Twenty-five years after The Hospital by the River first introduced Australians to the incredible work of Dr Catherine Hamlin, author John Little reflects on the woman whose compassion transformed tens of thousands of lives — and why her example of purpose and service remains as powerful today as ever.

Some stories simply refuse to fade.

Twenty-five years after The Hospital by the River first landed on Australian bookshelves, introducing readers to Dr Catherine Hamlin’s extraordinary work in Ethiopia, the story continues to move hearts, inspire generosity and remind us what one life dedicated to others can achieve.

For author John Little, who spent countless hours with Catherine while writing the book, there was never any doubt Australians would embrace her story.

“It was just one of those stories where, once you hear it, it’s obvious it has to be told,” Little tells Starts at 60.

“When I first heard about Catherine, it was like a light bulb went off in my head. I thought, ‘This is a story that’s got everything.’ You have these poor women who come to the hospital in a terrible state. Some have had body wastes leaking from them for decades, their husbands almost invariably divorce them, they’re pushed out to a little broken-down hut in the village, or they go into town to beg. That becomes their life.

“Then Catherine turns up in 1959 and starts treating them. They arrive at the hospital in a wretched state, spend a couple of weeks there, then have their big operation. Around 95 per cent are cured. They’re given a lovely dress and bus fare back to their village.

“It’s just a wonderful story. It brings tears to your eyes just thinking about it.”

A woman of warmth and curiosity

Australians came to know Catherine Hamlin as one of the nation’s greatest humanitarians, but Little says the woman behind the legend was refreshingly down to earth.

When they first met, Catherine was already in her mid-70s, still performing surgery and overseeing the Addis Ababa Fistula Hospital she and husband Dr Reg Hamlin had established decades earlier.

“What struck me was how intensely interested she was in everything,” he says.

“She lived in Addis Ababa, in the middle of a Third World country, pretty much out of touch with Western society, but she was curious about everything — what was happening in the world, about me, about anyone she met.

“That curiosity and engagement with life really kept her going at that age, along with her vocation, which she loved and had no desire to stop.

“She was absolutely inspiring to be around — not in a heavy, worthy way, but as a lovely, natural woman with a great sense of humour and a playful side. You could just see what an enormous difference she was making with her life.”

Changing lives and preventing tragedy

The Hamlins are credited with transforming the lives of more than 70,000 Ethiopian women suffering obstetric fistula — one of childbirth’s most devastating injuries. Left untreated, the condition can leave women incontinent, isolated and shunned by their communities.

But Catherine’s vision stretched far beyond surgery. Recognising the condition could only truly be eliminated through better maternal care, she established a midwifery school after realising Ethiopia had far too few trained midwives.

“The government wasn’t interested — they had so many other health problems,” Little explains.

“So she said, ‘Well, if the government isn’t interested, I’ll start a school myself.’ And she did.

“Now, women are graduating from that school and going out into the villages as midwives, and that’s made a huge difference to the incidence of fistula.”

A lesson in growing older

At 84 himself, Little believes Catherine’s greatest lesson isn’t simply about medicine or humanitarian work, it’s about purpose.

“One of the key things is to stay involved and engaged with the world,” he says.

“You also need some kind of hobby or purpose. That’s exactly what Catherine embodied. She was interested in everything happening around her, and she had this vocation that kept her going. She had something meaningful in her life, rather than just sitting around quietly and letting the world go by.

“There’s a lesson in that for all of us as we age.”

A story that changed the author, too

Perhaps the interview’s most unexpected revelation is the effect Catherine herself had on the man writing her story.

“That’s a long story,” Little laughs. “But the short version is this: Catherine was a missionary, deeply religious. I went to Ethiopia an atheist and came home a Christian.

“I went to Ethiopia an atheist and came home a Christian.”

“It wasn’t because she tried to convert me. In fact, she wasn’t interested in that at all. She simply wanted me to write the book.

“She wasn’t interested in proselytising me; she was interested in the work and in telling the story.”

Years later, he remains immensely proud to have helped share Catherine’s legacy.

“It did a lot of good for Catherine and the hospital,” he says. “I remember one woman reading the book, travelling to Ethiopia to meet Catherine, and afterwards making a donation of one million dollars. There are a few stories like that — people who read the book and then made large donations to the foundation.”

Want to know more?

The Hospital by the River remains in print 25 years after its original publication and tells the remarkable story of Dr Catherine Hamlin and her lifelong mission in Ethiopia. You can find out more about the book here: The Hospital by the River. To learn more about the work of the Catherine Hamlin Fistula Foundation, or to support its ongoing mission, visit: Catherine Hamlin Fistula Foundation  – The foundation continues Catherine Hamlin’s vision by funding free surgery, rehabilitation, safe childbirth programs and the training of Ethiopian midwives, working to prevent obstetric fistula and restore dignity to women across Ethiopia.

John Little spent 25 years working as a television producer and reporter before becoming a full time author. He has written eight non fiction books: Inside 60 Minutes, The Hospital by the River (with Dr Catherine Hamlin); The Man Who Saw Too Much, Down to the Sea, Jem, a Father’s Story, Christine’s Ark, Maalika (with Valerie Browning); Catherine’s Gift. He has also written a political thriller, Letters from the President. John lives on Sydney’s northern beaches with his wife, Anna.