Lighting ® a Candle A Midwife for Every Mother A STUDY GUIDE BY KATE RAYNOR http://www.metromagazine.com.au ISBN-13-978-1-74295-010-5 http://www.theeducationshop.com.au ‘I just want the world to know that there are women suffering and there’s something that can be done about it. We’ve let them down in this twenty-first century when so many advances have been made in medicine. And when a woman is at the most important time of her life, giving birth to a baby, she has nobody to help her.’ – Dr Catherine Hamlin AC ‘Dr Hamlin has spent her life translating the finest human values SCREEN EDUCATION and principles into practice. She stands as a source of courage, support and inspiration to all of us. Hers is truly a Golden Life.’ – Governor General of Australia, Ms Quentin Bryce AC 2 INTRODUCTION renowned teaching institution for fistula surgery. Doctors from many African countries and other parts of the developing world Lighting A Candle: A Midwife for Every Mother tells the inspiring come to be trained in the special surgical technique developed story of two compassionate and visionary doctors who deserve by the Hamlins. Also, the hospital has trained over 3000 des- to be household names. Gynaecologists Catherine and Reg perately needed health workers. Every year, the hospital treats Hamlin left Australia in 1959 on what was intended to be a short over 2000 women suffering from obstetric fistula and who come contract to establish a midwifery school in Ethiopia. Fifty years to the hospital’s main facility in Addis Ababa or to one of its five later, Dr Catherine Hamlin AC is still there, running one of the regional fistula centres spread across Ethiopia. The delicate sur- most outstanding medical programs in the world. gical technique developed by the Hamlins in most cases results in a complete cure. Since Dr Reg Hamlin’s death in 1993, Cath- Half a century ago, the Hamlins’ hearts were broken by the erine has continued their work, and more than 37,000 women many women they met who suffered from the catastrophic have now been treated and cured. The hospital restores the effects of obstructed labour. This is a problem easily dealt dignity of these poor young women, offering them the promise with in the developed world by assisted delivery or Caesarean of new lives. The hospital employs ten fistula surgeons and Dr section, but it can be disastrous without proper medical Hamlin, now well into her eighties, still operates on Thursday intervention. Days in obstructed labour can cause a hole or mornings, as she tirelessly continues to work towards her goal fistula in the bladder and sometimes the rectum. As a result, of completely eradicating obstetric fistula. the affected woman leaks urine and/or faeces constantly and has an offensive odour. Often her husband will leave her and The hospital has also established the Hamlin College of her family and friends will avoid her. The awful physical injuries Midwives which is training young women to be fully qualified are compounded by rejection, separation, loneliness and midwives and deploying them into regional areas to prevent shame. Many of these young women feel they have suffered a women dying in labour or suffering the tragic consequences of fate worse than death. Unable to turn away from their plight, obstetric fistula. SCREEN EDUCATION the Hamlins chose to dedicate their lives to these neglected and forgotten women, who, without help, face a lifetime of Lighting a Candle was produced by the Hamlin Fistula Relief incapacity, degradation and ostracism. and Aid Fund which is the registered Australian charity dedicated to supporting the Addis Ababa Fistula Hospital and The Addis Ababa Fistula Hospital, established by Drs Cath- the Hamlin College of Midwives in Ethiopia. Funding for the erine and Reg Hamlin in 1974, has become an internationally documentary was generously provided by AusAID. 3 CURRICULUM LINKS This important film highlights the plight of some of the most destitute women in one of the poorest countries in the world. Obstetric fistula is a huge problem in developing countries and serves to graphically highlight the terrible inequities that exist within and between nations. As teachers, we have a responsibil- ity to educate and inform our students about the world and their place in it. If our students are going to become adults who will participate in creating global solutions to the many crises we face around the world, then they need to be inspired by stories such as the Hamlins’. This is a film to awaken one’s conscience: students need to understand the tremendous privileges we in the West accept as a matter of course and to examine their own potential to act in concrete and meaningful ways to make the world a better