing, I couldn't understand
this at all.

PETER THOMPSON: Did you take long to fall in love with Reg?

CATHERINE HAMLIN: A long time, yes. Quite, well, a couple of years. He was a good deal older than I
was and, er - I mean I liked him very much, I respected his teaching and I was with him a lot, and
we got really fond of each other.

PETER THOMPSON: Did you need to keep the relationship a secret?

CATHERINE HAMLIN: Yes, we did, because there were other doctors there. So he would say, "I'll get
in a taxi, you start walking down Oxford Street and I'll pick you up halfway down", then we'd go
out for dinner together.

PETER THOMPSON: So you went to England and were both practising as obstetricians, and you come to
have your own baby, Richard. How easy was that?

CATHERINE HAMLIN: I was in hospital for the last two months of my pregnancy, having injections,
antibiotics, penicillin every day and I had a difficult delivery, I should have had the C-section.
I had a very good obstetrician but he did a very difficult forceps on me, because I had this blood
condition that I couldn't have a Caesarean Section. But first my husband was told that the baby was
dead so that was a blow but he said, "Never mind about the baby as long as my wife's all right",
but he recovered.

PETER THOMPSON: Now, as it was to turn out, none of those procedures were going to be possible for
the vast majority of women that were having children in Ethiopia.

CATHERINE HAMLIN: No. If the baby doesn't come out normally, they can't get help.

PETER THOMPSON: How big a culture shock was Ethiopia?

CATHERINE HAMLIN: A bit of a culture shock to begin with. Of course the airport in those days was
very quite primitive. Nobody was there to meet us so we started to walk down the road and we found
out of course later we were walking in the wrong way. It was getting very much like a countryside
with donkeys walking down the road and the occasional car. So Reg said, "Never mind, I'm taking you
back to Sydney next week." I said, "We can't, we must try, we just come." So he was feeling a bit
depressed, I knew. So we turned around and we went the other way and we walked straight into the
hospital, which was only about half a mile from the airport. But we didn't start working because
there was no contract for me.

PETER THOMPSON: Reginald seemed to be quite stubborn and strict.

CATHERINE HAMLIN: Yes. We kept getting messages from the medical director, "Lots of patients
waiting, you must come up". He said, "I'm not coming until I get this contract for my wife". And so
then the last day, he said, "I'm going back next Saturday". The contract was pushed under the door
on the Friday night.

We arrived in May 1959. I remember the first fistula patient - she was a very small young girl,
perhaps about 16, I think, or 17. And she was in rags. Mostly the husband would leave a girl
because of the difficulty of trying to live with a woman with a fistula in the bladder. And we were
appalled at her condition. She was pushed aside in the out-patients because she was smelling and my
husband found her sitting there alone. We took this little girl in and she had a very simple repair
to do. So we cured her in about two weeks or less than that. Of course others heard and we had 30 I
think that came. The next year, I think it was over 100 and then they built up very rapidly.

We were beginning to get very involved with these fistula patients and we realized that we were
there to look after them. We read all the books we could about fistula repairs. And we developed
techniques that some people hadn't thought of. We became successful in repairing these girls. In
the beginning, we thought we must enlarge our hospital, we must take every patient in. We built
hostels in the ground of this general hospital that we were working in for many years. Even those
became overcrowded, we had 60 women living there, some of them for years waiting to get a chance to
get into the hospital to be operated on. So my husband said one day to me, "Why don't we build our
own hospital?" So we were fortunate to have the Emperor's permission. We were able to open our
hospital. We took some years to gather the money together but we got it built and we opened in

PETER THOMPSON: Why is Ethiopia the world capital of this problem?

CATHERINE HAMLIN: It's not really any greater than for instance in Nigeria, there are just as many
fistula women. But our country is very mountainous and very full of rushing rivers and ravines and
deserts, and it's difficult to traverse. The average walk of our patients is two days to get to a
main road and so their difficulties are enormous. And the maternal death rate of these women, these
are just the survivors of those that don't die.

PETER THOMPSON: So you and Reg found yourselves not only doing curative surgery but really doing
social medicine.

CATHERINE HAMLIN: We feel we must treat the whole woman and other injuries associated with a
fistula that nobody knows about. These girls lie in bed thinking "If I keep very still, maybe the
urine will dry up". They curl up in bed, their knees become contracted and ankylosed, and their
hips and then muscles, waist, till they can't walk and soon become cripples.

PETER THOMPSON: Do you think either of you could have achieved what you've done with your work
without each other?

CATHERINE HAMLIN: Reg might have but I couldn't have.

PETER THOMPSON: Why do you say that?

CATHERINE HAMLIN: Well he raised all the money to begin with, mostly by writing letters and we went
around America speaking. Sometimes the Americans would shout out, "We want to hear the woman. We
want to hear the woman", and Reg would say, "She's my secret silent weapon." (LAUGHS)

PETER THOMPSON: It sounds like the perfect marriage.

CATHERINE HAMLIN: Oh, no, not at all. We had very many tiffs and arguments and it was a perfect
marriage as we loved each other very deeply, but just like everyone we had arguments and different

PETER THOMPSON: Must have been very difficult to make a separation between time for yourself and
time for the work you did.

