Seldom has a missionary painted such a compelling portrait of hope from darkest despair as Dr. Catherine Hamlin in her inspiring memoir, THE HOSPITAL BY THE RIVER. When she and her husband, Reg, embarked on their careers in gynecology in Australia, they never dreamed their work would eventually take them halfway across the globe to the third world country of Ethiopia to establish a teaching hospital.

Ethiopia's insistence on child-brides and the poor obstetric care in that country is responsible for the high incidence of women who suffer from fistula, a childbirth injury that results in constantly running urine and terrible internal injuries. The personal stories of these women as told by Dr. Hamlin will break readers' hearts. Divorced by their husbands and rejected by their families, many of these injured women live out the remainder of their lives ostracized alone in dark rooms --- all for want of an operation costing only a few hundred dollars.

A simple operation can alleviate their suffering, and most women are curable. (Hamlin takes payment in everything from live chickens to jewelry.) But although two million women suffer from fistula, less than 7,000 are treated each year. The challenges to create a hospital that serves these women --- and then maintain and finance operations --- are formidable.

Hamlin's descriptions will move even the most jaded readers to tears --- and sometimes to a queasy stomach. In one gruesome anecdote, she tells of a woman mauled by a hyena while giving birth (the hyena ate her baby while she was helpless to protect it). However, Hamlin wants us to understand the depth of this despair so difficult to relate to --- the horrific conditions these women live in --- in order to arouse our deepest compassion for their suffering.

In one memorable passage, she describes the life of one such outcast, discovered in a village by a medical worker:

"...They reluctantly showed her a side room. Inside it was dark, and the smell was almost unbearable. In the far corner, against the wall was a raised platform. Peering through the gloom they made out a woman lying on her side with her legs drawn up in a flexed position. Her bladder and bowel contents were leaking into a pool underneath. Because she had been in this position for five years the joints had become stiff... and she could no longer walk...."

This woman --- like more than 20,000 others --- was cured by Hamlin and her team.

This is a book of contrasts, from the gatherings thrown by royalty to the extreme poverty that most of the people of Ethiopia experience. Although the reader has to mine a bit too much detailed memoir to get to the good storytelling, it is well worth the effort. Her tone throughout is one of gratitude. Hamlin is quick to offer copious amounts of praise for others, even those who have perhaps wronged her in some way. She is vulnerable about her own shortcomings, especially as a parent.

Almost four decades after her work began, it's understandable why Hamlin has been called "The new Mother Teresa for our age" by the New York Times, and nominated for a Pulitzer Prize. This fascinating account of Dr. Hamlin's work will break your heart --- and offer hope that even the worst circumstances can be changed if we care enough to help. Keep the Kleenex handy.