Category Archives: Medical

Ethiopia: Selflessness

Addiss talks with each woman, giving swift advice and health care diagnosis as she recognizes issues. One by one, the women come in to the makeshift clinic, exposing their vulnerabilities and asking many questions.

Every woman has the right to deliver a healthy baby.

The husbands wait nearby, eager to hear of any news, with their hands reaching out to their wives. Waiting, waiting.

I watch Addiss care for one patient, two patients,…..six patients. Their eyes tell me of their desperation to be seen by a knowledgeable health care worker. Addiss simply moves through her day, ego in check. After all, this is what she sought: to help all rural women in this area give birth to their children without devastating results.

I ask Addiss if she has time for herself, and this question is met with curiosity. She can’t even comprehend what I am asking. After searching my face for a sign of understanding, she simply relays: I am dedicated to the mothers of Ethiopia.

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.

Ethiopia: Fistula At All Ages

Not all fistula patients are teenagers and women.  Some of them are children, such as Aynababa, age four.  Although child marriage is illegal in Ethiopia, many ancient cultural practices support this tradition, which is one situation that can result in fistula due to the young girl’s body not being fully developed to be able to handle childbirth.  Other situations, such as rape, does occur, however it is infrequent due to the gentle nature of most Ethiopians.

Educating the rural community about fistula is vitally important to the Hamlin Fistula Hospital organization. Each midwife is trained to perform education outreach to the most remote areas of Ethiopia.

Although Aynababa suffers from fistula, one can see how the Ethiopian spirit cannot be easily broken. Each person she meets is greeted with an infectious smile and a degree of expressed happiness I rarely see in my own country.

I fall in love with the Ethiopian spirit again and again and again.

Ethiopia: Brave Women

They have been called some of the bravest women in the world.

When a woman suffers obstructed labor in rural Ethiopia, she often has no place to go. She labors for days, and fistula can develop due to excessive and prolonged pressure on internal organs. The Hamlin Fistula Hospital is devoted to the repair of fistula and the psychological healing of women who suffer this devastating condition. They also are dedicated to helping to prevent fistula from occurring at all.

In November 2010, Dr. Hamlin’s dream came true when the first Hamlin midwife graduates started working in the field, offering prenatal care and a referral service to pregnant women in the countryside. The midwives work alongside the Ethiopian government to help reduce instances of fistula by providing much needed care to these women who live so isolated from health centers.

Each Hamlin health outpost has an ambulance to assist with referrals to regional hospitals where C-sections can be performed in emergency situations. The midwives, all coming from various villages around Ethiopia, are selected via a rigorous interviewing and testing process. Once they complete three years of training at the Hamlin College of Midwives, they return to their villages to work for six years. During this time, they are also educating villagers on maternal healthcare initiatives as well as building trust with the village as a whole. Their days consist of prenatal care, assisting with difficult births, education, and referrals of extreme cases.

It is not an easy job, living so far away from their colleagues and a team of ready support and modern equipment. But they are well equipped for support when they need it. This does not mean that they do not face extremely difficult situations alone. Rural women still prefer to give birth at home, and often go to receive help after it is much too late.

The Hamlin midwife becomes a wise health official rapidly.

Ethiopia: Educating Countryside Women

Women in the rural countryside of Ethiopia are smart, resourceful and highly creative, yet they rarely get a chance to be educated. Their days are spent fetching water, gathering firewood and tending to the home fires while the men work in the fields. Simply getting food on the table for the family requires incredible stamina and devotion to keeping family nurturing as first priority.

When a woman comes to the Hamlin Fistula Hospital and as her body is healing, she has the opportunity to learn many things: the visual alphabet, reading and writing, simple arithmetic and even nursing procedures. Some women are even hired as nurse aids after completing their education. What better person is there to care for a new patient than a former patient?

Educating a woman from the rural areas builds confidence psychologically for her eventual return to her village. The last time she was there, she was weak and lacked any kind of function whatsoever. She also most likely was ostracized and shunned.

Can you imagine how it must feel when she arrives home months later as not only a physically healed woman, but she can also read and write and alert other women to the signs and devastating effects of obstructed labor?

She may never completely eliminate the stigma of once having fistula, but she is well prepared to deal with this adversity with much more confidence. She also has become a crucial resource in educating other village women when they must seek outside care, rather than remaining at home during difficult labor.

                                                                                                                                                                                                                                                                                                                                                                         

Ethiopia: Strong Bodies, Strong Spirits

When Asnaku arrived at the Hamlin Fistula Hospital, she was extremely weak. Women who suffer from fistula cease eating and drinking, so that their body does not produce waste, thus contaminating their villages. The shame they feel is enormous, and they try to minimize the effects they have on their surroundings and loved ones.

Often, they arrive emaciated and dehydrated. Before they can have surgery, their body must be strengthened by nutrition and physical therapy. Each day, they are required to eat one egg and one piece of bread, and drink plenty of water. Nurses aides, former patients themselves, help them perform exercises so their muscles begin to strengthen.

Foot massages are given daily to increase circulation. This is a most intimate time, when a nurse aid gives a patient her massage, looking deeply into her eyes and ensuring that the patient feels loved and supported.

