Thursday, 7 July 2011

7th July 2011

As the departure date gets nearer and nearer, I am beginning to wonder exactly what I am going to achieve over the year. There are many possible projects that I feel I can contribute towards but I think it's important to start my time there with a specific focus. My main interest is in improving the referral system between the community and the hospital. Whilst I was in Gimbie last February, I was struck by the realisation that many of the women having their babies in the hospital didn't need to be there, yet many of the women having their babies at home seriously needed to be in hospital. Indeed, without the hospital treatment, these women were dying or suffering with serious life-long complications such as a fistula between the uterus and bladder.
Unlike the UK, the majority of women in Ethiopia (94%) have their babies at home. For many women, this is fine and they are able to have a safe childbirth. However, when things start to go wrong, the nearest hospital or health centre can be 5 or 6 hours walk away. Transportation is virtually non-existent in the villages and so women either have to walk to hospital or they are carried on a stretcher made by the family. As you might imagine, many of these women die on this rather hazardous journey to hospital, or they arrive too late to hospital for anything to be done.
The following letter was published in a paper that describes the problems of delays in getting to hospital and even though I have read it many times, it still horrifies me to think of the suffering that many families experience every day:

Today Mary, the lady who helps us in the house came late to work. I told her off for being late and asked why. She said that one of her townswomen had died in the hospital while giving birth to a baby. This was her fifth delivery….. By the time they found a vehicle to go to hospital, by the time they struggled to get her an admission card. By the time she was admitted, by the time her file was made up, by the time the midwife was called, by the time the midwife came, by the time the husband went and bought some gloves, by the time the gloves were brought to the hospital, by the time the midwife was called, by the time the midwife came. By the time the midwife examined the woman, by the time the bleeding started, by the time the doctor was called. By the time the doctor could be found, by the time the ambulance went to find the doctor. By the time the doctor came. By the time the husband went out to buy drugs, IV set, drip and bottle of ether, by the time the husband went round to look for blood bags all round town, by the time the husband found one and by the time the husband begged the pharmacist to reduce the prices since he had already spent all his money on the swabs, dressings, drugs and fluids, by the time the haematologist was called. By the time the haematologist came and took blood from the poor tired husband, by the time the day and night nurses changed duty….. and the husband signed the consent form, the woman died. Today the husband wanted to sell the drugs and other things they never used to be able to carry the body of his wife back to their village but he could never trace the body again in the hospital.