We visited six more rural health centers this week, assessing their capacity to provide maternity care and their ability to absorb more patients. The staff at these remote health centers always seem happy to have visitors, and are eager to chat and show us around.
Here are some highlights from our visits this week.
Elizabeth the Midwife:
At one health center, a bubbly, beaming midwife was particularly eager to chat. We bonded over our shared name- Elizabeth. Elizabeth has worked as a midwife for four years, and told me that she had always wanted to work in a profession where she could help mothers- and see a lot of babies! In a typical day, she may offer basic family planning advice or conduct prenatal exams, while always being on call for a delivery. I asked her what she considered to be the toughest part of her job, and she mentioned that many mothers are anemic from a poor diet. Elizabeth was passionate about encouraging mothers to eat a wide variety of foods during their pregnancy. She even had samples of six different types of local grains on her desk, to use as a visual aid. We explained to Elizabeth about SCOPE’s work in mobilizing community leaders and faith leaders to support and inform pregnant women. She agreed that community support is vital to making sure that mothers and babies are safe and healthy.
The Muddy Walk:
On another day, SCOPE data collector Mehari and I were trying to access a very remote health center south of Gondar. After nearly turning back several times due to poor road conditions, our car finally stopped- it could go no further. Mehari and I hopped out to continue on foot. The path was extremely wet and muddy. I don’t mind mud and dirt- but it was clear that balancing in the slippery muck would be difficult. The community immediately mobilized to help us. A shepherd lent me his staff to help me balance, and several strong men formed a sort of human chain to help Mehari and me across the worst parts. After about forty-five minutes, we reached the health center and were able to conduct our assessment.
As we were looking at the health center’s delivery room, I wondered how laboring mothers- not to mention those experiencing complications- would possibly have been able to make that trek. We only had to walk about a half-mile in the mud. Many families lived 10 miles or more from the health center. Again, in places like these, harnessing the power of community support is critical; ensuring that the community understands the importance of prenatal visits to detect problems early, and that the community has a plan for getting laboring women to the health center before problems arise. At several health centers throughout the week, we encountered homemade stretchers; simple frames for carrying sick people and laboring women to the health center. Even very poor, remote communities can do simple things like make these stretchers to ensure women are supported (literally) when they need health care.
The Young Mother:
A day after our muddy walk, we continued in another direction, deep into a tropical valley to the West of Gondar. Though the health center we visited was large, like many others, staff there were working with basic tools and dealing with broken infrastructure. A sink in the delivery area was nonfunctional and covered in spiderwebs. “Where is the handwashing station?” I asked. Two buildings away. “Where is the soap?” There hadn’t been any for awhile. It was also clear that the services which were available weren’t being fully accessed. For instance, of the women who came for a first prenatal visit, only about 20% completed all four of the recommended check-ups.
While we were waiting for the midwife to finish with a patient, we chatted with a young mother waiting in line to get prenatal vitamins. Tatugirman was pregnant with her second child, and was still early along. Her mother had accompanied her to the health center for her first prenatal visit. I asked her if she thought the care she was getting that day was valuable. Her face lit up, “Oh yes! They screen for so many problems at these visits. I think a lot of women, especially rural women, don’t realize how important this is.”
We thanked Tatugirman and the Health Center staff and hit the road again. In all, the SCOPE/FLAME team is visiting thirty rural health centers this Summer. Next week will surely bring more adventures, fascinating conversations, and insights.
I RECEIVED PERMISSION FROM ELIZABETH, TATUGIRMAN, AND EVERYONE ELSE PICTURED TO USE THEIR IMAGE, NAME, AND/OR STORY