Tag Archives: midwives

Altered Views: Lessons From Africa

For the past several months, I had the honor of traveling to Africa to document various projects for some really outstanding organizations that are performing tireless and devoted work in Ethiopia, Tanzania and Uganda. I welcomed these assignments as an offering to alter my lifestyle and challenge my perspectives, but more importantly, I wanted to set aside all other commitments to create imagery that might make a difference to people who are struggling.

Now back home as I reflect upon the past several months, I realize that I am going through reverse cultural shock. What once brought joy to me is altered. I still love meals from Portland’s creative restaurant scene and the idea of wearing a pair of sassy boots, but this trip has made me reach ever so fervently for how we touch the earth…and each other.

My days in Africa were spent in heated debate, exchanging innovative ideas, feeling the shock of human peril, learning about living a truly nomadic lifestyle. and dancing until I collapsed. My heart was so full at times that I had to shut down, fold up, and sit alone in a room to come down from this life high. And sometimes I needed a rest from the effects of my own physical and mental curiosity.

Africa is where we began. Lessons abound from the moment a person steps onto the Motherland. I have many stories to tell, but I will start by highlighting a few of the assignments that sparked a renewal of my mindset.

 

SABAHAR, Addis Ababa, Ethiopia

I started my journey by working on a fashion shoot for Sabahar, a collective of some of the finest weavers in Ethiopia. Their scarves are woven with super soft traditional Ethiopian cotton and silk spun by silkworms raised on their property. Most importantly, they are devoted to fair employment practices. Their Ethiopian staff are paid a great wage while working in a beautiful and supportive environment. Happy faces were seen throughout the garden-filled compound.

Sabahar

Sabahar

 

TERREWODE, Soroti, Uganda

Returning to Uganda seared my soul. Seeing friends I had met earlier in the year and getting to work more closely with TERREWODE (a reintergration center for fistula survivors) was an educating and heart-touching experience. A team volunteered services to teach goat milk soap-making to villagers and TERREWODE staff, advise on the development of packaging, develop a video about the soap-making process and document the way music, dance and drama are used to educate others about fistula.

Soroti Goat Milk Soap Making

Soroti dance drama music

 

OREGON HEALTH & SCIENCES UNIVERSITY, Portland, Oregon, USA and Mekele, Ethiopia

Some people say that a “silent epidemic” of prolapse conditions are occurring across the globe. Many women suffer from this debilitating healthcare concern while continuing to perform their physically demanding work despite the constant severe pain they experience. Medical staff from Portland joined their expert hands to repair prolapses in many women in the northern Tigray area of Ethiopia. In addition, they trained other Ethiopian medical staff how to perform this life-altering operation.

OHSU Ethiopian Doctors

OHSU Operating Room

 

DIGNITY PERIOD, Mekele, Ethiopia

Who would have thought that lack of education and support for menstruating girls and women would have such a dire effect on so many aspects of a female’s life? Lack of menstrual supplies and running water, coupled with little education about the natural occurrence and importance of menstrual cycles, has a direct correlation with how a girl can stay in school and the effects of self esteem for all women. Freweini Mebrahtu responded to this need and created a factory called Mariam Seba (named after her daughter) that makes reusable sanitary napkins and employs women. Dignity Period provides access to sanitary pads and educates students about a female body’s natural process. They also are in the process of researching latrine and water sources for schools to enable hygienic practices. In addition, they are researching the impact of this intervention on the lives of young school girls.

Watch a short video that uses my still images and video I captured while in Mekele, Ethiopia here.

Dignity Period Hands

Dignity Period Teen Girl

 

THE MEKELE BLIND SCHOOL, Mekele, Ethiopia

I am haunted in a very good and profound way from the way the students and other staff got to know me while I visited The Mekele Blind School. I was petted, nibbled, pinched and truly moved by the students, and learned many new ways of emphasizing one sense over the other. It was astonishing to see the children running freely and holding each other so closely when they were together. If only we all could experience each other more so in this manner. This school is in dire need of many improvements but they march on inspiring within each student the confidence that they can do anything they wish.

Mekele Blind School

Mekele Blind School Young Boy

 

TIGRAY ASSOCIATION ON INTELLECTUAL DISABILITIES, Mekele, Ethiopia

Every so often something will shake my foundation and enrage my soul. On this trip, I found out that girls/women with mental illness are often targeted for rape because some men believe these females are unwanted and therefore free from HIV or other diseases. The afflicted female needs to have 24/7 watch over her in fear she might exit the home compound without someone accompanying her. The Tigray Association on Intellectual Disabilities, founded by a sister of an intellectually challenged girl, helps to nurture and provide activities for both women and men, as well as keep them safe.

