Anna's Post

Our dear friend and OBGYN Anna blessed us with a visit in April. We thought we would have her share some of her thoughts and experiences with all of you…

I’m sitting here at the Big House desk on my final morning in Chiri, overlooking the incredibly lush, green hills that surround this community – and finding it difficult to express all that this experience has encompassed. These couple of weeks have been absolutely amazing, and I will miss this place very much. Although some have already heard the story of my first day observing at Chiri Health Center, I thought I might return to that day: my introduction to medicine (and obstetrics) in rural Ethiopia.

The day began with a woman who had delivered a stillborn infant in her home the day prior, now admitted with abdominal distension and pain. On exam she displayed alarming signs of infection, internal bleeding, or bowel obstruction – any of which could have been possible following a prolonged labor course. Obstructed labor is the primary cause of maternal mortality in Ethiopia – as 95% of women deliver in their villages, unattended by a skilled healthcare worker or midwife – leading to complications we rarely see in the US: uterine rupture, bladder fistulas, and stillbirth.

Later that morning--a patient arrived in labor with her first child. A second patient presented with bleeding in early pregnancy.

At this point in my day I had already encountered more OBGYN than I had expected, yet little did I know our sickest patient was on her way… Erin had been on outreach all morning at a distant health post. A very pregnant woman arrived at the health post looking for help—her dress soaked in the blood that was running down her legs. The outreach staff were an hour walk from the nearest road so they carried the woman on a stretcher to the car and drove another 45 minutes to reach CHC. They estimated she had lost two liters of blood in transit. Upon arrival it was clear that her condition was life- threatening and that she needed transport to Bonga hospital immediately. Jeff and I quickly drove her to the Hospital. In Bonga it was determined that the woman had dangerously high blood pressure--severe preeclampsia--causing placental abruption, neonatal demise and hemorrhage. The only treatment for this condition is delivery, but first our patient urgently needed medication to lower her blood pressure before she had a seizure or stroke. Amazingly, there was no blood pressure medication at Bonga Hospital, sending Jeff and me on a scavenger hunt through multiple Bonga pharmacies before we were able purchase the appropriate medicines to save her life.

That was all we could do. So we left – left Bonga, left our patient at the hospital with medications and enough money to hopefully cover the cost of her hospitalization, unsure whether she’d survive, forced to let go of our involvement in her care. So many unknowns filled our minds on the drive home…

We learned this week that this patient did well, delivered vaginally, and lived. Despite all of the frustrations and delays in getting her the necessary care, she was so lucky – lucky to have been found on an outreach trip; to be young and healthy enough to withstand such blood loss; to have her Bonga Hospital costs donated by friends in America; to have survived. I have thought of her many times over the last few weeks – a dramatic yet apt example of the realities of healthcare in a poor country. And yet I think there is so much we can learn from this place. I am continuously amazed by the sense of community here, as families and villages rally in support of one another: sell a cow to pay for medical care, or carry a patient on a homemade stretcher for hours or days to reach our health center, or grieve together in times of loss.

…and just now, as I am writing this post, Jeff has fetched me to see triplets born two days ago at home—two boys and a girl, all doing well—such beauty in these small miracles.