Health – UNICEF Ethiopia

Healthy mothers, healthy children, making healthy communities in Ethiopia

Dugem, Tigray REGION, Ethiopia, 21 December 2017 – In the health post at Dugem village, in Ethiopia’s Tigray region, Berhan Zebraruk, 25, gently strokes her child’s cheek and then gives him a sweet tickle on the tummy. Her first born, Awot Kaleab, is quick to respond to her touch. He cracks a beautiful smile displaying his toothless gums and looks his mother right in the eye for the play to continue. The little boy is restless. He grabs his mother’s cell phone and when that is taken away from him, he turns his attention to the baby next to him.

“My boy likes to play with everything he holds,” says Berhan. “I have to keep an eye on him, otherwise he put things in his mouth.”

Awot is now 9-months-old and it is time for his measles vaccination, which would complete his set of basic vaccinations for children under the age of 1, as recommended by WHO and the Ethiopia National Expanded Program on Immunization.

It is a special day for Berhan. Shortly after Awot received the vaccine, the health extension worker, Genet Desta, registered his name in the vaccine book. Then she called out Berhan’s name and handed her a certificate, a recognition that is given to mothers when their children complete taking the necessary vaccines.

Berhan is applauded by the other mothers in the health post for successfully vaccinating her child. She is also recognized as a role model for her best child feeding practices, including exclusively breastfeeding her son for his first six months.

Berhan attended school up to grade 10. Since she was a little girl, her dream was to become a doctor. Instead, she got married and became a housewife like many other women in her village. Yet, her education is considered an achievement in the eyes of fellow villagers.

“I wanted to become a doctor because I saw health workers treating people in my village,” says Berhan. “That wasn’t meant to happen for me, maybe it will for my son,” she added, gazing down at him.

Berhan understands that her child can only fulfil her unrealized dream if he grows up healthy and well. When she knew that she was pregnant with him, she started her pregnancy follow-up relatively earlier than other mothers.

‘’Berhan attended all of the four antenatal follow-ups and took the iron supplement properly,” says Genet, the health worker. “She was very conscious of her health and that’s why her child is very healthy.”

In Ethiopia, an increasing number of women are receiving care by skilled health workers both during pregnancy and childbirth. In the Tigray region, where Berhan lives, for instance, 90 percent of women receive antenatal care by skilled attendants, at least once, during their pregnancy, which is well over the national average of 62.4 percent.

In addition, 59 percent of the region’s mothers are giving birth in health facilities, instead of the old tradition of home delivery.

The country has seen significant improvement in immunization coverage over the past two decades. In 2000, it was only 14 per cent of Ethiopia’s children under the age of 2 who have received all the basic vaccinations, but in 2016, that number soared to almost 40 per cent.

Owing to its well-established community-based health service provision, Ethiopia is also enjoying a reduction in maternal and child deaths. Maternal mortality which was 871 deaths per 100,000 live births in 2000 has dropped to only 412 in 2016, a reduction by more than half in just 16 years. The same is also true when it comes to child mortality. More children in rural Ethiopia are celebrating their fifth birthday than ever before.

The nearly 40,000 female health workers, together with the women of the Health Development Army, easily access women and children in every household and provide much needed advice and services, including immunization to prevent the most debilitating child illnesses.

UNICEF is supporting the different components of the programme by providing both financial and technical assistance. UNICEF also supports the management of common childhood illnesses including malaria, pneumonia, diarrhoea and severe acute malnutrition at the health post level, contributing to a significant reduction in deaths.

Berhan’s task as a mother, caring and nurturing for Awot, symbolizes the bright future that lies ahead of children in rural Ethiopia. She is well equipped with skills and knowledge that will enable her to provide critical health and nutritional care for her son. Further help is also available since services, even for those in remote communities, are now more accessible.

48,000 babies to be born on New Year’s Day in Eastern and Southern Africa

NAIROBI/JOHANNESBURG/ADDIS ABABA, 1 January 2018: Approximately 48,000 babies will be born in the Eastern and Southern Africa region on New Year’s Day, UNICEF said today, as the UN Children’s Fund asked nations around the region to make sure more newborns survive their first days of life.

In 2016, an estimated 2,600 children around the world died within the first 24 hours, every day of the year. Across that same year, 136,000 newborns died in Ethiopia and The United Republic of Tanzania combined, placing them in fifth and ninth position, respectively, among the ten countries with the highest neonatal deaths in the world. Among those children, more than 80 per cent of all newborn deaths are due to preventable and treatable causes such as premature birth, complications during delivery, and infections like sepsis and pneumonia.

