And So It Goes

He’s waiting for us dressed in a pressed shirt and slacks and the first thing I notice about him is the urgency in his eyes. He blinks rapidly, face turned upward, and my heart is pierced by his expression of extreme yearning.

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He makes nervous gestures to ensure that we feel welcome and comfortable, arranging chairs into a circle under a tree that tempers the blazing Ugandan sun. He brings out a tray of tea and fresh grilled corn cut from the stalks that his wife tended. His wife, she who “flew away” recently despite the many expert hands that tried to save her from the devastating clutches of postpartum hemorrhaging. He watched her fade away, this woman he so loved and with whom he created his family of four precious little girls.

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Postpartum hemorrhaging (PPH) is the leading cause of maternal deaths globally. Each day, approximately 800 women die from PPH, a staggering statistic given the very simple remedy that could save these women. And so it goes that we live in a world that fails the most vulnerable, a woman giving birth to a new life.

There are many reasons why a mother dies from PPH: lack of skilled medical staff, inability of a woman to reach a hospital or for her family to pay for services, expired drugs, lack of syringes, poor education, and timing when she reaches care. Any or a combination of these scenarios can lead to death, swiftly and with little warning. Every day, women perish, avoidably, leaving behind a chaotic set of issues for her children, her family and the community spanning years of affect. And more often than not, she leaves a man in despair, his tears flowing at any mention or reminder of this woman he chose as his life partner.

Her memory lives on in this house of papa and his girls. He has kept her things (shoes, dresses, hair ribbons) in open baskets and keeps referring to “mama’s chickens, mama’s corn”.

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The eldest daughter shows us “mama’s bed”, where she and her younger sister now sleep so they are comforted by the remnants of her spirit by night. The twins she recently bore are in a loving care center until papa can get more organized and find his wise perspective on his newly shattered life. He visits them several times a week, cherishing her last gift to him.

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He is proud of his home, and leads us inside so we can see the rugs she wove and the pink bathroom he made for her out of their old chicken coop to enable her comfort while she nursed twin girls. As he shows us each room, his girls are right by his side, feeling his love as he strokes their hair and wipes their noses and looks at them with assured intention of how he will be there for them the rest of his life.

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Many African men often get mischaracterized by those who commit transgressions against women, marginalizing the men who express devotion to their wives and children. This man epitomizes love in its most tender form: being willing to care for his “band of girls”, ensuring their clothes are clean, playing with them, holding them when they ask for mama.

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There are many organizations that grieve these concerns and are working as fast as they can to eradicate these issues. Working tirelessly, they study challenges, assist with lack of resources, and work with the World Health Organization to build awareness and responses to the far reaching and devastating effects of PPH. And so it goes that we live in a world that is capable of rallying around the most vulnerable.

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No mother should face death from obstetrical concerns. No young girl should fear for her life as she gives life. And no husband deserves this kind of heartbreak.

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At the end of our visit, this profoundly affected man shakes our hand and says goodbye with a strained voice. Emotions run deep within him and frequently surface, and as they do, he reaches down to stroke his daughters’ heads in silence while each little girl raises her tiny hand to find his. Together they stand, facing us with hearts open wide. And a hope for better maternal healthcare for all.

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Darkroom Gallery: Multiples Exhibit

One of my photos created while on assignment with Hamlin Fistula Hospital was selected by juror William Albert Allard to be in Darkroom Gallery’s “Multiples” show. The exhibit opens September 14 in Essex Junction, Vermont.

These women each had been treated for fistula and were living in Hamlin’s rehabilitation center, Desta Mender, where they learned new skills such as reading, writing and math after their surgeries were completed.

Many women are ostracized by their villages when they develop a fistula, and often they must find new ways of supporting themselves. Undaunted by their struggles, they form a bond while residing at the hospital and help each other heal emotionally. New confidence is found, and together they help each other find new paths to walk, unbridled by the injury they suffered.

Fistulas can develop many ways, but most often it occurs due to obstructed labor. Dr. Catherine Hamlin saw the great need for prevention efforts and developed a midwifery college where young village girls are trained in midwifery and other maternal health care actions in Addis Ababa after which they return to their villages to provide much needed care in their remote home areas.

It has been an honor to stand in front of these brave women, the fistula survivors and the new midwives, and realize how devoted they are to their own healing and to the healing of others.

 

Desta Mender graduates 2015

Desta Mender graduates 2015

Hamlin Midwife Stories

A large part of my work now entails more than just capturing the still image. I am often asked to collect video and professional sound so that the content can be edited into small video stories or other applications. Here are two examples from my work documenting Hamlin midwives in Ethiopia.

Scrolling story

Video

 

Hamlin Midwife

The Cadence of Motherhood

I watch her slip into a surgical cap and gown, and carefully wash her hands. This isn’t the first time she has been in the operating theater in Africa, nor will it be the last. She stands tall and confident, and moves about as though she has the experience of a lifetime.

But she is only 18 years old, and she is on a mission trip to Ethiopia to help with maternal care surgeries.

Brynn in surgery

As I watch my daughter work alongside deft handed surgeons, my heart pounds a bit harder. Here she is, whole and healthy and grounded, and had we lived in this same Ethiopian town at the time when she was born, most likely we both would have perished. She means the world to me.

I suffered obstructed labor with my first child, and luckily lived in a nation where I had access to emergency obstetrical operations. Two other children came after the first, born under the same conditions, and all three are now enjoying robust lives. And now I have a family to cherish. They mean the world to me.

