The Women in The White Dresses

In the Ethiopian capital Addis Ababa lies a hospital for women only. The patients are all incontinent and all mothers of stillborn babies. They live with a hidden hole in their bladder and have come to the hospital to receive help. Some of them have lost everything and to them the hospital has become their only sanctuary. They all suffer from the childbirth injury fistula.

Worldwide more than two million women and young girls live with untreated fistula. Most of them live in Asia and sub-Saharan Africa in poor areas far away from hospitals. Prolonged labour, limited access to midwifery and teenage pregnancies are some of the factors causing fistula. The injury leaves the women and girls with a hole between the birth canal and the bladder, which means they can’t control the leaking of urine or faeces anymore. This places them in a very vulnerable situation. Many women experience being rejected by family members, left by their husbands and alienated from their local communities. It also makes it hard for the women to work due to the incontinence, and many are pushed out into further poverty.

The women’s hospital Hamlin Fistula Hospital in Ethiopia is one of the only hospitals in Africa that solely focuses on treating the injury. In Ethiopia alone it is estimated that, about 39.000 women live with untreated fistula and 3.700 develop the condition annually. The women’s hospital focuses not only on operating fistula patients. It also runs a rehabilitation centre for those women who suffer most severely under social stigmatization or incurable fistula.

© Ida Guldbaek Arentsen - A group of women sit on the wide steps leading down to one of the hospital wards braiding each other’s hair.
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A group of women sit on the wide steps leading down to one of the hospital wards braiding each other’s hair.

© Ida Guldbaek Arentsen - A nurse is preparing the beds with clean bedding on the ward for newly arrived fistula patients.
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A nurse is preparing the beds with clean bedding on the ward for newly arrived fistula patients.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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Messeret is 18 years old and got married when she was 14 to a man she didn’t know. She got pregnant one year after the wedding, but the delivery was complicated. After two days of labour she gave birth to a little stillborn boy in her mothers bed and became incontinent. After this her husband sold all their belongings and disappeared. Messeret moved in with her mother, but the house soon became a prison to her. Sometimes people in the village told her she was smelly, when she walked outside, and she started to feel ashamed of herself. “I felt that God was punishing me, and that I would rather die than live like this,” says Messeret.

© Ida Guldbaek Arentsen - Sichale undergo her fistula surgery at the hospital. She has been incontinent for almost one and a half year.
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Sichale undergo her fistula surgery at the hospital. She has been incontinent for almost one and a half year.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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In most cases fistula can be cured with surgery, but many women are not aware that they can get help, or it can be to difficult for them to reach a hospital performing the sugeries.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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Tjegarnish and Messeret are braiding each other’s hair outside one of the hospital wards. They are both waiting to recover after surgery.

© Ida Guldbaek Arentsen - The women are preparing for bedtime at the hospitals rehabilitation centre outside Addis Ababa.
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The women are preparing for bedtime at the hospitals rehabilitation centre outside Addis Ababa.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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Every morning Abebech is having thermotherapy on her legs. For four years Abebech couldn’t walk because of heavy nerve pains due to fistula. She could only sit or lie down, and as the years have gone her joints have become stiff. In some cases the fistula patients also come to the hospital with other physical injuries than incontinence. Fistula can also cause nerve injuries, infection and foot drop.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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Fantash is 26 years old and staying at the hospital ward for newly arrived fistula patients. Two years ago Fantash gave birth to a stillborn baby. She was in labour for three days, before she arrived to a hospital, and she got fistula and a severe infection as a result. Fantash vividly remembers the burning sensation on her skin, when she was bedbound for months. The pain was so unbearable, that she hardly noticed that she couldn’t control the leaking of urine anymore. One day her husband was leaning against the doorframe to the bedroom. He held his nose and made it clear that he was disgusted. “He said that I was of no use after our baby died,” says Fantash.

© Ida Guldbaek Arentsen - Zewda undergoing her fistula sugery.
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Zewda undergoing her fistula sugery.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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Monday, Wednesday and Friday are surgery days at the hospital. Normally the doctor operates three women in a day dependent on how severe their fistula injury is.

© Ida Guldbaek Arentsen - Image from the The Women in The White Dresses photography project
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Trees are reflected in the shiny surface in the lake of the rehabilitation centre and turn into soft silhouettes. Efto and Desta hold hands and move carefully towards the edge of the water. Desta picks a couple of the light green rush leaves. She ties them like a belt around Efto’s waist turning the shape of the large hospital gown into something more delicate. The last rush leaf she ties like a wreath around Efto’s head. “K’onijo,” Desta says and Efto smiles. Beautiful.

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