Mental Illness in Mekele

Mental illness in Ethiopia

 

HOPE ENTERPRISES SCHOOL, Addis Ababa, Ethiopia

Imagine living in the most desolate of situations at a poverty level that is at the lowest shanty structure level. Someone knocks on your door, and they ask many questions about your children that are living there. After a lengthy interview process, your family has been selected to be a part of the Hope Enterprise School in Addis Ababa, Ethiopia. Your child will be supported from the time they enter school through high school graduation and they will be assisted until they are placed in a job. This is just one of the many remarkable projects that are funded by Hope Enterprises.

Hope Enterprises School

Hope Enterprises School

 

STREET CHILDREN’S BREAKFAST, Addis Ababa, Ethiopia

I rarely feel the devastation of having great pangs of hunger. I can grab a cracker and know that a meal will be had soon. When I am very hungry, my senses get mixed up and I get irritable. For a young boy faced with living on the streets of Addis Ababa, Ethiopia, a breakfast in the morning can mean he can live a day of staving off hunger and not having to hustle or steal for food. Hope Enterprises feeds street boys bread, banana and milk each morning.

Street Boys Breakfast

Street Boys Breakfast

 

MATERNITY AFRICA, Arusha, Tanzania

Fistula is a devastating condition that affects thousands of women and the families they nurture and support. Dr. Andrew Browning is one of the best fistula surgeons in the world and after working for many years with the Hamlin Fistula Hospital, Andrew now is based in Arusha, Tanzania where he practices and teaches on a global level. Maternity Africa supports his efforts and is in the process of building a new hospital which will ensure that best practices are in place. They also are firmly devoted to fistula prevention by working with midwives to educate villagers about the dire consequences of obstructed labor.

Tanzania Maternity Africa

Tanzanian Girl Maternity Africa

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

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: 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: Hamlin College of Midwives

Join me as I travel to Addis Ababa, Ethiopia to meet some of the world’s bravest women as they support each other by reducing infant and maternal mortality and the occurrence of the physically and emotionally devastating condition of fistula.

It is a great honor to be asked to visit the Hamlin College of Midwives to capture the essence of their 2011 graduation ceremony. On October 15, 2011, the Hamlin Fistula College of Midwives will graduate a second class of trained midwives. After the ceremony, these newly trained women will return to their rural villages to care for new mothers and assist extremely difficult deliveries.

Every day, 1,000 women and 8,000 babies die due to complications from pregnancy or childbirth. And for each maternal death, at least 20 additional women suffer devastating injuries related to their simple desire to produce a family to help work the fields to sustain their food source.  These World Health Organization statistics are sobering, especially when contrasted with the kind of care that is received elsewhere in the world.

The Hamlin College of Midwives is responding to this crisis by training local rural women much needed midwifery skills and supporting them as they set up services in their rural home villages.

Come along as we celebrate these midwives and the mothers of Ethiopia!  I will be documenting this momentous occasion, as well as other aspects of the beautiful and innovative Ethiopian culture. I will also be writing guest blog entries on Phil Borges’ Stirring the Fire website.

We are hoping that a collective cheer from around the world will be heard as these Ethiopian women extend one of the most loving gestures to one another: helping a mother deliver the life that grew inside of her.

Each midwife has been able to be trained without having to pay fees, which they could never afford. Your help is critical in making this possible. Donations for the midwife college are being accepted now at the Hamlin Fistula USA website.

For Dr. Catherine Hamlin’s story, read about her book here.

Ethiopia: A Convergence Of Support

In our fury to obtain water and find sources of clean vegetables and resolve the insect biting problem and find the latest irrelevant lost object, we sometimes forget why we are here in this dusty, remote village of Mota. Bekaset’s story is a jolting reminder of the desperate need for help in this region.

Bekaset’s pregnancy progressed normally until she went into labor. As she labored, her pelvis was too small to deliver the baby, and the baby became wedged in her birth canal. She knew something was terribly wrong, but she lived far from any health care and there were no midwives in her village who could help her. Her labor became obstructed, and the contractions forced the baby lower and lower into her birth canal. The relentlessly intense pressure eventually tears her uterus open, and the baby quickly dies.

Had Bekaset not heard good reports about Mota Hospital, had she not made the decision to leave her safe and comfortable home in her village of Debrework to try to find help here, had she not felt physically able to make the long bus and foot trek to Mota Hospital, had the men in her life not supported this journey by carrying her as she labored, had she suffered in silence like so many Ethiopian women do, she would be dead today. This would have left her children motherless and her weary, loving husband, who toils all day in the fields, uncared for. It is apparent in the eyes of her husband, Niguss, that he is desperate for her to live. He looks at her tenderly, his fingers slowly stroking the edge of her blanket. Words are unnecessary at times such as these, and cultural differences disappear. His pleading, yearning, silent eyes say everything. They will haunt me for life.

