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Responding to Ethiopia's health care challenges

Ethiopia is a country of geographic extremes, with 85 percent of its population living on small farms throughout the country.

With this vast distribution of people, delivery of universal health care in this African nation produces its own set of challenges. Annette Bennett from the Hamlin College of Midwives at Addis Ababa Fistula Hospital in Ethiopia reports on how the hospital is responding to these challenges through midwifery education.


AVI volunteer Rosey King (right) with a first year Hamlin College student practicing antenatal care in a health centreThe main casualties of Ethiopia's lack of health care are women and children.

This landlocked nation on the Horn of Africa has one of the highest maternal mortality  rates in the world,  with approximately 678 women dying with every 100,000 births.

For every woman who dies, another 20 suffer devastating injuries as a result of childbirth without adequate medical care.

The Addis Ababa Fistula Hospital, which is located in Addis Ababa, Ethiopia's capital, and was founded by Australian doctors Reginald and Catherine Hamlin, has for 36 years been caring for women with obstetric fistula.

This is an injury that occurs during labour when the baby's head becomes stuck in the birth canal. The constant pressure of the baby's head crushes the internal tissue of the mother, leaving her with a hole in the wall of her bladder, vagina and sometimes rectum as well, causing the women to leak bodily fluids uncontrollably.

It is not hard to imagine in a country where water is very scarce and families share one room to sleep that these women are soon ostracised from their homes and their entire communities. They are often abandoned by their husbands and unable to attend markets, family gatherings and church or the mosque.

The Addis Ababa Fistula Hospital

In 2007, the Addis Ababa Fistula Hospital responded to the challenges of health care in Ethiopia and opened the Hamlin College of Midwives. This institution is training women from selected rural areas across the nation to deliver top quality maternal health care to rural communities.

The Hospital hopes to develop a comprehensive midwifery community training model that can be replicated by the government and other organisations concerned about improving maternal health.

With only 1200 midwives currently working in Ethiopia, the challenge to find well-qualified and experienced midwife educators is huge.

The College recognises the need to strengthen the sector and increase the number of local midwifery professionals. To do this, an "injection" of expertise from outside Ethiopia to fill the gaps in knowledge and experience in the midwifery sector was needed.

The Hospital receives many generous offers of short term assistance from health professionals from around the world. To achieve the College' goals it was vital that not only the right people with the right skills to support our activities were recruited, individuals that were prepared to provide long term assistance and capable of  working sensitively with locals were required.

With this understanding, and as the need for capacity dramatically increased, the College formed a partnership with Australian Volunteers International (AVI) and AusAID to support its human resource needs. As a result, AVI recently recruited Rosey King, an experienced Midwife Educator from Ballarat, Victoria, to join the training team at the College.

Having been screened and orientated to the vision of the College and the broader issues surrounding maternal health in Ethiopia, Rosey brings skills and passion that complement the integrity of the mission of the Hamlin College of Midwives.

Rosey is not only teaching in areas where there is a knowledge gap, she is also mentoring local staff to assist in making this college a centre of excellence, and following in the footsteps of the Addis Ababa Fistula Hospital.

Annette Bennett is the Vice Dean at the Hamlin College of Midwives at Addis Ababa Fistula Hospital, Ethiopia.

Learn more about the college at www.hamlinfistula.org/our-activities/midwifery-school.html