The object of our short visit was to revisit the two Government Health Centers to ascertain the improvements and suitability of the Health Centers to receive our BSc Midwives graduating in July.

Brian and I were very happy to be accompanied by Dr. Lil from Berlin University Hospital who had previously volunteered to work at our clinic at Keyit and was here as our medical advisor.

On arrival in Gondar we had an appointment with Atto Destau, the deputy Zonal health officer. We discussed our objectives and he confirmed that he had been working to improve the 2 health centers after our last visit. Destau also agreed to send Ambacho, one of his staff with us which was gratefully appreciated as it would put out a very firm messaged that we were all very serious to improve the standards of midwifery services in the Simiens.

Brian, Hawlt, Wendy and Lil drove to Debark driven by our new driver, Kadir, who is a delightful, bright young man and proved to be an excellent 4×4 driver. We delivered some donated medical supplies to Debark hospital and met our 3rd year Midwifery students who were there on rotation getting practical experience. Merkuria, the head of the Hospital, in the absence of Dr. Shegaw, agreed to accompany us to the Simiens.

The next day we drove seven hours into the Simiens to visit the first Health Center, Dlibza in Beyeda Woreda where, unlike our first visit, we were warmly welcomed by all the staff and health center chief. Ambacho and Merkuria commenced to complete the Gap assessment then we all completed the inspection.

Wendy and Merkuria concentrated on the cleanliness and infection control, Dr. Lil the medical aspects and documentation, Ambacho the assessment and Brian the placenta pit, water supplies and furnace etc. Following our inspection, we enjoyed a traditional coffee ceremony. Overall, the midwifery department was greatly improved. The staff had obviously worked very hard to improve everything which was unrecognizable from our last visit. The only outstanding issues were the water supply to the clinic and the need for further infection controls.

We spent the night in a local hotel and then travelled to Chiro Leba in Janamora Woreda the next morning which was also greatly improved. The midwifery department was transformed from our last visit and obviously a lot of effort had been put in by the staff. The midwives said that they were taking responsibility for the cleanliness of their areas if the cleaner was not available. Again, connecting the water to the clinic and infection control needed some attention.

After lunch, everyone visited our clinic at Keyit. We were very pleased to hear that it is seen as an example of a good clinic in the area. We dropped off supplies, met Addis our nurse/midwife, and had a coffee ceremony. En-route we met a water well expert to discuss boring a well in Tellempt where the local population relies on river water – consequently there is a high rate of gastrointestinal problems.

The following day we delivered a Mule Aid saddle to the park for use by elderly or disabled people wishing to explore the Simiens. We also donated another first aid kit and discussed the possibility of running another first aid course.

If the standards are maintained and progress made to rectify the deficiencies we will deploy BSc midwives to both health centers and another to Adi Arkay so that the 3 health centers would have 3 diploma and 3 BSc midwives to enable them to work 3 shifts of 8 hours instead of 12 hours as now. One of our midwives from Adi Arkay who will now have 1 years’ experience working in an excellent Health Center will be transferred to Chiro Leba. The remaining midwife from the Hamlin will go to Adi Arkay with another from Gondar.

The idea of our newly graduated midwives not only working at Debark Hospital for a month but rotating through the Adi Arkay health center as an example of an excellent health center was discussed before deploying them to their work places.

We also discussed the proposed competition among the Health Centers; Ambacho and Merkuria would work on a plan together with Mitiku. There are about 36+ health centers in the project area, some of them taking 2 days to reach so it was suggested that all the Woreda health officers nominate one of their health centers and these would then be visited by 2/3 members of the team over a six month period.

Before leaving for the airport Wendy and Lil went to the market together with the Beyeda health officer to buy both health centers 5 water containers with taps and soap to enable the staff to wash their hands between patients until the water was connected

In conclusion, the staff in both health centers had obviously worked very hard to improve the cleanliness of the midwifery departments which were greatly improved and the staff seemed much happier. Apparently the patients had commented on the improvement and there was a rise in the number of women attending. The two remaining problem areas in both health centers was the lack of connected water and poor infection control.

Hopefully we can keep our team together to inspect the health centers nominated by the zone for our next 7 BSc midwives graduating in 2018.-

We will next visit in September/October.