Asnaku also continues with her exercises after surgery until she is strong enough to return to her village. From the very beginning when Dr. Hamlin developed the program for the hospital, she and her husband Reg knew that whole body wellness was of vital importance.

As Asnaku becomes stronger, she also becomes part of the support circle for newly arriving patients, helping them to become stronger physically and spiritually.

 

Ethiopia: Asnaku Finds A Community

One vital function of the Hamlin Fistula Hospitals is to provide a sense of community for the women who have suffered the socially ostracizing condition of fistula. In the home village, a woman with fistula is shunned and left to live out her days in a nest-like shelter, often fending off hyenas which are attracted by her scent.

It is not hard to imagine how devastating this condition can be for a woman who only wants to raise a family.

When Asnaku was brought to the Hamlin Hospital by her brother, she was scared and ashamed of her body. When she walked into the compound, she instantly was embraced by many others who share her condition. She found not only acceptance, but also a sense of supportive community, even humor. Once again, her mind is freed and she feels hope that she can once again join her village as a healthy and confident woman. Her shame abates.

Her days are filled with new friendships and gestures of love. The women brush each other’s hair, eat together and attend group classes.

While Asnaku’s body heals, so does her spirit.

Ethiopia: Meet Asnaku! An Empowered Woman

It is an honor to introduce Asnaku, who comes from the Merabita kebele (village) in Ethiopia. Ask her how old she is, and she will say she does not know. I wish we all could have such a peaceful mindset.

Asnaku is a lovely woman, graceful and poised, and is an exceptional handcraft artist. She spends a great part of her day selecting colors and embroidering beautiful patterns onto fine cloth table runners that are sold at the Hamlin Fistula Hospital. One hundred percent of the proceeds of these sales return back to her. I talked with her instructor and she enthusiastically relays that Asnaku’s handiwork is some of the best she has ever seen.

When women find their way to the Hamlin Fistula Hospital, they are in for a great surprise. Not only will they be tenderly cared for from a physical standpoint, they will also find a community that rallies around who they inherently are. No longer are they labeled as “woman with fistula”; they become artist, educated woman, and caregivers themselves. Some of the patients even secure work at the hospital as all nurses aides are former patients who have learned much about healthcare during their stay.

Asnaku has developed many leadership capabilities in addition to her stunning artistic skills. Her quiet and confident demeanor have enabled her to make many friends here. She is a strong and assured woman. I could see her as a shop owner, a doctor, a CEO.

Today, she focuses on making the best stitches as she can: even, precise, and secured so they will not unravel with use. As she moves through physical therapy sessions and meals and classroom work, she is never without her stitchery.

Focused, steady and kind, she is the bastion of an empowered woman.

Ethiopia: Grace + Empowerment

We have all suffered to varying degrees. A lost relationship, death of a loved one, a missed chance. This summer has been especially difficult for several of my friends and also within our family due to various losses, to the point where I adopted a much practiced mantra: our happiness is in direct relation to how well we can grieve.

Grief comes in many forms, and I marvel at how often we try to push it aside and “get over it”, whatever the loss is. Lately, there has been so much of it in my life, I decided to try a different twist and embrace it. Learn from it. And I found that I am not very good at keeping that philosophy front and center.

I arrived at the Hamlin Fistula Hospital yesterday and within seconds was surrounded by women who suffer perhaps the most heinous condition a human being can endure. Fistula is not only physically debilitating, the effects are psychologically and socially devastating as well. And even if a woman finds her way to this miraculous hospital by the river, she still faces her return to her village where she often finds additional difficulties, and even a recurrence of fistula if she does not follow what she has learned while being cared for.

Yet all I see here on these grounds are beautiful women, with easy smiles, loving temperaments and deeply moving eye contact. They have felt the depths of pain that is unfathomable, only to reflect outward a generosity of spirit that is rarely encountered. It is as if their ability to suffer silently has instilled within them an ethereal aptitude to connect to humanity, instantly, at our most vulnerable level.

I am honored to be in their presence.

And as each women engages with profoundly perceptive eyes, I feel like a child, inexperienced, fumbling, uninitiated. They seem to know this, accepting this ferenji who lives such an easy life, and they take me into their graces with a tender hand, as if they know how easily I can break. These women are strong beyond imagination.

The Hamlin Fistula Hospital’s focus is not only to repair fistula, but they have built a comprehensive program that helps these women become empowered through prevention education and outreach, psychological counseling and community building. I spent the day with the patients, and followed one young woman as she showed me her daily activities.  I will share Asnaku’s experiences in the upcoming blog posts.

For now, here are some of the women who helped me deepen my understanding of grace.

Ethiopia: Maternal Mortality

I took my first trip to Africa and Madagascar when my three children were in preschool. I set off to bring back images so they could see how children live in developing countries.

Fast forward fifteen years, and this time next week I will be working with the Hamlin Fistula Hospital in Ethiopia to document the work they do to heal and also prevent a devastating maternal condition that occurs due to prolonged labor.

Had I been born an Ethiopian woman living in a rural area, chances are strong that I would have died during the birth of my first child. Ben was too large to fit through my pelvis, and I had an emergency C-section to halt his distress and enable me to give birth to him.

When I look at my three grown children, Ben, Aaron and Brynn, the love I feel overflows into an insatiable desire to help these suffering mothers in Ethiopia.

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