Of Wanderlust And Coming Home

Of Wanderlust And Coming Home

Elizabeth AtalayI try to keep a cool adult demeanor as I open the tiny package at my seat. In it I find a pair of socks, a diminutive set with toothpaste and toothbrush, and a sleep-mask. I want to turn to the older gentleman in the plane seat next to mine as I pull out each item to show him with bright eyes and exclaim “Look how cute this toothbrush set is!” but I manage to keep my cool.

Wanderlust ;  a strong desire for or impulse to wander or travel and explore the world.

Wanderlust is my favorite word.  Aside from being fun to say, it most aptly captures my enthusiastic desire to discover new places.   The more I traveled, the more I learned about new places I’d love to see. Put me on an airplane and I am as giddy as a child. I love to travel, and it’s not just about the destination. The journey itself thrills me as well. That sense of excitement and adventure as a trip launches. The forced stretches of time on the trip to read, write, or watch as many movies as I can fit in.  I love the diminutive compartments of the meals, accompanied by tiny bottles of wine.   I enjoy conversations struck up with other travelers, slices of lives in transit. Where we are, where we are going, and where we’ve been.  I’m excited by the anticipation of a new place, and of entering the unexpected.

As for the destination, the more foreign the culture or landscape, the more delighted I am. I enjoy seeing the world through the lens of a different culture. Not knowing my surroundings, often without knowledge of the local language, navigating the world in the way a child might before they fully understand all that is going on around them.  These types of experiences have given me deep empathy for visitors to my own country when I encounter them.  I think the world would be a kinder place if everyone understood what it feels like to be a stranger in a strange land, vulnerable.  World travel has been my greatest path of education and understanding.

One of the most important of those lessons I’ve learned is how important home is.  I remember exactly the first time this registered. I was traveling alone in my early twenties and on a bus in Thailand. It was night and the windows of the shacks we passed glowed with the warmth of the families within. As the bus came to a stop in front of one of these shacks I could see in through the window, and felt strongly how fortunate the family was to be cozy in their home together.  A sort of longing I hadn’t remembered ever feeling before.

I love travel as much as ever,  but I can’t wait to see my family when I get back.  There is nothing so sweet as that reunion, or precious as sleeping in our own bed with our family all under the same roof.  My passion for the discoveries of travel is as strong as ever, but I love what I come home with even more. A few trinkets to remind me of where I’ve been, a new perspective, and always a deeper and greater appreciation for my home and family. No place in the world matches being immersed in that inner glow of family and home.

 

#MakeWomenMatter

#MakeWomenMatter

She would never tell her family. They could never know.

SAMSUNG CSC

I was amazed that the young woman was brave enough to tell her story at all.

With a teary smile she explained that she was telling us because she was just so happy that her life was not over as feared.  She was just so relieved to have found someone to help her.  The week before she had called her friend to say goodbye.

Like many Ethiopian young women in search of a better future, the woman I met had been working as a domestic servant in one of the nearby Arab countries. The home she worked in was abusive, and she was raped.

Wrapped head to toe in her traditional Muslim dress she explained that when she found out that she was pregnant she knew that she would be killed if anyone else discovered the truth.  She could not stay in Bahrain; she could no longer come home.  She would have been blamed for this crime.

Her friend had told her about Marie Stopes in Addis Ababa. I happened to be there with the International Reporting Project Fellowship to report on newborn health the day that she came in.   Sadly many women in similar situations do not know where to turn for help. Over 21 million women in the world will turn to unsafe abortions as a solution each year. 47,000 of those women die as a direct result. Often these are desperate young women or girls who will go to any length, to keep their situation a secret.  That price is too often their life, frequently leaving older children motherless.

Maternal health is intricately intertwined with newborn health, and our visit to the Marie Stopes International site highlighted the importance of family planning in the fight to save women’s lives. The Ethiopian government has been working hard to reduce maternal deaths and the revision of the Ethiopian abortion law in 2005 was a step to save the lives of mothers from unsafe abortions. Before the change 35% of maternal deaths in Ethiopia were attributed to unsafe abortions.  Since the liberal law was put in place to allow women who are health risk, have been raped, are victims of incest, and a couple of other special circumstances to get abortions legally,  maternal deaths due to unsafe abortions in Ethiopia have dropped to 6%. These numbers back up the importance of women having control of their reproductive health.  Being able to make an informed choice and take control of your own reproductive health is a basic human right.

On top of the lives saved when women are in control, according to Marie Stopes International, voluntary family planning is one of the most cost-effective investments a country can make in its future. Every dollar spent on family planning can save governments up to 6 dollars that in turn can be spent on improving health, housing, water, sanitation, and other public services.

