For most of time, we were driving on the muddy bumpy road and passing by green farm lands. It is the raining season, so that farming season in Ethiopia. Everywhere we drove to, we saw cows fallowing fields. Herds of cows, donkeys, goats, and horses lazily walked on the same road towards us, until the car was honking at them, and then they would slowly move to the sides. The kids waved at us with big smiles; or some stared and looked so confused. Kids here have to take care of their animals, no matter how little they are or whether they are boys or girls! People live on their lands and farms, and this time of the year is difficult for them, because they just started planting. You can easily imagine that people do not earn that much in these rural areas. Sometimes we were really driving in the middle of no where, and could only see several huts here and there, but the scenery was extremely beautiful. Abdi and I were like curious kids, always taking pictures and asking questions.
Depended on where these health centers are, sometimes it takes 45 minutes drive on the nice road or two hours ride on the bumpy road to get to the center. We were both impressed that each Werka (county) has one health center, and in most cases they have pretty new buildings. Although these buildings look nice and new from outside, it is so common that it is empty in the rooms and they do not have adequate resources, such as lack of health professionals, facilities, equipment, and medicines. At most centers women can deliver there, but for few places the facility does not allow that.
At the Bekoji center, there are only one nurse and two midwives. The nurse has to treat emergency cases first, and then general patients, due to excessive attendance of patients. While we were waiting for pregnant women to attend our health workshop, patients at the waiting area almost had a fight, because they were too impatient to wait for the line. The midwife greeted us, and we were informed that she just finished delivering a baby right before we came and now she had to prepare for another case. For another instance, at the Arata center, the only midwife delivers more than 60 babies per month by himself. All the medical professionals were extremely busy, but they were very dedicated to their work. We give our special respect to these medical professionals at rural villages.
Besides these villages that are relatively accessible to towns like Assela, some of the centers are really in the middle of no where. We drove through hills and farms, and finally brand new buildings appeared in front of us - the Abraa Health Center. At this center, there are only one pharmacist and one midwife, who works as the doctor and nurse as well. We had a nice conversation with them, and they told us that their center just opened eight months ago, but as you can see, there were no furniture or medical equipment inside of any building. Also, they do not have power and lights, so when she delivers baby, she has to light candles. The other girl said, "I am the pharmacist, but I do not have medicine to give to my patients. I do not even have painkillers to give to mothers."
As you can see, this is the condition of health centers in rural areas. I could not imagine how women could deliver at home with even worse conditions. But for many people in rural areas, it is so natural for them to deliver at home, since their ancestors had done that for hundreds of years and they were fine. During our health outreach, Birke and we talked to the pregnant women about maternal health and fistula. We really encouraged them to deliver at the health centers, and if any complicated cases happen, they should be transferred to Assela Hospital immediately, for the safety of the mother and the baby. At most health centers, there are ambulances, and women only need to pay fuel costs when they go to the hospital. However, for some families, they might weigh fuel costs (around $30) more than lives of the mother and the baby when they cannot afford. Thus, as part of our Davis project, we support women who do not have money, with transportation stipend, allowing them to come to the hospital in complicated situations. We hope that small things like transportation support could prevent fistula and save lives of babies.
Since Abdi will talk more about our village visits in his upcoming blog, I will just share few pictures. People have been very welcoming in the villages, and for most of times, they might think I was mesmerizing, since I looked very different from them (probably not age-wise). When we went to Tijo, kids were chasing after our car for a long way, and they were laughing and waving at us. Finally when we got to the health center, I took a picture with these beautiful and happy kids. Look at the other picture of Abdi, showing these kids pictures of themselves on a digital camera. They were so fascinated. Even though we cannot understand each other because of language barriers, we knew something universal - smiling. While in the villages, Hailemarian took us to the market to get sugar cane, and I also went to a crazy Friday market with Birke and Hailemarian (while Abdi was sitting in the car waiting for us). These visits have been very meaningful!
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