Village Midwives

Dr Catherine Hamlin writes:

The only way to prevent the estimated 8000-9000 new cases of obstetric fistulae occurring in Ethiopia each year is to put in place strategies that will ensure women can receive appropriately trained medical help when the time comes for them to deliver their babies.

Training midwives is the key prevention strategy. A century ago Egypt, Sweden and the United Kingdom dramatically reduced the incidence of maternal mortality through the widespread deployment of trained midwives. It has been a great pleasure to me to see the Hospital establish its own midwifery training college.  Although we have started in a small way with the first intake of 12 students commencing in November 2007, this is the Hospital’s most important initiative so far towards preventing the scourge of obstetric fistulae.

First year midwifery student practising
Good progress has been made.  The students of the first intake have successfully completed the first year of the three-year course with final exams and a six-week clinical placement to practise their newly acquired midwifery skills.  They have studied labour and delivery, ante-natal and post-natal care, family planning, HIV/AIDS counselling, and community visiting.

The second intake of 20 students has come from the Tigray in the north, Oromia, outside of Harar, and the Sidamo Region in the south.  It is a key part of the strategy to select students from particular locations so that, when their training is completed, they can return to their home areas and work amongst their own people.  It is intended that two midwives would work from a purpose-built clinic and be supported from the regional outreach centres.

Class at work
The training these village midwives are receiving will enable them to identify women who are likely to have complications in giving birth and to arrange for them to be admitted to a hospital for delivery.  The fistula problem can be eradicated, as it was long ago in New Zealand, but it will take years of effort and considerable expenditure.  The Hamlin Trust NZ is committed to providing funds on an ongoing basis to support the village midwives programme.