“This New Year, UNICEF’s resolution is to help give every child more than an hour, more than a day, more than a month – more than survival,” said Leila Pakkala, UNICEF’s Regional Director in Eastern and Southern Africa. “We call on governments and partners to maintain and expand their efforts to save millions of children’s lives by providing proven, low-cost solutions.”

UNICEF says that babies born in Eastern and Southern Africa will account for 12 per cent of the estimated 386,000 babies to be born globally on New Year’s Day. Almost 58 per cent of these births will take place in five countries within the region, with the largest number of births on New Year’s Day projected for Ethiopia:

Ethiopia — 9,023
The United Republic of Tanzania — 5,995
Uganda — 4,953
Kenya — 4,237
Angola — 3,417

Over the past two decades, the world has seen unprecedented progress in child survival, halving the number of children worldwide who die before their fifth birthday to 5.6 million in 2016. But despite these advances, there has been slower progress for newborns. Babies dying in the first month account for 46 per cent of all deaths among children under five.

In 2016, sub-Saharan Africa accounted for 38 per cent of all newborn deaths. Despite stark improvements in child survival within the continent, child mortality remains high and important challenges need to be met to accommodate the projected increase in births and prevent African countries with high fertility rates from falling further below international benchmarks for maternal, newborn and child care.

Chief among them is to vastly expand systems and interventions for maternal, newborn and child health. The scale of this challenge should not be underestimated. From 2015 to 2050, some 1.8 billion babies are projected to be born in Africa – 700 million more than were born in the preceding 35-year period (1980-2014). Ensuring that these births are attended by skilled professionals and that new mothers have adequate care and attention before, during and after childbirth represents an immense and unprecedented challenge.

Next month, UNICEF will launch Every Child Alive, a global campaign to demand and deliver affordable, quality health care solutions for every mother and newborn. These include a steady supply of clean water and electricity at health facilities, the presence of a skilled health attendant during birth, disinfecting the umbilical cord, breastfeeding within the first hour after birth, and skin-to-skin contact between the mother and child.

“We are now entering the era when all the world’s newborns should have the opportunity to see the 22nd Century,” Leila Pakkala. “Unfortunately, nearly half of the children born this year likely won’t. We can all do more.”

MIND THE GAP – BABYWASH Launched on World Toilet Day to Improve Integrated Early Childhood Development in Ethiopia

By Samuel Godfrey

When you travel in a car through Addis Ababa, you will note that adult women and men vary greatly in height. There are tall people and short people. So which ones of these are actually stunted? And why? Scientifically stunting is defined as a reduced growth rate in human development and is a primary manifestation of malnutrition or more accurately under nutrition. The definition of stunting according to the World Health Organisation (WHO) is for the “height for age” value to be less than two standard deviations of the WHO Child Growth Standards median.

So how does under nutrition occur? Recent scientific evidence suggests that under nutrition is a result of recurrent infections such as diarrhoea or helminthiasis in early childhood and even before birth. In 2016, UNICEF Ethiopia, published a blog entitled BABY WASH – the missing piece of the puzzle[1]?, in which evidence from a paper published by UNICEF and John Hopkins University in the Journal of Tropical Medicine and International Health[2] highlighted the need to target interventions to reduce unsafe practices of disposal of baby and child faeces. To convert this evidence into action, the Government of Ethiopia, UNICEF and partners have developed a BABYWASH implementation guideline. The guideline aims at contributing to improving Integrated Early Childhood Development (IECD) through improving the baby and child environment.

World Toilet Day 2017: safe disposal of child faeces — Lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. ©UNICEF Ethiopia/2017/Mulugeta Ayene

The 2017 World Toilet Day was a perfect opportunity to launch the BABYWASH guideline. The document includes guidance on how to implement programmes with safe disposal of child faeces, providing protective environments through play mats and similar measures as well as prevention of soil transmitted helminths. The strategy was endorsed for implementation alongside regular safe sanitation and hygiene practices which are already being promoted by health extension workers. In his statement, H.E Dr Kebede Worku, State Minister of Health of Ethiopia said, “In Ethiopia, there is a common misconception that children’s faeces are not harmful while evidence shows otherwise. The current sanitation and hygiene promotion efforts, at times, overlook safe disposal of children’s faeces. In addition, most toilets are not designed keeping children’s special needs in mind. Hence, I am proud to endorse the Baby WASH manual today which was developed by the Federal Ministry of Health with the support of UNICEF and other partners in order to ensure a healthy environment for children’s growth and development especially those under three years of age.”

