The information we collected from all those visits to rural health centers around Gondar is now revealing insights! After thirty visits and seemingly endless questions, we now have a fuller picture of the current health care services available to pregnant women.

We learned that although midwifery services are readily available and free at all of the places we visited, most women don’t use them. And many women don’t come to the prenatal visits that are designed to detect complications before they turn into emergencies. Sadly, we learned that many health centers have very limited ability to rush pregnant women to hospitals if they show up late, with unforeseen complications or life-threatening problems.

The health center spaces where women give birth here are basic, and continuous improvement is necessary. Many delivery rooms don’t have clean water or soap readily available, and few have the full spectrum of basic emergency delivery supplies recommended by groups like the World Health Organization. Some maternity centers are so remote that cell phone signals don’t work, and patients often must hike for miles on dusty or muddy paths to reach health care.

But all of the health centers have staff that care; that is what I will remember most from the assessment visits. Health center staff were always eager to show us how they were trying to provide the best care they could. Some health workers, like the head nurse atAbawuram, asked us to share their frustrations and needs with the world. Others were excited to hear what SCOPE is doing, and hoped that their site would be selected for the next round of Priest training work. All were clearly dedicated to making sure babies were delivered in the safest way, in one of the world’s most challenging locations.

With my work now finished, I handed off my data, maps, and analysis into the capable hands of the SCOPE/ FLAME team members at the University of Gondar. Over the coming weeks and months, they will go on to collect more individual and focus group data, and will begin the Priest and health worker training which is the hallmark of the SCOPE maternal health intervention. It is our hope that this work will encourage more pregnant women to give birth in the safest way possible, so that their babies can have the healthiest start in life.

As I return to the University of Washington, I am diving back into my studies in maternal and child health with a renewed appreciation for the complexity of delivering care in places like Gondar. So many factors must come together to make maternal care safe and effective; staff must be well trained and supplied, women must value the care enough to seek it out, and emergency resources, including transportation, must be available. Overlaid on all of these issues are the cultural and religious factors that influence families’ decision making. Addressing such a complex yet vitally important need requires innovation and understanding. SCOPE is on the front lines of testing novel ways to save lives, and I am proud to have been a part of this work.

Last week, Sheldon and I said heartfelt goodbyes to the colleagues who have become our friends on the SCOPE team in Gondar. We walked around the bustling streets one last time, and were marauded for one last time by the neighborhood children whose hugs and greetings have become a highlight of our morning routine.  Now, as I get settled back here at home in Seattle, I find I cannot describe my experience in Gondar with SCOPE in just a few sentences. The immersion into front-line global health triggered more questions in me than it answered. But some things I know for sure- I will never forget the new friends and experiences that I gained while working with SCOPE, and I will keep working to improve the health of women and children in areas like Gondar. For now, I want to send heartfelt thanks to SCOPE’s supporters and donors for enabling Sheldon and me, and the entire SCOPE team, to do the hard work of learning, understanding, and hopefully, changing the world.