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When the UN General Assembly sits down to discuss the 8 millennium development goals this September, special attention needs to be directed towards goal #5.  MDG #5, to reduce maternal mortality, is lagging behind the other Millennium Development Goals, and only a small fraction of United Nations member countries are on track to meet that goal in 2015. Marie Stopes International knows that global maternal health can only improve if we #MakeWomenMatter.

Here are the facts:

  • Every day, 800 women die from causes related to pregnancy or childbirth
  • When a mother dies, the risk of death for her children under the age of five increases by 50%
  • The number one killer of 15-19 year old girls worldwide is pregnancy and childbirth.  Every year, 70,000 young women die as a result of pregnancy and childbirth – over 70% of these deaths are preventable
  • This year alone, it is estimated that nearly 22 million unsafe abortions will take place around the World

 

Worldwide, one woman dies every 11 minutes from an unsafe abortion. Yet providing access to reproductive healthcare is one of the simplest and cheapest ways to save women’s lives. If everyone who wanted to use contraception was able to, 79,000 women’s lives and 1.1 million infants’ lives could be saved in the developing world alone. – Marie Stopes International #Make Women Matter

When I think about the woman I met at the Marie Stopes clinic that day in Ethiopia I can still see her beautiful teary smile of relief.  Even in her emotional situation she was full of life and hope for her future, and things could have turned out very differently if she had not been given back her future.

To find out more about the Marie Stopes International Make Women Matter campaign you can follow #makewomenmatter or visit the website.

I traveled to Ethiopia with the International Reporting Project on a New Media Fellowship to report on newborn health.

Health Post At Mosebo Village, Ethiopia

Health Post At Mosebo Village, Ethiopia

Elizabeth Atalay

We had just spent the night at the source of the Blue Nile River. Lake Tana sits in Bahir Dar, Ethiopia, and as our caravan of Land Cruisers wove through the countryside from Bahir Dar to Mosebo I took in deep gulping breaths of sweet fresh Ethiopian air. The lush colors of our surroundings looked to me like they had been enhanced in Photoshop in the way that everything seemed to pop.  How could I feel this emotional connection to place that was never mine? A place I had never been?

Though this is my first time in Ethiopia, the verdant landscape brought me back to other rural parts of Africa I’d traveled through in my youth, similar topographies that had stayed with me ever since.  This time I’d returned to the continent as a new media fellow with the International Reporting Project to report on newborn health.  We were heading to one of the villages housing a Health Post which serves the local and surrounding population of approximately 3,500 people.

Photo by Elizabeth Atalay

Mosebo Village is part of Save The Children’s Saving Newborn Lives program, and as such is looked to as a model village in the Ethiopian Government’s plan to reduce maternal and newborn mortality.  Mosebo is a rural agrarian community that produces wheat, teff and corn.  There I met seven-year-old Zina whose mother, Mebrate was about to give birth.  Through our translator Mebrate estimated her age to be around 26, and told us that Zina was her first child.  As we learned from interviewing many mothers along the way, her age estimate was really more of a suggestion, and at times might be a full decade older than the expecting mother’s true age. I suspect this is somewhat the case with Mebrate as well.   She said that for economic reasons she and her husband had waited to have a second child, but again, as we also learned, this might not be the full story. Losing a newborn in the act of childbirth is so common, and almost expected in rural Ethiopia, that it is not spoken of openly.   Almost in the way a western mother might not offer up a miscarriage amongst her healthy born children if asked how many children she has.

When she had Zina, Mebrate had gone to her parent’s home to give birth, as women in Ethiopia often do. It is estimated that 80% of Ethiopian mothers will give birth in their home, often without a trained health care attendant. Towards the end of Mebrate’s first pregnancy she went to live with her parents as her family instructed, until after the baby was born.  In that way her mother could help her deliver, could care for her and the baby, and feed her the traditional porridge after birth. Although there were no complications during her delivery, sadly, many young mothers giving birth at home are not as fortunate. The time period during and around birth are the most vulnerable for the lives of both the mothers and babies. The Saving Newborn Lives Program aims to reduce maternal and newborn mortality beginning with awareness programs and pre-natal care on the local level at Health Posts like the one we visited in Mosebo.

Mosebo Health Post

The Mosebo Health Post and Health Extension Workers

We had met Tirgno and Fasika, the two Health Extension Workers at the Mosebo Health Post earlier that day as they showed us the two room interior, and explained their role in improving maternal and newborn health.  They work to raise awareness in the community about the importance of pre-natal care, and the potential dangers of giving birth at home for both mother and child. Newborn health is interdependent with maternal health, and the most prevalent causes of newborn mortality, infection, Asphyxiation, pre-maturity or low birth weight, and diarrhea can often be avoided with proper care.   These days in Mosebo after receiving pre-natal care at the Health Post women are then referred to the regional Health Center for deliveries.