Ms Gillian Mellsop, UNICEF Representative to Ethiopia on her part said, “UNICEF is pleased to support the Ministry of Health in preparing these excellent guidelines on Baby WASH. We know that a contaminated environment harms infants and young children and puts them at risk of increased child mortality and stunting. Together, we have to ensure that parents and guardians, teachers and community leaders are aware of the importance of Baby WASH.”

According to the Knowledge, Attitude and Practice (KAP) baseline survey on Water, Sanitation, and Hygiene carried out in eight regions of Ethiopia, there is a general misconception about child faeces disposal. The survey showed that a lack of knowledge on the health risk related to child faeces is a key factor behind poor hygiene practices in faeces disposal. According to the survey, only half (49 per cent) of women knew that child faeces are dangerous to health. Misconception is higher among rural pastoralist women where only 39 per cent said child faeces are dangerous as compared with 50 per cent among rural non-pastoralist women and 54 per cent of women in urban areas. Although it may not be clear who is stunted and who is not just by looking at a child, it’s clear that safe disposal of child faeces helps improve a child’s health. Therefore, UNICEF will continue to support the Government with the implementation of the guideline throughout the country.

[1] https://unicefethiopia.org/2016/05/24/baby-wash-the-missing-piece-of-the-puzzle

[2] https://www.ncbi.nlm.nih.gov/pubmed/27546207

Children Takeover Minister Roles as Ethiopia celebrates World Children’s Day and UNICEF Ethiopia’s 65th Anniversary

20 November 2017, United Nations Conference Centre, Addis Ababa: Today, Ethiopia joined the global World Children’s Day celebrations by giving children high profile roles to become champions of their rights. In line with the event’s theme ‘For children, By children’ child parliamentarians took over the roles of the Ministers of: Women and Children’s Affairs; Health; Education; Water, Irrigation and Electricity; Labour and Social Affairs; and Urban Works and Construction. In addition, children took over the roles of the Attorney General and UNICEF Representative. In their new roles as ‘shadow Ministers’, children shared their ideas on issues that affect their lives.

World Children's Day and UNICEF Ethiopia 65th anniversary — Sara Beshir shadow Minister of Women and Children Affairs. Her message on World Children’s Day: attitudes towards violence angst children and women need to be changed. ©UNICEF Ethiopia/2017/Nahom Tesfaye

At the event, which was truly owned by children, some of the key recommendations proposed by children include:

Accelerate efforts to end harmful traditional practices, including child marriage and Female Genital Mutilation/Cutting
Provide clean water and sanitation services for all children across the country, no matter where they live
Build more hospitals that are focused on child health and ensure health professionals treat children with care and love
Involve children in child justice
Ensure quality education for all children through skilled teachers, including pre-primary education
Ensure that girls stay in school and finish their education
Provide more playgrounds and safe spaces, especially in urban and peri-urban settings
Include children’s voices when adults and local authorities discuss issues that affect children’s lives.

Child parliamentarians from different regions also had an opportunity to discuss issues relevant to children in Ethiopia with shadow Ministers and dignitaries through a Q&A session.

In her opening remarks, H.E Ms Demitu Hambisa, Minister of Women and Children’s Affairs, stated that this year’s World Children’s Day is a day of action for children by children. She highlighted that decision makers need to ensure that children’s voices are heard and reflected in decisions that affect their lives.

Ms Gillian Mellsop, UNICEF Representative to Ethiopia, emphasising the need for the participation of children said, “Meaningful participation of children is not only a fundamental right – and enshrined as such in the Convention on the Rights of the Child – but is also key to ensuring that decisions made by adults are relevant to the actual needs of children.”

In addition, UNICEF Ethiopia launched its publication ‘Hulem Lehisanat- Always for children’ depicting its 65 years history serving children and women in Ethiopia.

The event highlighted the importance of including children’s voices by providing children with an opportunity to share their own solutions on how to keep every child in Ethiopia healthy, well-nourished, in school and protected.

‘BABY WASH’ boosted at this year’s World Toilet Day in Ethiopia

Addis Ababa, 15 November 2017 – Today, Ethiopia celebrated World Toilet Day by holding a half-day workshop with the theme “Safe Disposal of Child Faeces.”

At the workshop, the national ‘Baby WASH’ strategy, which focuses on hygiene of children under three years, was endorsed by the Federal Ministry of Health. The strategy includes safe disposal of child faeces, providing protective environments through play mats and similar measures as well as prevention of soil transmitted helminths. The strategy will be implemented alongside regular safe sanitation and hygiene practices which are already being promoted by health extension workers.

