Proposal Fistula Waiting Area (FWA) - Bethel Centre, Shire

Background
The northwestern zone of Tigray is sadly underserved with regards to maternal health. The Humera Hospital was closed for many years due to the conflict in that zone. The Shire Hospital was to have been the hope for pregnant women. Unfortunately, no obstetrician-gynaecologist has been able to remain there for any length of time. This gap has affected the number of women suffering from the effects of obstructed labour and the resulting sequel of obstetric fistulae.
 
Problem Statement
The women with obstetric fistulae are advised to 'go home and come back after three months'. Many go home and stay home or drift away to the big cities because of the tragic ostracism they face in their own communities leading to a high incidence of depression and even suicide.

Objectives

• To provide immediate close by shelter for these vulnerable women
• To care for them through good nutrition and hygiene
• To treat any basic medical need and help mobilize to prevent contractures
• To prepare them for eventual surgery in Mekelle Hamlin Fistula Centre

Project Design
There is a structure built to serve as a clinic with four rooms, toilet facilities and a small kitchen. As of end December 2007 this clinic was closed, because two kilometres away there is another clinic serving the community and there are plans to enlarge and develop this into a health centre. So in order to avoid duplicity and after discussion with the head of the zonal health bureau  we agreed together to use the building currently situated at Grace Village to house women with obstetric fistula, until such time as they can be either expedited to Mekelle Fistula Centre or collected by the Fistula Team in Mekelle.

The nurse Letiberhane Kidane and her assistant were trained during January 2008 in obstetric fistula care. They are now ready to care for women with obstetric fistula injuries; they will ensure they eat well, exercise plenty to avoid contractions and have regular baths to avoid infections. The patients will be given any required pre-operative treatment as recommended by the Hamlin Fistula Centre in Mekelle by the ground staff at the Shire FWA (renamed The Bethel Centre to avoid marginalization).

Monitoring
The Health Officer and the Medical Chief at the Mekelle Hamlin Fistula Centre will supervise, monitor and evaluated the project and the Zonal and Regional Health Bureau Heads have given their approval for this initiative.