Some Medical Realities

June 10, 2013
Today is a very special day, it is my daughter's and my three year "Forever Family Day". My mom and I picked my daughter up from the transition home three years ago today to be a part of our family forever.
In some ways, that day seems like a very long time ago but in other ways, those three years has gone by so very quickly.  I have been so incredibly blessed to have the great gift to raise my daughter and to love her for the rest of my life.  
The children at the KVI orphanage, our sponsored boys and all other children in the world are so precious and to think that 5 million children here in Ethiopia alone do not have parents to care for and love them is heart breaking.
As we spend more and more time with our sponsored boys and their friend Henok, our love for them is growing.  These children are intelligent, kind, hard working, resilient, loving and so in need of attention and love.  We are so thankful to have this time with them.  Oh how I wish Ethiopia was much, much, much closer to where we live!!!!!
There is one boy at the KVI orphanage that I have connected with in a very special way.  His spirit is very gentle, it is kind and my sense is that he has wonderful potential in his life.  I went back to the orphanage yesterday to help with our supplies but really it was because I wanted to see him again.  When we arrived, he was wearing a sweater of my daughter's that did not fit her any longer.  Oh how I wish I could do more for him and the other children in orphage and the children living on the street.  My heart breaks for the children who do not have a family of their own and the children who do not have the care they need.
We had some time today to do some shopping.  We visited the organization that rescues women from the wood carrying industry and trains them to weave scarves and baskets.  As we drove up to the organization's gate, we saw a huge bundle of long sticks to show visitors how large and heavy the load women carry when they work in the wood carrying industry.
Our driver Gecho told us that people say the women walk 20 miles both to the place they collect these bundles and then back to the place they deliver the wood each day.  The women would earn lower than the international poverty line of $1.25 per day.   I wrote the other day that Gecho told us he and our friend Bisrat have stopped to offer a ride for some of these women and it took three men to lift the  load of wood up to the roof rack of his van!!!
Many of these women (if not all) sustain very significant physical injuries due to the heavy weight being carried on their backs.  When my mom and I were here three years ago, I remember seeing an old women walking very, very hunched over with a cane and when I asked Gecho if this would be because she had been a wood carrier, he said yes.  No chiropractor, very, very limited access to medical help, no access to pain medication and no sick benefits if you are unable to work because of back/neck/shoulder/leg/feet pain for these women, can you imagine....... I cannot!!!
Our volunteers purchased many beautiful scarves and we were thankful for the opportunity to support these beautiful women in their work that is far more respectful and incredibly less taxing on their bodies.
We also visited an organization that has trained women who have HIV to make beautiful jewellery.  All of our volunteers purchased pieces of jewellery to bring back to friends and family.  Shopping to support the women who have made the scarves and this jewellery brings a whole new meaning and value to consumerism.
To celebrate Forever Family Day and to enjoy a cultural event, we spent the evening at a Traditional Restaurant.  A buffet with traditional foods, music and dancing were enjoyed by our volunteers, driver, our sponsored boys and Henok and the Executive Director of KVI and his brother Solomon who is graduating from medical school in three months.
I had an opportunity to speak with Solomon and learned some information I wanted to pass long to our blog readers.  There used to be one doctor for every 80,000 people in Ethiopia!  In countries like Kenya, they have one doctor to every 10,000 people.  In Canada, we have 2.1 doctors for every 1,000 people.  Imagine the implications of this disparity.  Treatable illnesses that take thousands and thousands of lives every day like  Typhoid fever, malaria, infections, etc. could be treated by general practioners if doctors were available.
The government has started to make some change in this county and Solomon told me that the ratio is now 1 doctor to every 40,000 people.  The reason for this change is that the government has opened three more medical schools in the country (they used to have only 3) and also they have allowed for the first time a private medical school.  A second reason for the change is that they are allowing a greater number of graduates in the medical school program and a third reason is that the government has introduced regulations that has reduced the number of graduates leaving Ethiopia for countries they can make more money.
Solomon said that although the ratio between doctors and Ethiopians is improving, the growth rate in this country has been unbelievable.  In 20 years, Ethiopia doubled their population.  Solomon said that family size has decreased recently with the average number of children reducing from 10 to 6.  In order to improve medical access, there will need to be a multi layered approach by the government - more doctors graduating, education to help reduce the population and incentives to attract doctors to the rural areas (many of the doctors would be located in the larger cities).  Eighty percent of Ethiopia's population is located in the rural areas of this country.
We visited the Fistula hospital in Addis a few days ago and learned about their work and some of the realities of child birth in this country.  For the vast majority of women in this country, child birth is without the help and care of any medical practioners.  When a birth is obstructed (meaning that the baby cannot descend through the birth canal), women will labour for up to six days until the baby dies.  Many, many women and babies die in child birth because they have no access to medical care and they labour for days with great pain and then when the baby is obstructed the baby most often dies and the woman is very much at risk for infection and death.
When a baby is obstructed and the woman cannot access medical care, the strain on their body often results in holes in the bladder and bowel which then produces leaking.  The women are shunned  by their families because they smell due to the leaking.  The women who cannot access or afford medical care (surgery) for the fistulas, are shunned and often lay for years trying to reduce the leaking.  Some of the women also drink very, very little in hopes they will reduce the leaking.  In some cases, the community the women live in do not know she exists because she is laying in a room away from everyone and is not seen by anyone. 
The fistula hospital provides surgery for the women that is life changing and it is at no cost.  The hospital is funded by organizations and individuals from around the world.  In some cases, there is a second surgery required.  The women stay in the hospital for at least 20 days and in cases where the women need extensive therapy due to a dropped foot or contractures (a dropped foot is a result of the prolonged labour and the impact on the nerves and the contractures are due to inactivity and laying still for a long period of time).  We saw pictures of women who had surgery and then therapy for 3 years but were totally transformed.
Families believe that the leaking is shameful and do not understand that it can be treated.  Education is very much needed to help families understand the availability and value of the surgery.  For many, many women, they would not be able to travel to the Fistula centres in Ethiopia.  The staff person who was giving us the tour told us that some women come being carried on the backs of their family members.
The women receive their surgery, physical therapy, group therapy and education on many topics such as nutrition, women's rights, family law, child care, etc.  The women who have had the surgery then return to their communities to share their stories to other women and to encourage them to go to the hospital.
We had a tour of the facility and saw women of different ages.  The youngest was approximately 12 or 13 years old.  We were told that in some cases, the women had been shunned and away from their community for 50 years before they had the surgery!!!
There is change happening in the medical system but there is a long ways to go to provide the Ethiopian people what they need.
Being here and learning about some of the medical realities of this country sure reminds me of how fortunate and blessed we are in Canada!