In his statement, H.E Dr Kebede Worku, State Minister of Health said, “In Ethiopia, there is a common misconception that children’s faeces are not harmful while evidence shows otherwise. The current sanitation and hygiene promotion efforts, at times, overlook safe disposal of children’s faeces. In addition, most toilets are not designed keeping children’s special needs in mind. Hence, I am proud to endorse the Baby WASH manual today which was developed by the Federal Ministry of Health with the support of UNICEF and other partners in order to ensure a healthy environment for children’s growth and development especially those under three years of age.”

A strong early childhood foundation, which includes a safe and hygienic environment coupled with adequate nutrition as well as nurturing parenting and stimulation for optimal brain development, is critical to ensure toddlers can develop to their full potential. This will facilitate a smooth transition to primary school and a better chance of successfully completing basic education. Therefore, investing in early childhood development through improved hygiene practices and environments is one of the most critical and cost‑effective ways to improve a child’s future health, education and productivity.

The Ministry of Health and UNICEF urge citizens, parents, teachers, health workers, policy makers and government officials to play their role in making sure that every child receives the benefits of Water, Sanitation and Hygiene (WASH) in their homes, communities, schools and health facilities.

The Government of Sweden grants US$ 2.5 million to UNICEF for emergency response

The Government of Sweden provides another US$2.5 million to UNICEF Ethiopia to support Water Sanitation and Hygiene (WASH), health and nutrition programmes in the drought affected regions of Afar, Oromia Somali and Southern Nations Nationalities and People’s regions.

In Ethiopia, where 8.5 million people are currently in need of relief food assistance due to the recurrent drought emergency, 376,000 children are estimated to require treatment for severe acute malnutrition, 10.5 million people require access to safe drinking water and sanitation services and 1.9 million school-aged children need emergency school feeding and learning material assistance.

The contribution provided by the Government of Sweden will be used to construct and rehabilitate water supply schemes, procure Emergency Drug and Case Treatment Centre kits as well as obtain Community Management of Acute Malnutrition (CMAM) supplies including ready to use therapeutic food (RUTF), tents and Stabilization Centre materials in the four regions highly affected by the drought emergency.

UNICEF is grateful to the Government of Sweden for its continued support for providing life-saving interventions during the current humanitarian situation which continues to affect mostly women and children.

In 2017, the Government of Sweden has contributed more than US$5 million to UNICEF-assisted humanitarian programmes in Ethiopia.

Researchers in Action for African children

Researchers from around the continent are gathered this week in Addis Ababa to Put Children First!

In Africa, two billion babies will be born between today and 2050, translating into more than 60 million new lives every year. By 2055, the continent of Africa will be home to 1 billion children, nearly 40 per cent of the number of children worldwide. Therefore, as noted in the conference by UNICEF Regional Director for Eastern and Southern Africa, Ms Leila Pakkala, nowhere in the world are children more central to a continent’s future than in Africa and “children must be put first”.

Putting Children First: Identifying Solutions and Taking Action to Tackle Child Poverty and Inequality in Africa — Policy makers, practitioners and researchers discussing better ways in identifying solutions for fighting child poverty and inequality in Africa. ©UNICEF Ethiopia/2017/Meklit Mersha

The international conference with the theme: Putting Children First-Identifying Solutions and Taking Action to Tackle Child Poverty and Inequality in Africa has been promoted by the End Child Poverty Global Coalition and organized at national level by the Ethiopian Centre for Child Research (ECCR) with UNICEF Ethiopia’s support. The Centre is currently establishing partnerships and research collaborations with potential researchers and research institutes nationally and globally.

At the conference, the Ethiopian Minister of Women and Children’s affairs stated, “Because of the Government and its development partners’ efforts, national poverty rates have seen a significant reduction over the past decade in Ethiopia, decreasing from 39 per cent in 2003 to 29 per cent in 2011. However, the decrease in poverty over the past few years has not matched the rate of economic growth, suggesting that economic growth has partly failed to benefit the most vulnerable sectors of society. Women and children are one of the least benefited and vulnerable sections in the society”.

ECCR will share an analysis on the dynamics of multi-dimensional poverty among children in Ethiopia which was also jointly presented with UNICEF Ethiopia at the Child Poverty Conference for MENA in Rabat and at the 6^th International Society for Child Indicators in Canada.

