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Doing Good: The Ethiopia Fistula Project

Published on: December 30, 2013

Local men and women excited by the new grinding mill in their community.
Local men and women excited by the new grinding mill in their community.

Earlier this year I attended a Half the Sky event organized to commemorate International Women’s Day. Several local nonprofits run by women billed as “changemakers” were invited to talk about how they were working to empower women and girls around the world.

Kristie McLean of the Ethiopia Fistula Project spoke, and I was immediately struck by her passion and dedication. And she was doing it single-handedly, raising funds and traveling to Ethiopia to implement her project.

In 2010, McLean traveled to Ethiopia with SalaamGarage to learn more about women’s reproductive health issues, particularly obstetric fistula — a condition caused by prolonged obstetric labor, when the mother does not have access to emergency obstetric care in the form of a cesarean section.  In about 90% of the cases, the baby dies, and if the mother survives, the tremendous pressure of the baby’s head against the pelvic bone causes tissue damage between the vagina and the bladder and/or rectum, causing a hole, or fistula. This is a huge problem in developing countries, where access to health care facilities is woefully inadequate.

The young age of many of the mothers, who are often still children themselves when pregnant and delivering (the average age of a fistula patient is 12-18 years old), is a key factor in fistula occurrence.

While she was in Ethiopia, she met a man named Tsega (which means “grace” in the Oromo language) who builds and installs water mills that grind grain like barley, wheat and tef. These mills are a huge time saver for women who usually do this laborious work by hand, and they provide a significant financial contribution to about 800 families (about 3,500 people).  In a ‘eureka’ moment, McLean realized she could raise funds to build a mill where the profits would directly benefit fistula patients.

“I learned that women needed a way to financially support themselves after hearing countless stories about rejection by their families and communities. The repair surgeries are free through the Hamlin Fistula Hospital [the only hospital of its kind in the world dedicated exclusively to women with obstetric fistula in Addis Ababa] but during the time afterwards they also need support. Some of the women are cured and can go home to their husbands and families again. Some of the women are not cured and really need additional help,” explained McLean.

She goes to Ethiopia every year, often multiple  times, to work on the fistula project.

The story of Ajayibe (“amazing” in Oromo)

During her talk, McLean told the story of Ajayibe, a woman who suffered from a fistula, which sparked McLean’s desire to help women with this condition.

Three men who worked for an Ethiopian Evangelical church regularly drove women with fistulas to the Hamlin Fistula Hospital in Addis Ababa. This is a 450-mile/two-day trip from their village near the Sudanese border, and they brought the women there and back several times a month, depending on what the church budget allowed.

On this particular day, they brought a car of three women on the journey, but on the morning they were to leave one of the women unexpectedly couldn’t come. During the journey the men encountered a crowd in the road. Stopping to see what was happening, they learned that Ajayibe had been driven to despair, having been shunned by her husband and community, and had tried to commit suicide by hanging herself from a tree. She had been pulled down by villagers. As luck would have it, Ajayibe was able to fit in the car and was taken to Addis Ababa.

Unfortunately, Ajayibe had several unsuccessful fistula repair surgeries. However, there is hope: The proceeds from the mill, which was constructed in 2012, have provided additional economic opportunities for her. She recently became the proud owner of a flock of sheep as part of a sustainable project that gets women back on their feet and able to support themselves. Once a new baby lamb is born, the women donate it back into the program so others can benefit.

Interview with Kristie McLean

In addition to being a photographer and coach, you mentioned you volunteer for a number of different causes. Tell me about them.

Tsega and McLean in Ethiopia
Tsega and McLean in Ethiopia

I was a volunteer with the Make-A-Wish Foundation for 7 years, have served with a homeless feeding program through my church, and have done photography both locally and internationally.

Tell me what or who inspires you to volunteer?

I grew up in a family where it was expected that we help out however we could. Sometimes that was as simple as noticing if an extra chair or napkin was needed at a lunch or party. Other times it extended to stopping if someone had car trouble or had an accident. I think it was this awareness of “other” that translates into different kinds of service, both formal or informal. I would want to raise my own children in the same way.

How has your photography had an impact on the people you have met?

On one of my trips to Kenya I took a photograph of three women who had come to collect water at a local river. When I turned my digital camera around to show them the image, two of the women smiled and giggled. The third woman had absolutely no reaction. Living out in a mud hut without any access to mirrors, she had never seen what she looked like. The other women had to point to the picture and tell her that she was seeing herself. The woman clapped her hand over her mouth in shock and jumped up and down. It was a truly amazing moment, and one that made me aware of the true potential impact of photography!

What kind of traveling have you done?

My first trip overseas in was in 1990. I have been to over 50 countries on six continents including two solo years around the world in 1999 and 2007.

You can help by donating money or frequent flyer miles. Contact McLean at

About Ethiopia

  • Ethiopia is the second-most populous nation in Africa, with over 93 million inhabitants. It is a multilingual, multicultural and multiethnic society of around 80 groups, with the two largest being the Oromo and the Amhara.
  • Ethiopia has a Christian majority and a third of the population is Muslim. The country is also the spiritual homeland of the Rastafari religious movement.
  • Ethiopia, which has Africa's second biggest hydropower potential, is the source of over 85% of the total Nile water flow and contains rich soils, but it nevertheless underwent a series of famines in the 1980s, exacerbated by adverse geopolitics and civil wars, resulting in the death of hundreds of thousands.
  • Ethiopia has the biggest economy by GDP in East Africa and Central Africa. The Ethiopian economy is also one of the fastest growing in the world.
  • There is one doctor for 300,000 people.

(Courtesy Kristie McLean)

2171Elizabeth Ralston is a writer with a public health background. She writes about topics on philanthropy, including profiles of inspiring people and organizations on her blog, The Inspired Philanthropist . When she is not writing, she enjoys spending time in the great outdoors with her family. You can follow her on Twitter.

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