Monday, 18 November 2013

Visit to a local health centre

There was a volunteer from Europe visiting and she wanted to see a Health Centre so I hopped into the van as well and went with her!

It was about a one hour drive away from Gondar Hospital into the countryside (Past Azezo and past the turning to the airport). The asphalt road ran out so then it was along very bumpy track.

Antenatal clinic
If there were any complications then the patients from here would be sent to Gondar Hospital - along said dirt road - either in the health centre ambulance or in the Red Cross one or Hospital one.

They said they had one or two deliveries everyday but there was no-one there when we visited. It was super clean!

 For the neonatal resuscitation
The health centre was staffed by 2 midwives and then there were 7 other nurses who did different clinics etc - the head midwife said he would love more training for the nurses as there were times that the midwives were not at work so the nurses cared for the pregnant ladies.

The autoclave

The smallest ambulance you ever may see!! They say it attaches onto the Bajaj (tuktuk) - would not fancy it though along the bumpy road - being in a 4x4 was bad enough! 

The Health Centre

The Delivery Suite at the Health Centre

The Delivery Suite

The conditions on Delivery Suite are hard - there are often women sleeping on mattresses on the floor and I feel awful when you have to literally step over them when doing the ward rounds.

It is quite unclean but it is so hard to keep clean with an uneven concrete type of floor as dirt just gets in the cracks. We have just swapped the wards around so actually this is now the post natal ward and the Delivery suite has a nice new floor and is much cleaner and brighter! Yeh! And sometime (supposedly June) there will be the new hospital!!

If a patient needs any drugs then the family member is given the prescription and goes to the hospital pharmacy to buy them - if they are not available in the hospital they have to go out to one of the private pharmacies to find them. This is the same if they need a Caesarean Section - the relative is given a full list including catheter, cannula, antibiotics, a number of sterile gloves, painkillers. Obviously if there is an emergency then they do have some spares but these would generally be replaced afterwards. If the patient cannot pay or does not have any attendants then again there are some spares and there are social workers who can sort out the finances. 

There is very little privacy and certainly no single rooms! The area where the women deliver has 3 couches (4 now we have moved) but there is no screen between them. The women deliver alone with no relatives with them. Spinals are given for Caesarean sections but not for much else...

Tuesday, 8 October 2013

RCOG go to The First FIGO Africa Regional Conference!

What an honour for Ethiopia to hold The First FIGO Africa Regional Conference! The organisation was excellent - there was no "African Time" here!! The sessions were extremely well coordinated. If I had one complaint it would be that there was too much going on - with 4-5 sessions running concurrently so it made it difficult to decide which sessions to go to.
The current president of FIGO Africa was present and very proud of his country (Ethiopia) and the whole conference.
The president of FIGO Prof Arulkumaran was heavily involved and very supportive of the conference.

The RCOG held some very well received sessions which really shows how committed they are to assisting Developing Countries to improve maternal mortality internationally.

Prof Walker
Prof Walker (Sen Vice Pres International -2013) ran two successful workshops about how the well established guidelines of the RCOG can be easily adapted to be used in Developing Countries. The created lively debate amongst the delegates attending the workshop but did culminate in a general agreement that when starting to create protocols and guidelines it is definitely easier to adapt established evidence based guidelines than to start from scratch.

The RCOG had a session chaired by Alison Wright on what the RCOG can offer Healthcare Institutions and Individuals outside the UK.

Paul Fogarty (Sen Vice Pres Global Health) spoke about the Global Issues that the RCOG was involved in and the benefits of overseas members - the picture shows the number of countries the RCOG already plays a part in.

Paul Wood spoke about the importance of a robust training and education scheme and how the MRCOG exam can be a very important milestone not only in the UK trainees career but also how important it can be for non-UK graduates to gain this very well recognised and respected qualification. 

There was a great representation from members of the RCOG and UK based obstetricians including Lesley Regan, Hani Fawzi, Justin Konje, Alison Fiander, Isaac Manyonda, Austin Ugwamadu, Babatunde Gbolade and this is just a list of the ones that I knew/met!