CATHERINE HAMLIN: Yes. Well, that was the trouble - Reg did nothing but work and I had to look
after Richard and give him some sort of a nice life. And so I wanted to go... for picnics and
things and Reg was very reluctant to even leave the hospital because we were alone there. I
remember another obstetrician who was working, a German man, he said, "Just leave if you want to go
away for a weekend" and Reg said, "No, I can't do that."

PETER THOMPSON: Well, you didn't pick a good time to open a hospital because the country was about
to be gripped by famine, the Emperor was overthrown and the military government installed.

CATHERINE HAMLIN: We kept a low profile because all mission hospitals were nationalized or taken
over by the government and many had to leave the country. And so we just went on working, we never
had an empty bed even through those years. But at that time, we did have a lot of fighting. I was
operating with a Russian professor in the room, in a theatre, and there was a lot of shooting
across the valley of the old palace, and he said to me, "What's going on?" and I said, "We're going
through a revolution." I said "I've never been through a revolution but you have so you might know
what it's about." (LAUGHS) After the Red Terror, that was the worst time. It was a terrible time
where people were being killed and you'd drive into the city and you'd see many dead bodies lying
in the plateau, and - I can't go into all the stories - they're very sad - but we lost a lot of
friends. We were confined really to the hospital. You had to get the permission to drive on
weekends if you wanted to go to church, if you wanted to go have a picnic, you had to get
permission for everything.

We did fundraise and my late husband was very good at writing letters, so we raised money, we
decided to enlarge the hospital. My husband got a cytoma, a very serious cancer which grows
quickly, and he got it in the leg. We thought it had been removed successfully but it soon came
back. So that was what killed him in the end.

PETER THOMPSON: How did you cope with that?

CATHERINE HAMLIN: I was very stressed, and... I didn't know how I could manage on my own. And one
of my - a wonderful old servant I had, he's still with me, came and knelt down at my feet one day.
I was reading early in the morning on the veranda, feeling a bit sad, I think, and he must have
noticed that I was looking disturbed and he came and kneeled down and kissed the back of my hand
and said, "Don't leave, we'll all help you." It really touched my heart very much. And he's still
there and I decided to stay.

PETER THOMPSON: Inevitably, you had to take over some of the work that Reg was doing.

CATHERINE HAMLIN: I did, I had to fundraise because we needed money and we knew we had to expand,
we had to raise the money for the running costs.

PETER THOMPSON: Well, among other public speaking chores has been talking to Oprah Winfrey.

CATHERINE HAMLIN: Yes, that was easy because she was so nice.

PETER THOMPSON: And that also led to an enormous fundraising.

CATHERINE HAMLIN: It did. She gave me a personal cheque of half a million. She has a huge audience
and we got three million donors over the next 6 to 9 months so that was a tremendous help.

PETER THOMPSON: One of the things you realized was that this work was overwhelming and you needed
to expand the number of hospitals that you had on the ground.


PETER THOMPSON: And you've done that, haven't you?

CATHERINE HAMLIN: The patients kept coming and coming and we thought, why don't we put up
provincial hospitals, smaller hospitals in some of the provinces and we started with one at Bahr
Dar which is at the bottom of a big lake with is the source of the Blue Nile and we set up a centre
there. Actually our builder paid for that centre out of his own pocket, which was an enormous

PETER THOMPSON: There's a fundamental problem here and that is that no matter how many of these
hospitals you open, you can't keep up with the number of women affected.

CATHERINE HAMLIN: There are 9,000 new ones every year and with all those centres running and our
own hospital, we can't do more than 5,000 operations a year.

PETER THOMPSON: Which comes back to a very fundamental thing which is -



CATHERINE HAMLIN: I feel that we've been doing this work all these years and done nothing about
trying to prevent it. This is an enormous challenge. And we thought why don't we put midwives into
these villages, properly trained midwives. We've actually started teaching on 1st January with 12
very bright students. We've got many hospitals now in three provinces running. A fourth one to be
opened soon in Harare, in the east of the country. I operate every Thursday. We have a huge theatre
with four tables, so we can do four operations at once. We're teaching other doctors to be fistula
surgeons, to make it known that these girls can be cured.

Now I'm getting old. I just enjoy my garden, and I enjoy my friends coming to see me. I love
reading, I like sewing, I like knitting. I don't feel lonely at night at all. I know God is with
me, God is behind this work and this is what I feel, I want to tell the world everything that I've
prayed for I've got, everything. And he answers prayer.

PETER THOMPSON: I suspect you might be one of the most senior active surgeons on the planet.

CATHERINE HAMLIN: I think I probably am. (LAUGHS) But I enjoy doing it, I can't see the point of
not doing it if I still got skills and I'm still able to hold the instruments without shaking. So I
just carry on.

PETER THOMPSON: And you've got a steady hand.

CATHERINE HAMLIN: Yes, absolutely.

PETER THOMPSON: (LAUGHS) It's been such a pleasure talking to you, I hope coming on Talking Heads
will make a small difference to the great work that you do.

CATHERINE HAMLIN: Thank you very much. I'm sure it will. Thank you.