Nov 23, 2011

Maternity

I wasn't sure how to describe this post for the title, but I think "maternity" sums it up nicely. I say this because I want share with you an update about Ryan, info about our tour of the Hamlin Fistula Hospital, and what we've learned about international adoption from Ethiopia.

God willing, Ryan is doing well.  I'm 19 weeks along and I have the tummy to show for it.  I feel as though I grew a lot early on and am now slowing down.  I don't think that my stomach is much bigger now than it was when I left the United States two weeks ago.  We've become a little concerned that I still haven't felt Ryan kick and this past weekend while we were at Lake Langano I experienced considerable cervical cramps.  For these reasons, we are headed to the Swedish Clinic in town tomorrow morning to make sure that Ryan is doing well.  They have an OB there that's apparently very good and also quite aggressive in her efforts to med-evac when necessary. I'll be sure to post what we learn as soon as we get back from the doctor's office.

I have always felt compelled to suggest that our wealth is "comparative" - e.g. we are wealthy when compared to most Ethiopians.  However, moving to Africa and realizing how most of the world lives, I am quite aware how legitimately wealthy we are.  The things we complain about not having and those that we wish we could afford are uniquely affluent desires regardless of where you live in the world.  America certainly skews that perception because there is so much wealth concentrated there.  This was put largely into focus after we made our appointment with the Swedish Clinic (where we will pay out of pocket) and proceeded to visit the Hamlin Fistula Hospital. 

What's a fistula? So glad you asked! Ethiopia has 80 million people and 130 OB doctors to serve them.  Of the 130 doctors, 101 are in Addis Ababa where the population is only 4 million.  That leaves 29 doctors to serve 76 million people, roughly 34 million of those are women, who live in the rural parts of Ethiopia.  Because most women in Ethiopia live in impoverished, rural communities, they never see a doctor or clinically trained midwife during their pregnancy.  Most often women deliver either on their own with the assistance of female family members or with a community midwife who has simply delivered a lot of babies but has no medical knowledge to ground her decision-making. When women go into labor, as also occurs in the US, often the baby is not turned correctly.  Perhaps their back is facing down and they are horizontal rather than head-down and vertical.  In the United States, these women would have a cesarean.  In the rural communities they suffer for 4-7 days of labor where midwives regularly sit on their bellies to try and push the baby out. Soon, the baby dies inside the mother and becomes very small so it is easy to remove.  The mother, however, is left in what seems disrepair.  Her bladder and rectum have lost blood supply for days, resulting in the formation of a single hole through which urine and feces flow uncontrollably.   Unable to endure the constant odor she produces as urine and feces trickle down her leg and infect her leg as well, her family will most often build her a small hut on the outside of town where they leave her and bring her food once or twice a day. The lucky ones are brought immediately to the Fistula Hospital in Addis.  Many however, spend years living in these huts where their legs begin to atrophy from lack of movement.  They stop eating and drinking as that produces waste - the great cause of their pain.  Divorced, isolated, without their children and starving, these women learn of the Fistula Hospital and sell everything they own to make it to Addis. When they arrive at the Hamlin Hospital, they are welcomed by trained psychiatrists and therapists who are previous patients as well.  At the hospital they begin the long process of rehabilitation, surgery, and recovery.  For many, this takes years.

Mark and I toured the Hamlin Hospital today and had a difficult time selecting the right words for the most beautiful place in Addis: magical, spa-like, inspirational, rejuvenating, a place where God works.  The small campus is nestled on the backside of a hill overlooking a large river.  While Addis is dusty and full of diesel fumes that leave you gasping for air, the Hamlin Hospital grounds feels more like an enchanted spa retreat than a hospital.  Each of the units appear in separate white buildings tucked into trees and gardens.  The rooms have large windows and plenty of ventilation to prevent the women from enduring further embarrassment from their odor.  We first went to the recovery ward, where we saw women full of hope and excitement as they lay in bed recovering from surgery.  We also went to the building where women wait for surgery. The last three places we visited were both the most difficult and encouraging to experience.  In one small room, full of light upstairs in a building there were 8 beds.  These beds were filled with the women who, for one reason or another, the recovery surgery failed for them.  They either need additional surgery or will need to wear bags for the remainder of their lives.  The latter is much like a death sentence.  At home, they will continue to be isolated. Accessing the funds to travel to one of the five satellite hospitals so they can receive their 6 month supply of bags is nearly impossible to keep up. Remarriage is an almost impossibility for them in this state.  These women gave up everything they owned to make it here and were told of a better tomorrow, that day is not going to come for them and it was hard to watch and will remain difficult for me to accept.  We then went to a physical therapy building. For the aforementioned reasons, women often arrive to the hospital in an unbelievably frail state.  What we saw were five women, all barely resembling more than a skeleton, eating boiled potatoes to gain weight as they participated in physical therapy exercises targeted at building their strength so their bodies can endure the surgery they need.  One woman was left alone for 7 years and has been participating in rehab for 8 months.  She is still a long way from walking. Despite these two difficult stops on our tour, the last stop Mark and I made was the highlight of our trip.  It was the maternity ward.  These women successfully recovered from their fistula surgeries, returned home and remarried.  They are now expecting their second or third or even fourth child and are here to ensure that there are no complications with their baby and to undergo a cesarean delivery.  One woman was feeding her newborn baby and the others were laughing and gossiping with delight - their swollen bellies shaking their entire hospital gowns.

The woman who guided Mark and I through the hospital was Fevan.  She is an inspiration and the kind of woman that passion, heart and servitude flow from without ceasing.  Fevan and I exchanged contact information and she is going to begin the process of finding me the right opportunities to serve women in and outside of Addis.  The nursing staff at the hospital, primarily former patients themselves, Fevan and the doctors are the living hands of God.  It was inspiring and humbling to see them all busily at work.

I've clearly written the longest blog post in the history of blog posts, so I will share what we've learned about Ethiopian adoption later.  In the mean time, if you're thinking about adopting from Ethiopia, you shouldn't.

If you're wondering why I didn't take pictures - the Hamlin Hospital requests that you don't out of respect for their patients.  We were happy to play by the rules. You can learn more about the Hamlin Hospital by reading Hospital by the River, written by Dr. Hamlin herself. You can also donate to the Hamlin Hospital by visiting their website.

3 comments:

  1. Due to this post, I have already educated someone on Fistula and that adoption in Ethiopia is not as glamorous as some movie stars make it look.

    Thank you.

    PS-Glad to hear Baby Ryan is healthy!

    ReplyDelete
  2. I have a book for you about a physician who worked in Addis Ababa and with patients like these...send me your address :)

    ReplyDelete
  3. *A book of fiction, sorry, but that crosses stories like these; deals with medicine and Addis Ababa :)

    ReplyDelete