Ben, Aaron, Brynn

My connection to women in Ethiopia runs deep. I am devoted to bringing their stories afar with the hope that more people will rally around global maternal care concerns. Each time I look into their eyes, I want to express my sorrow for the inequity of health care around the world. Why was I so fortunate to have had access to emergency obstetrics and these women, the women who teach me so very much, do not? In this day and age, it is unforgivable.

Fatumo

Yet, faced with so many problems and maneuvering a day’s hard work of fetching loads of wood and carrying heavy jerry cans of water while traversing rugged terrain just to get food on the table for their loved ones, these mothers show no remorse and reflect only astonishing resilience. In their eyes, I don’t see sorrow or resentment or desperation; instead, I see a quiet fortitude, boundless happiness, and flickers of hope.

Lalo

Ethiopian woman praying

One woman takes my hand and helps me learn how to milk a camel and cook over a fire. Another tells me that my attire will never attract anyone. And yet another mother shows me how to nurture a child through a tantrum. They all, each and every one of them, show me the virtue of grace and the benefits of choosing happiness over despair, even while experiencing dire circumstances.

Taiko Cooking

Joni and The Camel Milk Producers

The demand for good maternal care in Ethiopia is high. Men will carry a woman for days to a health post only to find no staff in sight due to a shortage of doctors and health care officers. Women will stand in line at rural health posts for weeks, waiting for assistance. I applaud organizations such as The Liya Kebede Foundation, The Hamlin Fistula Hospital and The Barbara May Foundation and many others as they work tirelessly to bring effective health care services to these women.

Women waiting in Gimbie

Woman waiting for health care in Gimbie, Ethiopia

Yet it is the young girls who are embedded in my heart the most. They learn early on to withstand pain and suffering, and to only focus on the positive threads in each day. It is these girls who need reassurance the most – that the world is here for them, and substandard and inequitable health care practices are unacceptable.

They deserve to know that they mean the world to us.

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Young girl in Sheno, Ethiopia

The Passage

 

New Storytelling Format

We just launched a new visual format for telling some of the stories we capture, incorporating several types of media: still images, video, sound, and slideshows.

Follow this link to view the first two we created!  The first story is about Degie, a young woman in labor in rural Mota, Ethiopia , and the second story is about Fatuma, a camel milk producer near Jijiga, Ethiopia.

Stories

A mother contemplates her long walk home after surgery in Motta, Ethiopia (For the Barbara May Foundation)

Camel milk

Dr. Catherine Hamlin Turns 90!

I had the honor of attending Dr. Catherine Hamlin’s 90th birthday party this month, and what a celebration it was!

Dr. Hamlin’s many decades of work surrounding maternal health in the area of fistula repair and prevention has earned her a well deserved Nobel Peace Prize nomination this year so there were many reasons to celebrate her life.

She was joyous and curious during the whole event, and even came to an intimate dinner party that same night.  She is an incredible inspiration to many!

Nicholas Kristof wrote an article about her, and Oprah made a generous donation to the hospital in her honor.

I am hoping to be able to devote more time to the organization she started.  First up: a redesign of their website and assistance with a revamped communications plan.

And yes, relaying more stories regarding how Hamlin Fistula Hospital saves and improves the lives of rural Ethiopian women.

Dr. Hamlin's 90th Birthday

Dr. Hamlin's 90th Birthday

Dr. Hamlin's 90th Birthday

Dr. Hamlin's 90th Birthday

Ethiopia: Meet Addiss, A Hamlin Midwife

Her name is Addiss and she is 21 years old.

She lives in a small village, Wotetabay, just outside of BahirDar, Ethiopia and she has dedicated the next six years of her life to helping rural Ethiopian women give birth to healthy babies. A recent graduate of Hamlin College of Midwives, she also knows the signs of fistula and will refer at-risk women to health centers and hospitals where they can receive the care they need to prevent this devastating condition.

She lives alone in a small thatch roof hut, after completing her three years of study at the Hamlin College of Midwives, and her dedication is unlike anything I have ever seen.

She sees patients as they arrive daily, helping them through miscarriages and difficult births and general health care issues.  Five times a month she walks, sometimes for seven hours each day, to outreach health centers where she educates the community on women’s health issues.

My heart reaches for her.

I watch her as she helps a women who has just had a miscarriage. She educates the women about hygiene and proper care, and she tends to the husband, answering each of his questions.

She thinks nothing of my words as I say I honor her and will work hard on her behalf.  This is simply her calling in life: to dedicate her time to the Hamlin philosophy of ensuring maternal health for all Ethiopian women. She looks intently, directly, into my eyes.  She has seen far more than I have.

I follow her to her outpost, walking through corn fields and forests and open fields. She asks for water, and I give her my bottle.  It is the least I can do for this girl, my hero. Confidently and with grace, she proceeds to traverse over harsh landscape, focused on arriving before too much time has passed.

The bush clears, and I see a large group of Ethiopians, celebrating church services. Addiss takes her place in the middle of the village people crowd, and when the priest gives her a signal, she begins speaking, educating those around her about maternal health. Clapping, cheering, declarations of promises break out, and the energy is so fervent, I cry. Look at her!

I hear that the village is building a new church, and I give a donation of 400 birr ($24) and the crowd cheers with heartfelt passion. A $24 donation really goes a long way for this village. They proceed to show me the base infrastructure that is in place, and as much as  would like to stay and look at every element, and I see Addiss in the distance beckoning me to come. She is late now, and I need to move on.

We walk further, in terrain more difficult to navigate. Finally, I see a break in the landscape ahead and there, nestled in a small field, is a cluster of small mud walled structures. The health outpost at last.

Women are lined up, having waited hours for Addiss to arrive. Pregnant women, mothers with babies, older women. They count on Addiss’ dedication to them.

Copyright 2018 Joni Kabana. All rights reserved. Site by TD