This is my last blog as we are leaving on Saturday to journey back to the UK via Djibouti. It has been a very hectic couple of weeks as I have been trying to get all my project work done. I feel that I have largely achieved what I set out to do; I have seen over 900 women at the antenatal risk screening clinics and have included 423 in my study (women over 30 weeks gestation); I’ve followed up most of the 274 women identified as being at obstetric risk; and I’ve carried out 7 focus group discussions to understand why women deliver their babies at home, hospital or the health centre. I am now trying to get everything written up so that I can send off various papers to be reviewed for publication. What is clear is that the women here have a really tough life and are often left with little choice about their health care decisions. One in every 34 pregnant women die through pregnancy or childbirth. Around 10% of the women in my study had a previous stillbirth, with 3% having had 2 or more stillbirths. There are many possible reasons for these devastating figures; poor nutrition, lack of finances, difficulty in accessing services and lack of medication and equipment are just a few. Accessibility of health services is certainly an issue, with many women having to walk for over 2 or 3 hours before they can reach even fairly basic health care. Higher levels of health care are simply inaccessible for many as the cost of transport can be prohibitive.
Nevertheless, I am constantly astonished at the courage of these women when facing the difficulties surrounding childbirth. They will sell a coffee tree to pay for health care, they will deliver their baby on the side of the road when labour is too quick to make it to the health centre, their acceptance of possible death in childbirth will result in a home delivery which avoids ‘unnecessary’ costs, their desire for an ultrasound scan leads them to walk for 4 hours when 9 months pregnant, their need to continue to earn money leads to them daily carrying of 30Kg of wood on their back right up until the delivery day, their ability to deal with complete childbirth induced urinary incontinence without any underwear or pads, their ability to live with the knowledge that 1 in 17 children will die before the age of 1 year, their ability to work throughout the pregnancy despite an absence of iron supplements, their acceptance of enormous goitres through a lack of iodine in the diet, the absence of any painkillers during labour, the ability to walk the 2 or 3 hour journey home just 3 hours after delivery………..
I could go on and on and I am sure that when I look back on the time I have spent here, I will be constantly reminded of the bravery and the strength that the Ethiopian women face in their everyday lives. I have enormous admiration for them and it has been a privilege to have met them and hopefully provided some useful care. Possibly equally important, I hope that I have been able to show them some kindness and compassion; something that few women seem to experience. Indeed, one woman in my focus group discussion cried when she described the kindness that she had received and how this had made such a difference to her life. I wish I could do more for women like this but you can’t change the way things are. You can only hope to leave them with some hope that there are people out there that care about them and want to help them.
I take with me the memories of the smiling faces of women who try to hide their amusement at my efforts to speak to them in Oromifa, their amazement when I show them the heart beat of their baby on the scan, their generosity when they offer me some corn from their field, their kind invitations to have coffee with them in their house, their desperate efforts to make sure that I am comfortable, their amusement when I show them a photo of their baby, their gratitude when I give them a photo of their baby or some baby clothes. I will also be taking back the many memories of Jaba, whose first birthday on October 21st I will sadly miss. He continues to go from strength to strength and it is hard to think of those many weeks when he was in the ‘cheese counter’ fighting for his life. He has an extremely promising future and is very fortunate to have such a loving family to care for him. He is, of course, also very lucky to have such a large and caring extended and international family, who I am sure will want to be kept up-to-date with his progress. I think I will need to set him up on facebook so that people can follow his life.
Our last few weeks here are enriched by the company of Karen and Adam Lowton, who arrived last Monday despite BMI cancelling their flight the day before. Clearly, I am extremely happy to have them here and really hope that they enjoy their time here and in Djibouti. I have booked an amazing hotel in Djibouti. They have brought with them more luxury goods than I have seen in a very long time – dairy milk chocolate, chicken tikka in a bag, F&M champagne truffles, a bottle of pink Sancerre, and L’Oreal face cream, to mention just a few. So I think we shall be having some amazing meals and will probably be the envy of all of Gimbie. It’s Saturday film night tonight so we are going to share a chilli con carne (yes, with meat imported from Waitrose) with the ex-pats here and I might even open the Dairy milk. This is certainly a big event and will be the talk of the town for the next week. The Sancerre is definitely for personal consumption only.
I have been very grateful for your company throughout this blog. It has been lovely to know that there are people who have been interested to hear about our lives here and it has been a great comfort to hear from you. If you have followed the entire blog, you have read 49,128 words. It’s not quite as much as my thesis but hopefully, a little more interesting.
We will be back in the UK on 8th August and look forward to catching up with you over the weeks to come. I leave you with a few of my favourite photos, some of which you may have seen before……..
At least I have a pair of shoes....
Jeremy & Waishun
Camels in the South of Ethiopia
Waiting for a chance to get mangos
By the pool in Djibouti
Bonfire of bones (animal) at Green Bar
My very first delivery
Focus groups brought many happy women together
Maybe at risk but all turned out well
Hannah with Jaba
Antenatal clinics create fascination for children
My birthday chicken from Heidi & Andre
Jaba one month old
Jaba 7 months old
Birthday celebrations with Clara
Scanning creates amusement
Twins 5 months old
Twins 1 week old