Society Revitalizing healthcare: MSF empowers communities, transforms maternal care in Northern Ethiopia
By Metasebia Teshome (Special To The Reporter)
April 14, 2024
In the wake of the devastating conflict that engulfed Northern Ethiopia, Médecins Sans Frontières (MSF) has embarked on a mission to breathe new life into the healthcare system. The organization has taken a proactive approach, rehabilitating an operating theatre at Korem General Hospital and dispatching additional mobile medical teams to remote and inaccessible areas.
On a fateful Monday, February 12, a 43-year-old woman embarked on a grueling journey, enduring an arduous hour-long commute via public transport to reach the nearest health center from her humble abode. Undeterred, she pressed on for an additional ninety minutes, eventually arriving at Korem’s General Hospital.
Her referral was prompted by pregnancy-related complications that had emerged a mere few days shy of her due date. Recognizing the imminent threat to both mother and unborn child, the medical team resolved to perform a life-saving caesarian section (C-section).
“In emergency situations, it is dangerous waiting for a natural delivery. So it is in these cases that our teams decide to perform a C-section,” explains Ryoko Hirayama, the MSF OT Nursing Activity Manager in Korem.
After a week under the hospital’s diligent care, both mother and baby triumphantly left the premises, their lives preserved and hopes restored.
Northern Ethiopia’s healthcare system had been ravaged by a debilitating two-year conflict. However, in November 2022, a peace agreement was inked, leading to the gradual reestablishment of healthcare services in previously inaccessible and strife-ridden regions. Alas, many communities remain mired in the quagmire of limited healthcare access.
Responding to this dire situation, MSF commenced operations in December 2022 in the environs of Alamata and Korem. The organization was disheartened to discover that the health facilities in these areas had been reduced to rubble, pillaged, bereft of essential supplies, and struggling to replenish their stock. The communities had languished without medical care for months and years, enduring severe physical and psychological repercussions.
To ensure a modicum of humanitarian access to healthcare, MSF deployed two mobile medical teams, now providing essential support to seven health centers and three health posts in remote and hard-to-reach areas.
Between January and December 2023, a staggering total of 31,072 medical consultations were conducted across five mobile clinics. Of these, over 13,000 concerned children under the age of five, while more than 6,500 women received comprehensive maternity and gynecological care. In a bid to expand their reach and impact, MSF doubled the number of mobile clinics this year, elevating the count from five sites in 2023 to a commendable 10 sites in 2024.
While this concerted effort has undeniably improved access to primary healthcare, the process of referring patients with complications to hospitals remains a daunting challenge. Moreover, numerous health facilities continue to grapple with inadequate supplies and materials, jeopardizing the delivery of basic quality care.
In the preceding year, from March 8 to the close of December 2023, a significant number of patients—238, to be precise—were referred from the mobile clinics to Korem Hospital, with a notable proportion requiring urgent maternal healthcare.
One of the most lamentable consequences of the prevailing difficulties in reaching health centers is the alarming frequency of home births among pregnant women. This predicament further exacerbates the barriers they face in obtaining the necessary care when complications arise during delivery, thereby perpetuating a vicious cycle of inadequate support and heightened risks.
In a noteworthy collaboration between the MSF and Ethiopia’s Ministry of Health (MoH), a momentous occasion unfolded on January 16, 2024.
Korem General Hospital bore witness to the grand inauguration of its state-of-the-art operating theatre (OT) and the advent of a Comprehensive Emergency Obstetric and Newborn Care unit (CEmONC). This groundbreaking development marked a turning point for women grappling with complications during pregnancy, delivery, or postpartum, as well as newborns in need of comprehensive care.
Emphasizing the significance of this achievement, Chiara Martinotta, MSF Project Medical Referent in Ethiopia, underscores the dire circumstances faced by many mothers: “We receive mothers with serious complications after giving birth at home. Many women have no other choice than to deliver at home. People have to walk two, three, up to five hours to reach a functional health facility.”
The restoration of the operating theatre is poised to enhance access to surgical care and cater to the medical complexities encountered by expectant mothers. However, MSF’s involvement in Korem extends beyond the confines of the hospital walls. The team engages in imparting health promotion trainings to both hospital staff and community health workers residing in remote and inaccessible areas.
Recognizing the invaluable role played by these community health workers, Martinotta says they can provide crucial support in preventive endeavors when MSF’s physical presence is lacking. By offering timely assistance and sparing patients the arduous five-hour journey along treacherous roads, these health workers ensure a continuous presence of healthcare professionals to monitor the well-being of mothers and babies following childbirth.
Nearly two months have elapsed since the ceremonial unveiling of the operating theatre, and the MSF team, in collaboration with MoH personnel, has already performed a series of surgeries, including seven emergency cesarean sections, and diligently tending to the needs of newborns and their mothers in the dedicated unit designed to provide comprehensive care.
Hirayama, reflecting on their achievements thus far, remarked, “We didn’t have many patients at the OT yet, but we already managed to save lives. We had some positive impact. The staff is improving, and we are feeling positive about the outcomes.”
The MSF team stationed in Korem sees a resolute vision of a positive and enduring impact, driven by a commitment to fortify the capacities of MoH personnel—a cornerstone of the project’s foundation. With their sights set on the long-term, the collaborative efforts between MSF and the Ministry of Health hold the promise of transforming the landscape of healthcare provision in the region.