17th March 2012

Another hectic week has passed and over a hundred pregnant women have been screened for obstetric risks. The usual mal presentations, twins, women who have had over 4 pregnancies (at times this rises to 7 or 8), and those with previous stillbirths have all been given advice about where it would be safe to deliver their baby. Interestingly, having previously seen very few women with high blood pressure and symptoms that suggest pre-eclampsia, I came across 3 women this week who were certainly heading for trouble. All of them had blood pressures around 190/105, which was accompanied by oedematous feet and protein in the urine. One also had bilirubin in the urine, suggesting that something was going on with her liver. None of these women had any idea that they had a problem with their pregnancy, despite one woman having had 2 stillbirths in the past. The problem is that women simply will not have heard about the risks associated with pregnancy unless someone tells them. There is a move to try and provide health education in this area and to be honest, the messages do appear to be seeping through to some women. However, many remain uninformed of the risks and are therefore very surprised when I tell them that they need to be taken to hospital. They go though and I have certainly found that women are very receptive to the advice that they are given.

One of the clinics I went to was really out in the sticks and I had to do some very clever off-road driving in order to get there. The staff at the health centre, who came with me were suitably impressed with my driving skills and said that I was now eligible to drive anywhere in Ethiopia. Another very interesting clinic was held in a remote area where they are mining for gold. I’m not quite sure how much this benefits the villagers who live there but one bonus was that the mining team have 4x4 cars and will always take a pregnant women to hospital in the even of an emergency and she will not be charged for this. This is really an important service as there is no other way to get to hospital other than to walk for about 6 hours.

 The long and dusty roads to health centres

The faranji visit always creates a source of amusement

The woman that was pregnant with twins (see 11^th March) has now delivered a health boy and girl (1.7Kg and 1.9Kg). she had a caesarean section as one was breech and the other transverse but all went very well. Since I was going back to Ganji on the day she was ready to leave hospital – 4 days after the CS – I took both her, her husband and the twins back with me. This meant that she didn’t have to catch the bus home and also that she didn’t have to walk the 3 hours from the bus stop to her house, something that would be a little painful after a CS. Mind you, it’s what most women have to do but if you can make it easier for some of them then it’s a bonus. I’m going to visit her in a few weeks time to give her a copy of the photo I took. She was really keen to have this as she said that she wanted these children to know the story of the Faranji who came to Ganji and how she helped them in so many ways. They were a really lovely couple and so very appreciative of the care that they had received.

1 hour old twins from Ganji

A happy ending for the twins and their parents who are now back home



The faranji returned to Ganji

Having been out and about so much now, I am beginning to feel like one of the locals. Despite the distances that I travel, I now recognise many of the people in the villages and we exchanges waves as I drive through each day. I don’t know exactly what they think about me but they’re very welcoming and it’s nice to see a familiar face in the morning. Actually, it’s nice to be able to see anything as I am driving along the roads – the dust/sand is really very thick now as it hasn’t rained for so long and I feel terribly guilty as I look in the mirror at the plumes of dust that fill the air following the car. What must it be like for people to be constantly covered from head to toe in dust? How can they ever keep things clean? I see people washing their clothes in the river and then hanging them on the dusty bushes to dry and gather more dust. The rainy season is apparently on its way, although for the past month now, everyone tells me that the rain comes in 2 months time.

The 'car park' outside Ganji Health Centre

I don’t really go to the hospital very much now as I tend top spend most of my time in the community health centres and health posts. I did, however, pop in last week to see various people and could help but notice the all too familiar brown cardboard box that sat on the floor outside the labour room. I must have been staring at it for a little too long as one of the nurses looked at me with a smile and nodded to confirm what I had suspected. ‘The young girl with the ruptured uterus?’ I asked. ‘Hmmm’ she muttered, looking towards the box and then back to me. It feels quite bizarre sometimes to be standing in the corridor having these conversations but word gets out about the tragedies here. Jeremy had told me about 2 young girls, both of who had ruptured their uterus. Since labour will have been going on for some 2 or 3 days before the uterus finally slits open, the babies don’t survive. Thankfully, the mothers seem to be pretty tough and many of them do make it to the hospital in time to have the uterus sewn up, possibly allowing just enough time for it to heal before they are pregnant with their next baby. Hopefully, they will automatically come to the hospital for the delivery next time.

Baby Rabina; sadly his mother died from sepsis shortly after childbirth

I have joined a group Oromifa lesson now as I have got to the stage where I need to be able to have a little more communication with the people I work with and the women that I see in the clinics. So far, this is going well, although I don’t find it a particularly easy language to master. I don’t suppose it will be of much use in the future either but it would still be nice to learn a bit more. My next lesson is on Tuesday so I will do some homework over the weekend.

 I will be out and about in the community over the next week, although I have no idea exactly where this will be. I am bound to be somewhere remote. It’s bound to be very dusty and numerous people are bound to ask me for a lift in the car, clearly wanting to avoid the arduous walk to the next village. My priority is always to take the pregnant women and since I generally need to take one or two back with me I reserve any spare seats for them. Interestingly, despite there appearing to be very little in the way of dairy products here, my Ethiopian passengers always smell faintly of milky, buttery vomit.

Jaba 5 months and very happy

Showing a keen interest in toys

Note the England football outfit

When I came home one evening, a toad was happily sitting on the door step. No idea where he came from but he was gone in the morning - probably wise, since I imagine he would have ended up as dinner for someone........