Prevention

Health Extension Worker

In a perfect world, the Fistula Hospital should not exist! There are no new medical advances or new drugs required to prevent obstetric fistula. In the developed world it has been eradicated through giving every woman access to good obstetric care during both pregnancy and delivery.

Prevention of obstetric fistula in Ethiopia and other countries with similar challenges is not a simple task.

The root causes are:

Poverty that leads to

Poor nutrition and stunted growth.
Lack of access to education

85% of the population live in rural areas with poor access to roads and transport that could take them to a centre providing health care.
Drastic shortages of skilled medical practitioners who could provide emergency obstetric care.
Lack of community understanding of the need for skilled birth attendants.

Our response

Patient Education

Students listening to HEW (health Extension Worker) about Maternal Health Issues

In Addis Ababa we have for many years had fistula health education programmes for our patients. Cured patients returning home are an important means of educating rural women about fistula prevention and identification.

Mini-hospitals
Our new mini-hospitals have begun to build networks with rural communities. Each will have a Health Officer part of whose role will be to train front line health workers and to gather statistics on women of child-bearing age and the access that they have from their home area to health services. We will work to strengthen the referral process and to develop the capacity within a community to bring a woman to the care she deserves.

Working with National and Regional Health Authorities
The government plans to place two rural Health Extension Workers (HEW’s) in every community throughout the country. We have already trained more than 4000 of these HEW’s in safe delivery and fistula prevention and will continue with greater momentum in the future.

Media

Midwifery Student

We use a beautiful video “ALEM” about a young fistula patient to deliver the message of the how, why, and what of obstructed labour and what can be done. This is available in Amharic, Tigrinha and Orominha and is being used with schools and community groups.

With partners we have developed a weekly 10 minute programme in three languages, now broadcast nationally, to raise awareness of the causes of obstetric fistula and the possibility for treatment. With other partners we have produced a song for popular radio and a music video about the life of a young woman who was injured in childbirth. It calls on the whole community to “not be silent” but to speak up and act to prevent such things. [Link to song download, words?]

Midwifery
In Ethiopia there is a lack of skilled birth attendants. ,In October 2007 we opened a Community Based Midwifery School with the first intake of 12 students, chosen from the areas around our mini-hospitals. It will train women to monitor women in safe motherhood where the need is the greatest - in rural Ethiopia - with a good referral system, radio communications and transportation available for emergencies.