For an Ethiopian woman, the lifetime risk of maternal death is one in 40 (UNICEF, 2010). Multiple factors contribute to this situation. In Amhara Region, only 16% of women have frequent access to media, and fewer than 10% have had the opportunity to complete their primary education. The average Amharan woman will have five pregnancies over her lifetime (Ethiopian Society of Population Studies, 2005). Numerous women in the region have developed obstetric fistula. In Amhara, there is an urgent need to provide women with more options for maternal health services, particularly emergency obstetric care. To address Amhara’s needs, the Fistula Care Project (funded by the U.S. Agency for International Development [USAID]) has partnered with the Tefera Hailu Memorial Hospital to start a new pre-repair unit (PRU), which opened in late November 2010.
The pre-repair unit, which is located in the town of Sekota, provides Amharan women with the first steps of fistula treatment. A unit vehicle may help women reach the center, which provides nutritional support and treatment for any conditions that a woman may have that could affect the outcome of the surgery. The unit has three rooms in which to accommodate patients and a staff mentor to address the social and psychological impacts of fistula. When patients are healthy enough for surgery, they are referred and transported to the Hamlin Fistula Hospital in Mekelle, where they undergo fistula repair surgery.
The PRU staff strive to create greater community awareness about fistula. Recently, they organized a one-day fistula awareness workshop with 45 participants from hospitals and community groups in the region. The workshop trained participants on fistula prevention, patient identification and referral, and PRU activities.
The workshop participants expressed their dedication to the issue of fistula and shared innovative ideas for improving prevention and access to treatment in their region. Ato Moges Ares, the head of the Zonal Health Department, stressed that religious leaders, women’s organizations, and public figures should partner to reduce the incidence of fistula. Belaynesh, Head of the Zonal Women’s Affairs Office, commented that many women with fistula were isolated and needed referrals to hospitals for improved access to care.
Although it has only been open for a few months, the PRU has made progress toward improving access to fistula repair services in the Amhara Region. The PRU has trained health care providers on obstructed labor, partograph use, and neonatal care. The unit referred seven fistula patients to Hamlin Fistula Hospital for surgery in December 2010. Fistula Care’s implementing partner in Ethiopia, IntraHealth International, looks forward to continuing to support the new PRU as it improves access to fistula repair services in the Amhara Region.
Ethiopian Society of Population Studies. 2005. Levels, trends and determinants of lifetime and desired fertility in Ethiopia: Findings from EDHS 2005. New York: United Nations Population Fund. Retrieved from: http://ethiopia.unfpa.org/drive/Fertility.pdf, Feb. 18, 2011.
UNICEF. 2010. Ethiopia Statistics. Retrieved from: www.unicef.org/infobycountry/ethiopia_statistics.html, March 7, 2011.