Life Disrupted and The Return to Normal

Author, Veronica Gray’s  Note:
In November 2010 I traveled to Ethiopia with SalaamGarage.  We had been invited to visit the Hamlin Fistula Hospital in Addis Ababa.  There, I met Alemtsehay Mamo and Engocha Marefia.  I had the privilege of these two very remarkable women permitting me to look into the windows of their lives.  They taught me so much about being alive – they touched my spirit as nothing else/anyone has. Here are their stories.  They will steal your heart and take your breath away.  You can make a difference to women like Alemtsehay and Engocha who suffered from obstetric fistula.  Help others like them walk the road back to normalcy and regain their dignity.

The women’s names have been changed to protect their privacy. Many thanks to Ruth Gadissa, Senior Nurse at the Hamlin Fistula Hospital, who was my translator.

“MY STORY” as told to Veronica M. Gray

My name is Alemtsehay Mamo. I am 19 years old. Yesterday, I was operated on for the third time in three years.  I suffer from obstetric fistula and complications from my first pregnancy.

I was born in Shwa Deira, Ethiopia.  Until I was 13 years old, I lived with my parents and 4 brothers and 4 sisters.  I attended school in my village.  I was learning English and taking science courses because I wanted to become a nurse and help people.  I still do.

At the age of 13 years old I was introduced to my husband who is 10 years older.  We soon married and I left my family to live with my husband, his parents, and his 7 brothers, and 3 sisters.  Before I became pregnant, I worked on my family’s farm, growing tomatoes.

I was 16 when I first became pregnant.  There was nothing unusual about my pregnancy until it was time to give birth.  My mother was with me when I went into labor.  This is typical in my world to only have our mothers assist us in giving birth – without the assistance of a doctor or midwife because any clinic or hospital is too far away.  As my labor continued hour after hour – day after day – the pain became unbearable. I thought I would and in fact wanted to die.  My parents were beside themselves because they could not help me.  They then took me to the medical clinic which was a 3 hour walk from our village.   When we arrived at the clinic, my condition was so bad that no one there could help me.  Somehow, my father arranged to have me taken to Black Lion Hospital in Addis Ababa.  On the 4th day of labor they pulled the baby with forceps from my body.  My baby had died during our journey to get help.  I was so very sad.  I cried and cried.

My heart ached for my baby; I did not know what to do.  And, I was still in so much pain.  The next day, I realized that there was something very wrong.  I was leaking feces and urine down my legs.  I did not understand and was frightened.  The smell was awful.  It was humiliating – I just wanted to die.  Then the doctor told me about the Hamlin Fistula Hospital.  My father and brother took me to Hamlin but when we arrived they told me they could not help me for at least 3 months in order to give my body time to heal.  I was so upset but had no choice but to return to my village.  I was so ashamed of my leaking and cried all the time.  I did not understand why this had happened to me.  I wanted to commit suicide.  My family was also shocked and did not understand.  My sisters had given birth to healthy babies.  I couldn’t help asking “what had I done to deserve this? – why was this happening to me?”  Although my family, my husband, and my village embraced me with their love – I was very sad and lonely – not knowing how long I would continue leaking.  As a result of the leaking and not being able to move freely – I developed foot drop – my legs would not hold up body.

After 3 months I returned to the Hamlin Fistula Hospital and was operated on.  I stayed at the hospital for several weeks and met other young women with obstetric fistula.  What a relief to know that there were others like me and I was not the only one.   I made friends at the hospital.  We would talk and laugh and walk through the gardens sharing secrets and our shame.  It was as if I had many sisters all at once.  Although the fistula operation was successful, my injuries were greater than anyone had realized – my bladder was still leaking urine.  After several weeks, I returned to my village to live with my parents.  With my father’s encouragement I returned to school.

Several months later I returned to Hamlin to have my second operation to stop the leaking.  Although it was successful, there was still more to cure.  I was still leaking.  I returned home and told my husband that I was still leaking urine and could not work on the farm.  I told him that he should find someone else and remarry.  I simply could not go back and live with him.  It was too humiliating.  I also felt uncomfortable living in my village so I returned to Addis Ababa.  I am renting an apartment with 2 of the women I met at Hamlin.  I was very lucky to have these new friends to live with and to find work washing clothes.  I am also going to school at night so I can become a nurse.

I have just recovered from my third operation and I am no longer leaking.  I am back at work and going to school. I am so grateful to the doctors and nurses at Hamlin and to all the friends I made there.  I hope that other women do not experience what I did.  My mission is to tell all women that they need to see a doctor when they become pregnant so they can give birth at a hospital and avoid what happened to me and if they leak as I did – the Hamlin Fistula Hospital is there for them and they do not have to pay.  It is free.