Zina shyly smiled when we ask her how she felt about having a new sibling, she stood straight and tall listening intently as we asked her mother about the babies’ arrival.  When Mebrate goes into labor this time, with her second child, she will embark on the walk along rural dirt roads for around an hour to the nearest Health Center to give birth.

This story was reported by Elizabeth Atalay from Ethiopia where she traveled as a fellow with the International Reporting Project (IRP). This post is a modified version of one first written for World Moms Blog.

Health Extension Workers Impact On #EthiopiaNewborns Via ONE.org

Health Extension Workers Impact On #EthiopiaNewborns Via ONE.org
Photo Credit: Elizabeth Atalay

Photo Credit: Elizabeth Atalay

“My turning point, was I lost a mom of six from bleeding,” said Dr. Abeba Bekele when speaking about her commitment to maternal and newborn health in Ethiopia. She distinctly remembered that moment as her turning point.

After having practicing medicine for five years in deep rural areas of the country, “I saw the issues, the problems, the challenges,” she said. “What made me decide actually to go into public health…..was I lost a mom of six from bleeding. Just bleeding on a couch because there was nothing, no supplies in the facility, we didn’t have IV fluids. The family was not willing to give blood for various reasons. But there was nothing in the hospital. So we tried to do everything, I had two midwives with me, and myself, and we lost her. I said, OK this is it. I don’t want to continue my life seeing these types of challenges. I have to go into prevention.”Now the Thematic Sector lead at Save the Children Ethiopia’s Saving Newborn Lives Program, Dr. Bekele has stayed true to that vow. Maternal deaths have been reduced by two-thirds since the year 2000, from 1 in 24 to 1 in 67.Ethiopia has been praised as a success story in Child Health, having reached Millennium Development Goal #4, to reduce child mortality, ahead of the 2015 schedule. Yet while the mortality rate of children age 1 month to just under 5 years has annually declined by 6.1%, the neonatal mortality rate in Ethiopia is only declining at a rate of 2.4 %. Newborn deaths account for 43% of all deaths under the age of 5 years old.Save The ChildrenThe major issue in Ethiopia is that approximately 80% of women give birth at home, often without the presence of a trained health care worker. The majority of the population lives in rural areas with poor access to health care.Dr. Abebe’s own story also illustrates that even in the presence of the most skilled physician, without resources, or transportation to a hospital from a remote area, lives can still be lost. The fact that less than half of newborns are protected against tetanus is another major contributing factor, especially for home births in unsterile conditions.The country’s success on MDG 4 illustrates that with dedicated financial and intellectual commitment, Ethiopia’s goal to reduce the number of newborn deaths by 2015 can be achieved. The Health Extension Plan implemented by the government to target the issue is deploying trained Health Extension Workers, and the Health Development Army, both key delivery platforms at the primary level.

The ultimate goal is one health care post for every 5,000 regional inhabitants attended by two Health Extension Workers. Then one larger health care center serving every five health care posts and one major hospital for each of the 800 districts of Ethiopia. Health Extension Workers train for one year after graduating high school in the communities in which they will serve. The Health Development Army volunteers have been key to the success of the program on a local level by educating their own communities.

In such a large, diverse country, there are cultural challenges to getting mothers and communities to adopt new health practices. In the southern region of Ethiopia when women were not coming in to the new Health Care Center to give birth, they figured out that the women did not feel comfortable with the birthing position on the table. When they changed it to a more culturally suitable option, women began to come in to give birth. Working with formal and informal community leaders has also proved important.

Dr. Abeba Bekele has kept her pledge from that moment when she lost that mother years ago as she continues to implement change in her country through her work with Save the Children. The government of one of the poorest countries in the world seems committed to preventative health care measures, and with education the thinking in rural communities is beginning to change. The great hope is that the newborn mortality rate will soon significantly change as well.

This is a slightly altered version of an article that appeared on ONE.org.  ONE Mom Elizabeth Atalay was in Ethiopia as an International Reporting Project Fellow on a New Media Fellowship to report on newborn health. Follow her journey on Twitter with hashtag #EthiopiaNewborns.

 

 

 

#EthiopiaNewborns & Maternova Innovations

#EthiopiaNewborns & Maternova Innovations
7 week old #EthiopianNewborns

7 week old #EthiopianNewborns Photo by Elizabeth Atalay

The first thing I pulled out of the bag was the strip of condoms. As a happily married mother of four I can’t remember the last time I handled a strip of condoms, and I confess that they made me giggle. I was checking out the contents of the Maternova backpack I was bringing to Ethiopia, and was quickly informed that they were not included for that reason.

