Every morning, Tirhas Mebhratom walks to her health post in Adwa, Ethiopia, a town in the Northern part of Ethiopia. But her post isn't near the town. In fact, it's close to 10 kilometers (6+ miles) to the nearest health center. She and her partner make the rounds, visiting those who are too sick to come to her, seeing those patients who do manage to trek in, some barefoot, some having walked their own mile or two, just to be seen.
The space where they work is tiny by American standards. Just three small rooms with open windows, covered in charts of handwritten reminders. Some are in English -- "health is a human right" -- but many others, those listing the names of all the pregnant women in the village, for instance, are in Tigrinya, the language of the region.
Mebrhatom's work isn't all that different from that of community health workers across the globe; however, unlike them, Mebrhatom is being recognized globally for it. She is the recipient of a prestigious award that honors healthcare workers across the globe.
The official tag line of Save the Children's REAL Awards is, "Some people enlighten us. Some people entertain us. Some people save our lives."
Born from a partnership between STC, the Frontline Health Workers Coalition, and several other sponsors, the award is in its first year. It honors health care workers around the world for all the incredible work they do. But it also serves a larger purpose in terms of raising awareness about the global health care shortage.
By some estimates, the world is short a staggering 4 to 5 MILLION health workers and the few health workers that we DO have are overworked, underpaid, and sometimes underappreciated. This in a country where every spring we gather to watch celebrities congratulate themselves through awards -- the Grammys, the Golden Globes, the Oscars -- and sports stars get their shining moment at the Super Bowl and World Series. There is very little praise for the regular people; the medical professionals who deliver our babies, advise us on our health, and, in many cases, save our lives.
This is where the REAL awards come in. Two weeks ago, Tirhas' entire country -- and people from around the world -- got the chance to see her good work up close and personal as part of the REAL Awards celebration in Adwa, Ethiopia.
The award went to 10 people from other countries as well as nine from within the U.S. STC invited The Stir along on the trip to Ethiopia to be part of the ceremony honoring Tirhas -- to witness firsthand the work she does there that saves so many lives and the way that health care truly changes lives. The trip was life changing in so many ways and included two American Real Award recipients: Dr. Robert Clifford, a pediatrician from South Carolina, and Rhonda Dixon, the director of an at-home health agency in West Liberty, Kentucky. What we saw was surprising and eye opening, both in terms of the challenges faced and the progress that has been made.
The ceremony itself was a testament to just how much Ethiopia has come to value health workers. Dignitaries from around the country came to meet Tirhas. They showered her with gifts and love and broadcast the event on national television. And while Tirhas herself, a quiet woman with long braids and a big smile, seemed embarrassed by all the fuss being made over her, it isn't an understatement to say that she saves lives every single day.
Tirhas tours one family's home
The reality is that while some of us live in a bubble where health insurance has never been in question, doctors have always been readily available, and parents have a pediatrician on call 24/7, we are the minority.
This isn't just a problem in developing countries. It's everywhere, even in parts of the U.S., and it covers every field in medicine from community health workers to pharmacists and midwives. In fact, 57 countries have less than 23 clinicians per 10,000 people, which means people suffer. In places where there are established health workers, the people thrive. This is something we saw firsthand.
We met one 12-hour-old newborn whose latch required work, and we met the doctors who knew the issue and could help her. We met mothers practicing kangaroo mother care, holding their newly born, gestationally small babies against their naked chests so that their babies could grow stronger and more robust. Had these babies been born at home -- like 88.5 percent of Ethiopian babies -- they may have struggled to thrive ... and in some cases -- survive.
Many mothers opened their doors to us and answered our questions largely because they too understand what a difference health care makes. In two cases, we went into homes where the mothers told us about their families, their births, and the difference health care has made in their lives. One mother said that her family hadn't had a single case of diarrhea (the number one killer for kids in the developing world) since they started using soap and water on a regular basis -- something Tirhas encourages in all her patients.
And while the number of home births may seem staggering, this is an improvement from 2005 data where 95 percent of women said that their last delivery was at home.
This change is due in no small part to the tireless work of Tirhas and her partner. Dixon, whose work in rural parts of Appalachia most closely mirrors the work Tirhas did, said she was blown away by what she saw.
What moved me the most was how the Ethiopian government [Working with Save the Children] has empowered their women to be the ones to carry this new standard of care out into the community, this is amazing in a country where women have been treated as property in the past. Their care is successful because the decisions are made at a community level and the people are responsible after training for their own self care and outcomes.
Exactly. In fact, the single most important factor in the birth outcomes for women seems to be education. By and large, the more educated women were about their options, the better things turned out for everyone.
A 2009 University of Addis Ababa assessment of Tigray (the region in which Tirhas works) found that 80 percent of all maternal deaths happened at home, and 50 percent of these deaths were because it took too long to transport the mother to the hospital. At one center we visited, mothers who had reached term were living in a room. "The maternal waiting room" housed at least five moms at any given time, all of whom live too far to try to transport to the center once labor began. All of them knew that in order to give their babies the best possible beginning, they needed to be close to trained care.
It's not easy to change old habits. Tirhas is working against traditions that say mothers should give birth the way their mother did. Many families want to perform their rituals to welcome the new life, and hospitals and centers haven't been amenable to that.
It's also a matter of infrastructure.
Every time Tirhas wants to bring supplies -- bandages, gauze, vaccinations -- back to her post, she must load up bags, carry them by hand, and walk the nearly 10 kilometers (6 miles) back to her post. She walks over rocky terrain, over roads where the mud is thick on rainy days and the ground glows almost orange under the sun. Some days she may get a ride, but those days are few and far between. Cars are scarce in this part of the world.
But she makes the trek back to her post where her job is to educate people -- especially women and moms -- on the decisions that will bring better health to their families.
In Ethiopia, this means encouraging pregnant women to deliver in hospitals against so many cultural barriers. It means encouraging parents to bring their sick children to the health post in case they need hospital referrals. It means teaching about using soap and water and general hygiene issues that can mean the difference between life and death for people living off a city sewer system and far from any city or municipality. It's difficult work that requires a dedication unheard of for many people outside of health care.
It's easy in the U.S. to look at other countries and pretend like you know how to fix their problem. But until you see it with your own eyes, you have no idea. The work STC is doing is nothing short of miraculous. The next time I see my own nurse midwife, I will thank her profusely for the work she does and the lives she saves just by showing up every day. There is no field that does more for humanity.
Are you a health worker? Know someone who is? Have you thanked them?
All images via Sasha Brown-Worsham
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