Instead, Bekaset is now under the care of skilled midwives and our medical team. A decision is swiftly made to remove the dead baby and her uterus, so she does not perish. Her surgery proceeds without issues, and her recovery is quick.

Days pass, and it is now time to go home. Her husband and father, who have been patiently caring for her and bringing her food during her days of recovery, are there to walk with her to the bus terminal. Her face is drawn; she has lost the baby she had come to know within her, and she also realizes that she will never bear another child. Yet, there is a deep respect for those who helped her here at Mota Hospital: she is alive, well, and able to return to her other children and household duties.

We give her a pair of donated KEEN shoes to make her walk home a bit more comfortable, and I watch as her family take tiny steps behind her to ensure that she is supported. The love is so apparent, more so than I have witnessed in many recent years of observing my own culture. They know what Mota Hospital has done for their lives, and without words, we all know why we came here.

Eyes speak, hearts leap, hands join.

Ethiopia: Birth!

I am a mother three times over. My offspring are away at college, and I try hard to release my hold on them and not hover like a mama bear. But it is an undeniable truth that they are a physical part of me, each one, with all of their idiosyncrasies and troubles and joys. I feel them, like they are appendage, even when they are miles away.

Before I had my first child, I never thought I would be changed because of the experience. I had grand plans to return to work after a respectable six weeks off, only to hold my firstborn son Ben in my arms and sob uncontrollably, knowing that my decision making was altered for life. Everything, everything, began to be centered around what is best for this child. My own desires seemed lofty and were suddenly not so important.

My first pregnancy progressed well, and I ballooned a 60+ pounds. I was proud of my spindly legs carrying such an enormous belly. People stopped to stare when I was only in my seventh month, thinking I was about to deliver any minute. I soaked up that attention and felt like a queen everywhere I went. Doors were opened, chairs were offered. The whole while, I felt glorious, never sick or weak, only blissfully content as a felt each kick.

Ben announced his entry into this world almost exactly on his due date, and all seemed fine at first. Then, after laboring for 17 hours and pushing for 3 hours, it was determined that he was in extreme stress and he simply could not fit through my birth canal. A whopping 9 lbs 11 oz of a baby he was! He also broke the hospital’s record for being their longest baby at 23 1/2 inches long. I was proud of my Big Ben.

I reflect on this now, as I watch a mother suffering her labor after walking miles to get to Mota Hospital. Had I lived here, I would surely have died during childbirth. I would never have come to know my three children. I would not have seen Ben write his first magazine article, or Aaron develop his love of the electric bass, or Brynn fly effortlessly on her feet while she danced. I would not have settled countless arguments or worried late at night when they did not come home or cry when they said they hated something I did.

I am now in the birthing room, and I watch Adele suffer. She repeatedly pulls on her ragged dress in pain, and I see that the baby is not easily coming. The midwives scurry to get the vacuum and swiftly adhere it to the baby’s head. With mighty force, they begin to pull, as she writhes in pain. They pull harder. They yell at Adele. Two people pull even harder together. They must cut her to widen the opening, determining she does not need a C-section. They pull with all of their might. Dr. Philippa steps in, and tells them to alter their angle: lift up, not down. Finally, after much screaming and fierce pulling, the baby is out. Adele stares at the ceiling, her eyes not searching for the baby at all. I can’t fathom what she is thinking. I watch her, and slowly she turns her head in search of her first born child.

The midwives ask her to get down from the table, and she walks over to the door where her mother and grandmother wait for her. They will assume post care, feeding her, keeping her warm.

I am in complete awe of the midwives here at Mota Hospital, and it is a true honor to even be in their presence. Tedele is quiet as I acknowledge his skill. He looks away, then down at his bloodied hands. I am sure that not all of these situations resolve so easily. He knows that I am only seeing one small aspect of his job.

Tedele turns to the buckets of water and silently washes his hands.

Ethiopia: A Midwife’s Role

I ask Paul Howe, the administrator of Gimbie Hospital, what he thinks the hospital needs most.  More midwives is their #1 priority.  If a woman has pre-natal care, signs of difficult pregnancies can be detected early and prolapse or fistulas can be prevented.

Paul would like to see more skilled midwives coming to Gimbie to train local midwives how to make these detections.  Marie, seen here with a patient in labor, is exhausted by the intensity of her work days, yet she consistently soothes each patient with an energetic and loving hand.

Anna, a fundraiser who traveled with us, fills in where needed, quickly learning techniques to comfort a woman in labor.

Copyright 2024 Joni Kabana. All rights reserved. Site by TD