The support from Lizzie Rafii-Tabar (Overseas), Lorraine Rossati (Director of Global Health RCOG) and Ann Tate (Director of Development RCOG) was superb throughout the whole conference.

And the session ended with Dr Sophia explaining why she is flying throughout Africa!! raise awareness of the massive challenges African women have with access to healthcare and how much more likely they are to die in childbirth than their European Counterparts.


Saturday, 5 October 2013

Would you fly in a tiny plane around Africa for the sake of Women's Health?!!??!?!

That is what Dr Sophia Webster, UK-based Obstetrician, is doing!!! All because African women face many more health challenges than their European counterparts and are much more likely to die as a result of having a baby.

Me and Sophia!! (I was in awe!!!)

I was soooo impressed to meet Sophia and hear her talk so passionately about the challenge that she has set herself to raise awareness of the massive barriers African women have during childbirth.

 She is:
  •  visiting multiple medical and midwifery units
  •  donating essential midwifery + medical equipment 
  •  facilitating skills teaching among local staff focusing on the 3 most serious pregnancy  complications: massive bleedingserious infection and very high blood pressure
  •  listening to and recording the stories of the patients and their carers that they encounter
  •  visiting schools
  •  stimulating discussion within each country and beyond about the factors which influence the  health of women during pregnancy and childbirth
  •  inviting donations to 7 key maternal health charities performing sustainable work in this field
See more here!!



I met with the RCOG Global Health Team and we had a very successful meeting with VSO Ethiopia. The RCOG are very keen to increase their involvement in Global Health which I feel will be a really positive move which will benefit not only the developing countries involved but also will provide excellent training opportunities for members of the College.

At the meeting we discussed the successes of the VSO/RCOG partnership and how maternal health in Ethiopia has improved thanks to the efforts of previous volunteers. These include Kate Darlow (read her story!!) who took over from Ruth Lawley in Bahir Dah and Mary McCauley who had a very successful time in Yirgalem Hospital and had numerous posters accepted at the FIGO conference for her work there!
Kate Darlow

We discussed how beneficial it will be when we can increase the number of volunteers in Ethiopia as this would allow projects set up by one volunteer to grow and develop. It would be great if both senior trainees and consultants were involved as both different groups have very valuable skills to offer. From a personal point of view I would highly recommend coming to work in Ethiopia! The doctors here have been very enthusiastic to have a UK trainee working with them and it is a fantastic and friendly country!! And believe me - if you have had a little idea in your head that you might want to do this kind of work at some point don't ignore it - just go for it!! Once you start applying there will be some obstacles but you just need to take your time and work round them and then you will find yourselves out here meeting so many amazing new friends and colleagues and learning so much!!

Present at the meeting from the UK were Alison Fiander, Justin Konje, Alison Wright, Lorraine Rossati, Ann Tate and Lizzie Rafii-Tabar.

Monday, 23 September 2013

G'Oats so simple

I won't be graphic - and don't worry there are no graphic pictures either!

Goat market

Bit of bargaining...
Off we go!!
How else do you get your goat home, if not in a bajaj?
Goat stew, Goat pie and actual Tibs....yummy!!!

Thursday, 12 September 2013


Lalibela is a World Heritage Site and it is amazing! It is famous for churches that are carved out from the rock - "rock-hewn" to use the correct term. It is said that all the work was completed in 23 years and this was possible because while the regular workers were sleeping, angels came down from heaven to work on the churches through the night.

Essentially there was flat rock and then they chipped rock away to leave these amazing churches which are below the ground - just imagine being the first person to do the first bit of chipping away.

King Lalibela decided to build them to avoid the pilgrims having to make the dangerous journey to Jerusalem. Or he may have been inspired to build them after he went to heaven (while he was in a coma after his brother had poisoned him) and met God who told him to re-create Jerusalem in Ethiopia. Whatever the reason the churches are so interesting and here are some piccys.

Then there is these really odd looking restaurant which has amazing views, good food and plenty of beer - but no power on the night that we went....