While news from Ethiopia is dominated by the conflict in Tigray, there is also horrific ongoing violence in the western Ethiopian state of Oromia, where Village Health Partnership conducts the Screen, Transport, and Treat (STT) Program.
The Ethiopian federal government and the Oromo Liberation Army continue to clash over who should hold power in the region, leaving a trail of violence that, as so often happens in armed conflict, has had a devastating impact on women and girls. With the increased violence, access to healthcare is limited at best. As a result, more women are giving birth at home, more are dying in childbirth, and more are developing severe gynecologic complications of childbirth including obstetric fistula and severe pelvic organ prolapse.
In the face of ongoing armed conflict, we are still screening, transporting, and treating women with these devastating conditions. The suffering is great. Many need treatment in order to simply function normally in their daily lives, but entering areas impacted by the violence, even when offering aid and staying neutral in the conflict, is extremely dangerous. Those who do this work on the ground continue to astound us with their bravery and dedication to bettering the lives of women in rural Ethiopia.
“The violence is getting worse in the country as a whole… No one is quite sure what will take place in the near future.”
Dugasa Benene, Project Coordinator for the STT Program, is a hero. He travels to remote areas of western Ethiopia, sometimes on foot and often through conflict zones, with the ever-present threat of violence, to find women who need treatment for severe gynecologic complications of childbirth.
We communicate with Dugasa from the United States when possible through email and by phone, although it is not uncommon for the internet to be taken down and phone service to be disconnected. When he is able to send reports from the field, they reflect the difficulties faced by those traveling or living in this region.
“I was away from Dembi Dollo for about 20 consecutive days. I went to the remotest districts of the Kellem Wollega Zone to remobilize and screen women with gynecological complications of childbirth. I walked to these districts as there was no means of transportation due to violence and heavy fighting.
Women are suffering…”
– Dugasa
In spite of the armed conflict and difficulty of accessing women in need, there is a groundswell of support for the STT Program. More women are asking for our services, and the local government offices of Labor and Social Affairs frequently call Dugasa to let him know that people are requesting our services. Women who receive care through the STT Program are able to reintegrate into their communities and live healthier, more productive lives. Mrs. Hundatu, pictured below, is one example of a former patient who says the STT Program “has been a miracle.”
With generous support from the Fistula Foundation, we are able to treat 25 fistula patients each year. We also treat 150 patients with severe pelvic organ prolapse each year. The need is great!
“While screening women for fistula, I came across many more UVP [uterovaginal prolapse] patients. What can be done with these excess UVP patients? I am not feeling comfortable with sending them home untreated. What do you suggest?”
– Dugasa
These women have 3rd and 4th degree vaginal, rectal, and uterine prolapse, meaning they have internal organs hanging outside of their body. Many are incontinent and leak urine and stool. Without water to bathe, malnourished and debilitated, these women are unable to care for themselves or their families. The consequence of these injuries is devastating. We, like Dugasa, do not want to turn them away, but we need more support in order to treat them. The Tropical Health Alliance Foundation (THAF) has stepped up to support the STT Program! With financial help from the THAF, we will now be able to treat 100 more women with severe pelvic organ prolapse for a total of 250 women in 2023.
The women that Dugasa identifies when screening for gynecologic complications of childbirth are transported to Aira General Hospital for treatment. Through the STT Program, Aira Hospital has become a center of excellence for women’s health in western Ethiopia. There is ongoing armed conflict all around the hospital, and the hospital itself has on occasion been the target of violence. Despite this, the doctors and nurses on staff continue to treat women in need, including those transported there through the STT Program.
Pictured below are the doctors who care for women under the STT Program. They too are heroes! Dr. Tariku Wakuma, MD, surgeon and former Medical Director of the hospital, has treated women with pelvic organ prolapse and fistula since the beginning of the STT Program. He is highly committed to the program and puts in many, many hours in the operating room. Dr. Workineh Gemechu, MD, just joined the surgical team as the new OB/GYN at Aira Hospital. He works under the direction of Dr. Tariku. Dr. Tesgera Jabessa, MD, is the Medical Director of the hospital. He supervises patient care at Aira Hospital and collects detailed data on all patients treated under the STT Program. Working with Dugasa, these doctors keep the STT Program running despite the threat of violence and the risk to their personal safety. We are deeply grateful for their hard work and dedication to treating women identified through the STT Program.
