It’s high time for me to write about what I am doing here in Ethiopia. It’s a bit complicated to explain, but I will try my best.
My volunteer placement is involved with the BEMONC training of the health workers, midwives, nurses and birth attendants in the peripheral health centres. (BEMONC= Basic Emergency Obstetric and Newborn Care. At this primary level of care, it is now aimed to train the health workers to provide the following services: 1. assisted vaginal delivery- vacuum extraction 2. manual removal of placenta 3. management of postpartum hemorrhage 4. management of eclampsia 5. management of sepsis 6. manual vacuum aspiration 7. newborn care and resuscitation but they do not have the services of the secondary referral centre of having blood transfusion and Caesarean section).
Often these health centres are staffed with health workers with very minimal medical training or very young and junior midwife totally on their own without much supplies, equipment and supervision. There is no doctors there. They are often in very remote and isolated rural areas where the nearest referral hospital is hours if not days away.
In order to decrease maternal and neonatal mortality in Ethiopia, several partners and NGOs – the Federal Ministry of Health, UNICEF, JHPIEGO and Ethiopian Midwife Association have started an intensive 3-week BEMONC training program aiming to train 2000 health workers in the periphery to provide better delivery service in the rural areas ( 500 health workers in the Amhara region where I station)
So my job has two roles:
1. I am working as a facilitator at the BEMONC training program at the Felege Hiwot Hospital (NB. I am not a trainer. Since we encourage long term development and skills transfer, all the teaching and training is done by the Ethiopian midwives. My role is to facilitate, giving technical feedback and comments especially during skills practice sessions)
I had a student who had to travel 5 days to come from his village on the mountains to Felege Hiwot Hospital in Bahir Dar. He had to walk 3 days by foot before he hit the main road and then a 2 day road trip.
2. Another duty of mine is to develop an after BEMONC training program for monitoring, evaluation and support of these trainees after they return back to the isolated working environment . This is to ensure they can get the support to practice and sustain the newly acquired skills and knowledge in the real life situation. For this job, I am basically sitting in the Amhara Regional Health Bureau reviewing literature, national and international standards and guidelines to develop assessment tools for this purpose and writing up proposals.
So I am kind of a “government official” too haha! since my local “employer” is the Amhara Regional Health Bureau (To make things more complicated- my position is funded by UNICEF- so my desk is inside the UNICEF office)