Using an adaptation of the Multiple Overlapping Deprivations Approach, it has been showed that share of children who are deprived in two or more poverty dimensions, such as lack of appropriate or access to health and education services or poor quality of housing declined from 82 per cent to 35 per cent between 2002 and 2013. In the meantime, the percentage of children non-deprived increased from 18 per cent in 2002 to 65 per cent in 2013.

For researchers and other professionals in various fields, children should be the top-most priority as we all look for pathways to unlock poverty and inequality in the continent. The ongoing conference would be a great opportunity for practitioners and policy makers from Africa to contribute to the overall debate on child poverty-towards contributing to address child poverty in all its dimensions while promoting evidence generation.

WHO, UNICEF and Rotary International urge to sustain the polio-free status of Ethiopia

24 October 2017, Addis Ababa: Today, as the world commemorates World Polio Day, we, the World Health Organization (WHO), UNICEF and Rotary International, reaffirm our commitment to building on the success of our joint polio eradication efforts and sustaining the polio free status of the country.

Today, we are looking back at nearly three decades of concerted global polio eradication efforts. The Global Polio Eradication Initiative was created in 1988 after the World Health Assembly resolved to eradicate poliomyelitis globally and has since made remarkable progress towards reaching the eradication target. As a result, polio cases globally decreased by over 99 per cent from an estimated 350,000 cases in 1988, to only 37 reported cases in 2016. Furthermore, the number of countries with polio endemic decreased from 125 to only three countries – Afghanistan, Nigeria and Pakistan. However, until the polio virus transmission is interrupted in these polio endemic countries, all countries remain at risk of polio importation.

Nahom Alemseged gets a mark after receiving a polio vaccination — Nahom Alemseged get his finger marked after receiving a polio vaccination during a national campaign. ©UNICEF Ethiopia/2013/Sewunet

Ethiopia maintained its polio-free status for almost four years (45 months) after the last wild polio case was reported in Somali region in January 2014. We recognize that this achievement is a result of the effective leadership of the Federal Ministry of Health and the great partnership of polio eradication initiative collaborators, donors and partners including: Rotary International; Bill and Melinda Gates Foundation; WHO; UNICEF; USAID; CDC; CORE Group; and many frontline health workers who have played a key role in the successful fight against polio.

We are committed to building on the recommendations which Ethiopia received from the Africa Regional Certification Commission (ARCC) in June 2017 when Ethiopia’s submission of a national polio free status report was accepted. As such, we will strive to strengthen and maintain routine immunization and surveillance with a particular focus on pastoralist communities, refugees, hard to reach and border areas as well as strengthening outbreak preparedness and coordination, cross-border surveillance with Somalia and others.

The theme for this year’s World Polio Day in Ethiopia is “Commending Ethiopia polio free status, sustaining the gain.” While we celebrate Ethiopia’s polio eradication success, we remain committed to continuing our joint polio eradication efforts in order to sustain this incredible achievement. In particular, we will build on the lessons learned as we strive to achieve regional certification.

The Polio Eradication and End Game Strategic Plan, developed by the Global Polio Eradication Initiative, envisages a polio free world by 2018. While we have come very close to achieving this goal, much remains to be done. We would like to call on all stakeholders to renew their commitment to a world which is free of polio.

Ethiopia to Host the fourth Acting on the Call Conference of Ministers and Policy Makers on maternal and child survival

Media Advisory

What: The Ministry of Health will officially announce that Ethiopia will be hosting Acting on the Call conference of Ministers and high-level policy makers on maternal and child survival

When: Friday 18 August 2017, from 2:00 P.M – 3:30 P.M

Where: Ministry of Health, Addis Ababa Ethiopia

Who:
· H.E Prof. Yifru Berhan, Minister of Health, Federal Democratic Republic of Ethiopia
· Dr Ephrem Tekle, Director, Maternal Child Health and Nutrition Directorate, Minister of Health, Federal Democratic Republic of Ethiopia

Why:

Hosted by the governments of Ethiopia and India, 2017 Acting on the Call conference will gather around 500 participants across the world, including Ministers and high-level policy makers from both the public and private sectors from 24 countries. The organization of this conference has been supported by many partner organizations such as USAID, UNICEF, the Bill & Melinda Gates Foundation, NGOs as well as private sector actors. This conference has these objectives:
· Highlight successful approaches to increase the use of high-impact reproductive, maternal, newborn, child and adolescent health interventions (RMNCAH) with equity, quality and sustainability.
· Increase commitment from countries, private sector and NGOs to strengthen the system required to overcome the remaining key obstacles for maternal and child survival both within and outside the health sector.
· Demonstrate global commitment and continued the momentum to move forward towards the goal of ending preventable child and maternal deaths.

