The Cupertino Courier

News

Repairing childbirth injuries, women's lives

By Erin Hussey

Try and imagine living in Ethiopia, one of the poorest countries in the world, as a 15-year old girl. You don't have a car, you live a two-day walk from the nearest road, another two days to the closest doctor and you're about to go into labor. What do you do?

For most women giving birth in Ethiopia, the answer is nothing. With only 104 registered obstetrician-gynecologists serving a country of 7 million, about 90 percent of women give birth without any trained help, not even a midwife. As a result of their age and malnourished bodies, many women suffer from obstructed labors, leaving them with stillborn babies and a childbirth injury called obstetric fistula.

"Fistula is a medical term for a hole between an inside organ and the external world that shouldn't exist," said Kate Grant, executive director for the Fistula Foundation. Grant is a Sunnyvale native who graduated from Fremont High School in 1976.

With obstetric fistula, the holes develop in the tissue that separates the vagina from the bladder and/or rectum. It's caused by the pressure of the baby's head on the pelvis over many days of obstructed labor. The injury leaves women with permanent incontinence.

In Ethiopia, approximately 9,000 new cases of fistula are reported each year. While fistula was largely eradicated in developed countries in the late 1890s with the use of caesarian sections, the World Health Organization estimates approximately 2 million women worldwide suffer from fistula.

"The good news is about 90 percent of the time, surgery by a skilled surgeon is successful and can mend the holes," Grant said. "But unfortunately, what happens with most of these women is that fistula goes untreated. And in a place where women develop status from having children, if they are unable to do so and they are also incontinent, they generally end up as a social outcasts."

But with the aid of The Fistula Foundation, which helps fund the Hamlin Fistula Hospitals in Ethiopia, nearly 30,000 women have gotten their lives back.

The Addis Ababa Fistula Hospital, the first of six hospitals in Ethiopia, was founded by Dr. Catherine Hamlin and her late husband, Dr. Reginald Hamlin, in 1974. It remains the only medical center in the world dedicated exclusively to fistula repair. At the age of 82, Dr. Catherine is still performing surgeries.

"There are 100 shades of gray on the continuum of jobs," Grant said. "On the black end, there are people arming child soldiers with drugs and guns and then there is Dr. Hamlin. I'm not a particularly religious person but, if I believed in saints, I would believe she is one. She's near the white end. I feel to do work that basically helps her to do more then I'm kind of near that white end. And that's a privilege in life to get up and do a job that feels like that."

After completing her undergraduate degree from UC-Berkeley, Grant worked in advertising for 10 years. "Advertising was fun," she said. "I had an expense account and stayed at nice hotels and ate at nice restaurants, but at the end of the day, you think, 'Gee, I'm using creative ways and some big brains around me to figure out ways to get people to buy things they probably don't need.' "

In order to figure out what she wanted to do with her life, Grant spent seven months traveling around the world. But unlike your typical traveler, she passed on Western Europe for counties such as Uzbekistan, India and what was then the Soviet Union.

"It was an eye-opening experience," Grant said. "I realize we have so much here to share to make other people's lives better."

When she returned to the United States, Grant received her master's degree in public and international affairs from Princeton University. She served on the House of Foreign Affairs Committee staff working for chairman Lee Hamilton and during the Clinton administration as the special assistant and deputy chief of staff to USAID administrator Brian Atwood.

Grant also started working as a consultant for various nonprofit groups including the Rockefeller Foundation and the International AIDS Vaccine Initiative, which eventually lead her back to California and a job as the executive director for the Fistula Foundation.

"I find it very satisfying. I think there is a lot more work, probably a lifetime of work to be done,'' Grant said. "There is a very compassionate public out there that wants to help, but I feel like we are barely scratching the surface of that compassion because most people have never heard of fistula.

"I think it's important to share the experiences of others with people who have the privilege to help. I think that widens the sense of humanity."

For more information on the Fistula Foundation or ways to donate, visit www.fistulafoundation.org or call 408.249.9596.