Upon learning that I would be traveling to Ethiopia as a New Media Fellow with The International Reporting Project to report on newborn health I had immediately reached out to my friends at Maternova. Maternal and Newborn health is what they do, particularly in low-resource settings, and I knew they would have some great insights as to what topics I might see on the trip. Part of our reporting will be from rural villages in Ethiopia where most births take place in the home, without a trained healthcare attendant. Maternova is headquartered in the state of Rhode Island where I live, but provides the leading global on-line resource for Governments, non-profits, and health care providers to access affordable healthcare solutions to save the lives of mothers, and newborns.  I asked founder Meg Wirth to tell me about a few of the Maternova products that I was bringing on the trip, and how they are used to save lives.

Lake Tana source of the Blue Nile, Bahir Dar, Ethiopia

Lake Tana source of the Blue Nile, Bahir Dar, Ethiopia

Elizabeth Atalay: The condoms in the bag actually come with instructions on how to save a woman’s life from postpartum hemorrhage with the Condom Balloon Tamponade method.  Can you talk a bit about the evolution of the CBT method?

Meg Wirth:  Well listen, if someone needs a condom you should probably give it to them—because averting a pregnancy, as you know, can save a life too.  But the condom also has another very intriguing use—a brand new condom can be used as a kind of do-it-yourself medical device to stop postpartum hemorrhage.  We sent you with instructions!  Rather than break it down step by step here, suffice it to say that the condom can be attached to a foley catheter and IV, filled with saline or water when inserted in a uterus post childbirth.. the pressure of the condom balloon can stop internal bleeding.

EA: I am also bringing the Maternova solar head lamp created for night birthing scenarios, can you remind me of the story you once told me about observing a night birth when you first introduced me to this product?

MW: Well that story wasn’t mine, but we hear stories every single week about birth occurring in the dark.  While a normal birth may be fine in the dark, a complication or a hemorrhage create a serious problem because no one can manage the complication properly.  A simple solar lamp allows task lighting to manage births but they also light the way for heroic midwives who are so often called out at night to remote places and could use light for their own safety.

EA: It is always been surprising to me that newborns in Sub-Saharan Africa can die from simply preventable causes like hypothermia. Two of the Maternova products I am bringing come in tiny packages, yet can be the difference between life and death of a newborn. Can you talk about the importance of the Sterile Foil Baby Bunting, and the Thermo Spot stickers?

ThermoSpot

MW:  The ThermoSpot is a temperature indicator that, when stuck onto a newborn (in a very specific place) can signal—just with color—whether the infant is too cold.  The face on the round sticker fades from green to black and indicates that the core temperature of the infant is far too low. Remember, the average villager in Ethiopia is not going to have a thermometer at the ready, and this amazing, re-usable, ultra low-cost device is a thermal indicator that can be ‘read’ just with color meaning the mom or father need not be numerate or literate. The mylar bunting is a very lightweight wrap to keep infants warm, particularly during transport or when separated from mothers.  Both of these items are in major trials in Pakistan and Kenya though they are already in use in many settings.

EA: I recently learned that in Ethiopia most rural healthcare clinics do not have pregnancy tests available.  Are women able to keep track of their cycles and pregnancies with the CycleBeads for family planning?

MW:  Yes the CycleBeads can be used by anyone with a regular cycle to predict ovulation times!!!  They are a very rapidly-spreading form of birth control.

Cycle Beads

EA: What are some of the issues of newborn health in Ethiopia that you and the Maternova team are interested in hearing about? What innovations should be keeping an eye out for?

MW:  We are interested in local ‘fixes’ or ideas that nurses and midwives have come up with.  Part of our mission is to spread innovation more rapidly and if we can learn from them and spread the messages quickly we’d be thrilled.  See if they have working blood pressure cuffs in the clinics.  See if they have magnesium sulfate.  What about misoprostol?  How do they stop postpartum hemorrhage?

EA: I will definitely be looking to see what innovative solutions the midwives have developed in their communities and share what I see.  Just a few days into the trip we have already been gaining real insight into the Maternal and Newborn landscape here in Ethiopia.  Despite the lack of resources, there seems to be a real commitment to preventative measures and education so I’m excited to bring the Maternova products to midwives we are meeting with later this week!

MW:  Thank you for your work Elizabeth!!

I am in Ethiopia for two weeks with The  International Reporting project on a New Media Fellowship to report on Newborn Health.

You can follow along at The International Reporting Project #EthiopiaNewborns