Women Volunteer Their Time to Help Eradicate FGM/C

By Esete Yeshitla

Zahara Ali, a volunteer social worker for Aseita Primary Hospital, Afar regional State. Zahara serves her community by teaching about FGM and the consequences after taking training. Zahara advises women with FGM complications including Fistula to come to the hospital for treatment. Zahara does the advocating job without being paid. Aseita Woreda, Afar regional State. UNICEF Ethiopia/2017/Mersha

AYSAITA, AFAR, 18 May 2017 –Even with her sun-stricken skin and tired eyes, one can feel the vibrancy and strong personality of Zahara Ali. Zahara is a volunteer social worker who dedicates herself to helping her community without any compensation. With some broken Amharic mixed with a translated Afari language and a smile on her face, she starts to explain how she ended up serving her community.

“My first daughter was lucky not to get mutilated,” explains Zahara, “I was sensitized about FGM/C at that time.” However, her second daughter was cut. “I was heavily pressured by family and neighbours.”

Zahara allowed the traditional cut to be done on her daughter at seven days old, not knowing that it would end up being the most ‘incorrect and terrible procedure’. Facing complications and enduring pain, her daughter had to be brought to Aysaita Primary Hospital for corrective surgery.

After that experience, Zahara became much stronger and committed to teach others about the harm of FGM/C. When a community FGM/C sensitization programme was started in her town, some volunteers were deterred due to the lack of compensation, but for Zahara, that did not matter. “After going through the pain with my second daughter, I decided to work as the hospital’s social worker. I am convinced that I have to help mothers with FGM/C complications and make a difference in people lives,” says Zahara.

“The hospital contacts Zahara to sensitize the community,” says Dr. Hatesy Abraha, the gynaecologist at Aysaita Primary Hospital who has been hired through UNICEF’s FGM/C programme. He adds, “It is sort of demand and supply. The hospital provides treatment while utilizing people like Zahara to sensitize and convince mothers. Otherwise, it is not common for mothers in the Afar region to go to the hospital.”

Zahara was trained on FGM/C by the community sensitization programme, which was launched by UNICEF and the Regional Health Bureau. She then goes into her community with volunteers like her to teach about the symptoms of FGM/C complications. That is when women with FGM/C complications and other gynaecological needs seek treatment from the hospital. Zahara brings in mothers who have medical cases such as fistula or urinary complications. She advices pregnant women to have antenatal care and institutional delivery.

Medibo Ahmed,60, Aseita woreda, Afar regional State. Medibo was infibulated each time after she gave birth. The FGM was the cause for her complications. She had deinfibulation and vaginal prolapse repair and uterus removal at Aysaita Primary Hospital. She is happy with the procedures she had. UNICEF Ethiopia/2017/Mersha

While visiting the hospital with Dr. Hatesy, we met patients who had undergone such corrective procedures. One patient was Ebo Ahmed, a 60-year-old who has had many complications due to the type III FGM/C that was performed on her years earlier. Ebo has been stitched after every birth of her five children. Now, she has had vaginal prolapse, a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel or the vagina itself begin to fall out of their normal positions. In addition to repairing the prolapse, the medical team removed her uterus as well, all done in effort to ease complications from her FGM/C.

Ebo says, “I used to visit the hospital frequently as I was in severe and constant pain.” This constant pain was due to repeated urinary tract infections and other complications she had due to the FGM/C. Ebo is determined to advocate and teach her community by sharing her experience. “I will advise, if they give me their ears,” she declares. As she prepares for discharge, she expresses her gratitude for the medical procedure, which was nearly free of charge thanks to UNICEF and partners.

Aysaita Primary Hospital is one of the hospitals in Afar region that was upgraded from a health centre in 2014, providing services for a majority pastoralist population of approximately 100,000. Through UNICEF support, the hospital employed a gynaecologist in May 2016. Following his assignment, the hospital started providing inpatient and outpatient management for FGM/C complications and different gynaecologic and obstetric cases.

The hospital has five trained health providers on clinical management of FGM/C victims and has two admission wards with a total of 10 beds. In 2017, they treated 292 cases, up from zero in 2016. With efforts from community members such as Zahara and Ebo and treatment from medical staff such as Dr. Hatesy, the goal is that one day again, the cases will be at zero – this time as a sign of tremendous progress towards eradicating the FGM/C practice.