place. This film has relevance to middle and senior secondary students in SOSE/HSIE, Economics, Civics & Citizenship, Geography, Women’s Studies and International Studies. It could also be used in English as the basis for a char- acter study or a study on identity. It raises challenging issues concerning: poverty in the developing world; women’s repro- ductive health and status; human rights; humanitarian aid; and the relationship between the West and Africa. The main aim of this guide is to present a wide range of teaching and learning opportunities based on the film, varying in sophistication and complexity. Teachers are encouraged to pick and choose tasks that suit the particular interests and BACKGROUND abilities of their students and the timeframes within which they are operating – not to work through the guide systematically. Women’s HealTH IN ETHIOPIA Most of the activities target literacy outcomes: speaking and listening, reading and writing. There are also activities that A woman born in Ethiopia has a life expectancy of forty-one address ICT and creative thinking. The statements presented years – roughly half that of an Australian woman. On average, in quotation marks are intended to be thought-provoking or she will marry at the age of seventeen and give birth to six controversial and can be used in a number of ways: as a focus children, not counting those she will lose during pregnancy for discussion, debate or oral presentations; and as a direction or within the first five years of life. There is only a 35 per cent for further research, analysis or creative writing tasks. chance she will be literate and a 50 per cent chance she will live below the poverty line. For the 29 million women who live in the rural, mountainous areas of Ethiopia, early marriage is common. Pregnant women customarily deliver their babies at home (94 per cent of births in Ethiopia are at home) with only a female elder in attendance. For a woman in obstructed labour, the closest skilled doctor able to perform a Caesarean section may be more than 300 kilometres away. While having many children is extolled in Ethiopian culture, pregnancy and childbirth are risky endeavours, with the Ethiopian maternal death rate being SCREEN EDUCATION amongst the highest in the world. If women born in the West are among the luckiest women in the world, then based on these national indicators, a woman born in rural Ethiopia must be one of the most unlucky. – From <http://www.fistulafoundation.org/ hospital/womenshealth.html>. 4 FACTS & FIGURES At least 2 million women are living with fistula in developing countries, with 50,000 to 100,000 new cases each year. These numbers are conservative estimates, due THE ADDIS ABABA FISTULA HOSPITAL to the isolation surrounding the condition. Almost 70 per cent of fistula victims end up with no living children, further The Addis Ababa Fistula Hospital is one of the few hospitals isolating them from the traditions of their community. in the world that specialises in treating women with obstetric (Figures from the UNFPA Campaign to End Fistula fistula. 93 per cent of women who come to the hospital are and the Worldwide Fistula Fund) cured and return home to live new lives. The main facility in Addis Ababa and the five regional centres treat over 2000 Of the 137 million illiterate youth in the world, 63 per cent women each year. The location of the five regional centres are female. Only 62 per cent of girls in rural Ethiopia have ever attended school. A developing country study showed means that many more women who suffer from obstetric fistula that doubling the proportion of women with a second- are able to access skilled medical help more readily. Over ary education would reduce fertility rates from 5.3 to 3.9 37,000 women have been cured. As all the women are destitute children per woman. they are treated free of charge. (Figures from UNFPA and the Girls’ Education Project) Some women have injuries which are so severe that they Approximately 19 per cent of the world’s population lives can never be completely cured and require ongoing medical on less than US$1 a day. 73 per cent of the population in the world’s least developed countries lives in rural areas. treatment. The hospital trains these women, many of whom are illiterate, to work as nursing aides, or in the laundry or kitchen. (Figures from 2008 UNICEF State of the World’s Children) Other women are trained to run the hospital’s farm located in In countries such as Bangladesh, Central African Republic, the purpose built village of Desta Mender (Joy Village) where Chad, Guinea, Mali and Niger, more than 60 per cent of dairying, horticulture and egg production are undertaken and a women marry before the age of eighteen.