Enatnesh Amare came to the Hamlin Hospital from a village named Ambo. She is 19 years old and has been at the Hamlin and Desta Mender combined for 18 months. The women visit Desta Mender for precounseling prior to their surgeries. Enatnesh has sustained 4 surgeries at the Hamlin, her 5th surgery was to fit her with a Colostamy bag. She is glad to have the option of living at Desta Mender over going home, she was married and is now divorced due to her medical condition. She is familiar with the training program and would like to become a vendor for grains and teff. She had heard about the Hamlin hospital on a radio program and came to the hospital to be repaired. The image in the background is a landscape near Addis. The pelvic bone xray symbolizes the ghosted hope of a marriage and pregnancy, the reality of our anatomy, and the many, many, many losses due to complications sustained by obstruction when the bones of the birth canal are undeveloped.


Retraining at Desta Mender follows the model of the Non Formal Adult Literacy Program. The NFAL consists of a 5 part curriculum. First the women are assessed for prior knowledge and then grouped accordingly. 1. Knowing myself 2. My life of opportunity 3. Let me try out 4. My winning strategies in life 5. Ensuing sustainable livelihoods. If a women entering the program has some prior experience, she may take some selected courses to fill the gaps or if she has a very good attitude she could go right into the Livelihood program. In the Livelihood program, women develop a specific skill enabling the them to start a small business. A bank account is set up for them and they learn to manage money and budget for expenses and rent. Zemzem Abdu is originally from Arsi Bale. She is 40 years old and has been at the Hamlin Hospital and Desta Mender combined for 5 years. After 2 years of training she became an independent contractor in Tailoring. The hospital supplies her with a sewing machine and fabric. She  supplyies the hospital with new bedsheets, hospital gowns, pajamas and OR masks. She makes her own dresses and sometimes repairs clothes for her friends. Zemzem lives 3k from Desta Mender in a compound owned by a priest and rents her own apartment and studio space. The background is a landscape on the way to Desta Mender from the Hamlin Hospital, the fistula surgical needles are symbolic of the surgeries she sustained and her new profession, the patterning is symbolic of the ethiopian crosses, her beauty, her courage and her faith.


Sometimes a woman has a difficult fistula. Sometimes there is muscle loss and infection. Sometimes the fistula does not close completely. In these cases, the women are trained to live with a Colostamy bag. Desta Mender or Joy Village is a Retraining and Recovering center about 10k from the Hamlin Fistula Hospital. Desta Mender has a number of small business models on site. With assistance from ANFEAE http://www.anfeae.org/; the business models at Desta Mender include: 1. The Juniper Cafe 2. Dairy 3. Poultry 4. Organic Farming 5. Tailoring. These businesses support operations at Desta Mender. At Desta Mender, 30 year old Kebebush Assefa works as an Accountant. She manages the finances of the Dairy Farm. Before coming to the Hamlin Hospital and Desta Mender, she lived alone in a hut for 8 years curled up in a fetal position to try to stop the leaking; her Aunt would throw her food. She had to undergo intensive physical therapy to regain strength in her legs as her leg muscles had atrophied from staying in one position.  The Dairy Farm is shown in the background. The scales symbolize her profession, the judgements made against her while she suffered the aftermath of her injuries, and her ability to reclaim balance in health and quality of life. She is a symbol of confidence regained from healing at the Hamlin and retraining at Desta Mender.



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