My name is Engocha Marefia. I am 20 years old. I am a patient at the Hamlin Fistula Hospital in Addis Ababa, Ethiopia.  I am recovering from my second operation as a result of giving birth to a still born baby.  I only hope and pray that the leaking has stopped now.

I was born in Feres Moga Georgis and now live in Assossa Iwollega – which is in northern Ethiopia, near the Sudan border.  My mother died when I was 10 year old.  My father remarried but I did not live with him growing up.  I have one brother and 3 half brothers.  But I did not live with my father growing up – I lived with neighbors/my friend’s family.  I never thought about gong to school but worked simply to survive.

I was lucky and was introduced to my future husband.  I feel in love with him and we married.   He was 22 years old and good looking as I.  At 18, I became pregnant and did not have any problems until I went into labor.  I was at home and the neighbors tried to help.  The pain was unbearable.  We went to the nearest clinic but it was unable to help me.   We then spent all our money and rented a car to go to the nearest hospital several hours away but it was too late.  My baby did not survive.  I spent many days in the hospital and realized I was uncontrollably leaking – feces and urine – and could not do anything about it.  I felt very disconnected and disoriented and so ashamed.  No one said anything to me about the leaking and I was too afraid to ask.
The doctors all seemed too busy and I did not want to bother them.  After 10 days, I returned home.  I cried every day.  I did not know what to do.  The pain was overwhelming and ran through every inch of my body and the leaking continued.  I was unable to take care of myself.  My husband and neighbors had to help me do everything.  I worried everyday about what was going to happen to me.  I prayed to God to help me.  Then one day,  someone told me about the Hamlin Fistula Hospital.  After traveling many days, I arrived there in early 2010.  I had my first operation and it helped a lot but I was still leaking urine.  I returned to live with my husband but could not do very much.  I tried using pads but it was very uncomfortable.  I had to wait 6 months before I could return to Hamlin for my second operation.  I now lie in bed knitting and waiting to see if the leaking has stopped.  If it hasn’t, I do not want to return to my husband.  I am too embarrassed.  The nurses at Hamlin encourage me to return to my husband.

I am so grateful for Hamlin and all the love, care, and friendship they have given me.  I do not know what I would have done without them.  I now know how important it is to have medical care.


Obstetric fistula is one the most devastating and serious of all childbirth injuries.  It is an internal injury caused generally by days of unrelieved obstructed labor.  During labor contractions, the baby’s head is constantly pushing against the mother’s pelvic bone – causing tissue to die due to lack of blood flow to this area.  The pushing creates a hole (a fistula) between the birth passage and internal organs such as the bladder or rectum. The result is that urine and bowel content cannot be held.  Fistula is preventable when timely emergency obstetric care such as a cesarean section surgery is available. Unfortunately in the world’s poorest countries, most mothers as Alemtsehay and Engocha live in rural areas and delivering their babies without medical help.

The Hamlin Fistula Hospital in Addis Ababa, Ethiopia provides free fistula repair surgery to approximately 2,500 women every year and cares for 50 long term patients.  The Hospital also has five mini-hospitals planned, of which three are already functioning and two are in the planning/construction phase. A more recent project is the establishment of a midwifery school to train midwives who will work in rural areas to help prevent fistula from occurring.
You can give a young woman a new life – the gift of dignity is priceless!
Hamlin Fistula Hospital and Hamlin Midwifery College Needs:

  • $500 covers the cost of a fistula operation
  • $3000 covers the cost of  1 Student for 1 year at the Midwifery College
  • $8 buys a blanket for a new patient
  • $4.50 buys a nurse uniform
  • $2 buys plastic slippers for patients without shoes

For your donation (any amount) click here to reach USA Hamlin Fistula Fund.


Veronica is a prominent trial lawyer at Nossaman Law Firm in Orange County, California, with over three decades of experience litigating and negotiating employment issues for her clients. She leads the Employment Practice Group.

Over the span of Veronica’s career, she has taken on a leadership role in many professional and philanthropic organizations on a local and international level, with a focus on micro-enterprise and children’s education.

Veronica is also a passionate photographer, and her remote travel has allowed her to capture the striking close-up images of the indigenous people she interacts with in places like Nepal, Bhutan, Tibet, India, China, Kenya, Ecuador, Peru, and Nicaragua. What started out as herprivate passion turned into an opportunity to share them with those in her community who would not otherwise have access to remote areas of the world. Veronica has donated her photography to many non-profits to support their fund raising efforts, and her photography has been on exhibition at the Chapman University School of Law and the Peter Blake Gallery in Orange County, and in Orange Coast Magazine.

  • wandering educators

    SO important – and i am so glad to read these stories. i am happy that these women are finding ways to move forward. bravo, hamlin fistula hospital! thank you for sharing this.