6 July 2004


Press Briefing

press conference on 2004 un population award

Two Australians dedicated to groundbreaking work on some of Africa's greatest challenges received the 2004 United Nations Population Award today in New York.  The individual award went to demographer John Caldwell, who has done extensive research on the HIV/AIDS epidemic in Africa, while the award for an institution went to the Addis AbabaFistulaHospital, a vital service that Dr. Catherine Hamlin helped establish in Ethiopia over 30 years ago.

The honourees were introduced at a press briefing this afternoon by Joseph Chamie, Director of the United Nations Population Division, and Australian Ambassador John Dauth, who said that it was a proud day for his country having two of its most distinguished citizens honoured for their inspiring work.

The annual Award honours individuals and institutions for their outstanding work in the field of population and in the improvement of the health and welfare of individuals.  The Award Committee, chaired by Ambassador Iftekhar Ahmed Chowdhury of Bangladesh, selected the winners after reviewing nominations received from around the world.  The Committee is made up of United Nations Member States, with the United Nations Population Fund (UNFPA) as its secretariat.  Each winner will receive a certificate, a gold medal and an equal share of a monetary prize.

Mr. Caldwell, 75, an internationally acclaimed demographer who focuses on Asia and sub-Saharan Africa, has produced an unparalleled body of work to frame the HIV/AIDS epidemic in Africa as a demographic, epidemiological and sociocultural phenomenon.  Today, he said he had been fortunate because his life and career had spanned the greatest changes the world had ever seen.

He and his wife began working in the 1950s and had been drawn to particularly challenging trends, such as the unexpected and huge decline in mortality in third world countries, and later the attempt to try and control fertility so as to reduce population growth, and finally, for the past 16 years, they had headed a programme at the Australian National University, studying the cultural, social and behavioural contexts of the African AIDS epidemic.

He said that fertility was falling everywhere today, except in perhaps sub-Saharan Africa.  Indeed a major challenge for demographers was that in the developing world fertility might soon go well below replacement levels.  China was already there, as were a range of countries in South East Asia. He said it was very important to train professionals for the future, noting that the University had trained several hundred graduate students in demography.

Looking ahead, Mr. Caldwell said the challenge would be to deal with those decreasing fertility levels in a world that had changed dramatically over the past 50 years.  And the demographic changes were by no means finished.  The world’s population was expected to grow perhaps another 50 per cent over the next generation or so, with sub-Saharan Africa threatening to treble or quadruple its population, despite very limited natural resources.  There was a real fear that as fertility decreased in the developed countries, everyone would lose focus on how important it would be to also get fertility rates to climb in the developing world, especially in sub-Saharan Africa and Asia.

Dr. Hamlin, 80, is a Sydney doctor who for 30 years has worked among the poor in Ethiopia.  She and her late husband went to Africa in 1959 on a government contract, expecting to train midwives.  Instead, they encountered scores of women, and “these poor little girls”, suffering from painful fistulas, or tears in the area between the vagina and rectum, caused by obstructed labour when emergency care, chiefly Caesarean section in this case, was unavailable.

The couple founded the FistulaHospital in Ethiopia in 1974, which uniquely specializes in the treatment and care of women living with obstetric fistula, a devastating childbirth injury that damages a woman’s birth canal and leaves her incontinent.  Today, she said that while obstructed labours -- often caused by small or malformed pelvis or a badly positioned foetus -- occurred in five per cent of women worldwide, it was particularly devastating in Africa, where there were so few doctors, few hospitals, and even fewer navigable roads.

“The plight of these women and girls is one of the saddest in the world, because not only does she endure a long and painful labour -- sometimes five or six days -- she goes on to deliver a stillborn baby”, Dr. Hamlin said.  And with the hope of a live child shattered, the pain did not end there, because the mothers then realize that they have no control over their bladders, and as many as 16 per cent had no control over their bowel movements.

“My husband was a very compassionate man.  He’s the one who set up everything and raised money all over the world to build a place to look after these girls and young women -- and to love them”, Ms. Hamlin said, adding “our hearts were affected and we just could not leave these sad, beautiful women.”  The FistulaHospital treated 1,200 women a year without charge -- it is funded by donations and grants -- but some cannot be cured.  Often those women stayed on at the Hospital, where they worked as medical assistants.  Some even became fistula surgeons.

There was nothing more heart-rending -- or heart-warming -- than when a young fistula patient came through the Hospital gates with nothing more than hope, faith and urine soaked clothes, looking for a cure and someone to love them.  “And they are easy to love”, Ms. Hamlin said.  The Hospital has done some 25,000 fistula surgeries over the past 30 years, with five surgeons and a staff of compassionate assistants.  The Hospital had been very successful in raising money and had been able to train doctors from New Guinea, Afghanistan, Nepal and other countries, so that they could return to their homelands and help the women there.

One of the best things about the Hospital, today’s United Nations award and the work of other international organizations was that they were all bringing the horrors of fistulas to light.  “This has been going on for centuries and nobody’s done anything about it”, she said, mainly because the women were ashamed -- and “hid in dark little huts” all over Africa, the Pacific Islands and parts of Asia where there were not enough doctors or hospitals.  Their husbands would reject them because they were of no use.  The Hospital’s job was to send the women back to their villages “on dancing feet” to start their lives over.

She went on to say that the World Health Organization (WHO) had helped the Hospital set up and maintain a village for those women whose surgeries, which left them wearing a bag for urine drainage, prevented them from returning to their own homes.  Some 60 acres of land had been donated by the Ethiopian Government and the WHO had helped out with farm equipment, tractors and a freshwater well.

Still, overall needs were increasing, so funding was a top priority.  While the Hospital handled 1,200 or so operations yearly, it was estimated that some 8,000-9,000 new patients needed treatment every year.  The Hospital drew from its trust fund, and was helped by the Australian Government to improve programmes and facilities, as well as Ethiopia Aid of England, with American groups helping with outreach programmes.  She said that the Hospital had begun to open small regional medical centres to help those that could not get to Addis.  She added that a philanthropic trust in California was raising money to secure the future of the Hospital and its programmes.  “This is my dream, that the Hospital will be secure and keep operating after I go”, she said.  

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For information media. Not an official record.