The journey to eradicating fistula in the most rural areas of Ethiopia is extremely challenging. The Simien Mountain Mobile Medical Service (SMMMS) was a recipient of our Small Grants Programme in 2019 and 2020, and are a family-run charity. They reach out to isolated communities in the Simien Mountains to provide maternal healthcare.

The Simien Mountains are a UNESCO world heritage site and home to a quarter of a million people. The main form of transport in the mountains is either by foot or by mule, and 89% of women give birth at home, increasing the risk of neonatal fatalities and obstetric fistula. In fact, the area has one of the highest maternal mortality rates in Sub-Saharan Africa. Before SMMMS was founded in 2011, antenatal and postnatal care was almost unheard of, contributing to high infant mortality rates as babies contracted hypothermia, tetanus and infectious diseases. There was a small network of government-run health centres, but these were a 2 day hike for some Simiens and even the smallest transport fee proved too expensive for many families.

During a visit to the mountains in 2010, Wendy and Hugh Lovatt saw first-hand the lack of medical care Simiens had access to and felt compelled to help. In 2011, the Lovatts started deploying mobile medical teams, consisting of an Ethiopian nurse with medical supplies, a mule to carry them and a man to guide the mule. They also started building, equipping and staffing a clinic in Keyit to support the local community there. After realising that female Simiens needed encouragement to go to the health centres, SMMMS created a “push-pull” strategy. Mobile nurses started identifying and encouraging/pushing pregnant women to go to health centres for antenatal care, delivery and postnatal care. Furthermore, after purchasing saddles from Saddle Aid UK, SMMMS employed local mule men to help transport these women their nearest health centre. To draw/pull people into using the centres, SMMMS started working with the North Gonar Zone, woredas health officers and local health centres to improve the level of care provided.

In 2012, they started offering 4-year Midwifery BSc scholarships at the Hamlin Midwifery College to girls from the mountains, on the condition they agreed to return and serve their local communities. When the University of Gondar started offering a 4-year BSc in Midwifery, SMMMS started awarding scholarships there, with 5 girls studying there in 2013 and 6 in 2014.

SMMMS now have 14 midwives, who have all graduated and are working at several different health centres in the Simiens, along with their at own health clinic. Because of their dedication, the number of Simien women visiting health centres has increased every year.

One such midwife is Eden, who graduated with honours in 2016. Eden demonstrated the qualities SMMMS needed and was offered the position of Women’s Healthcare Co-ordinator to work with local health centres and improve availability to healthcare services for Simien women. She now works with SMMMS’ project director, Hawlt, to improve all care offered at health centres and the nearest hospitals, including the University of Gondar Hospital.

SMMMS also employ five mobile nurses who travel between mountain villages providing antenatal and postnatal care in areas inaccessible by other means as well as general medical care, health education and immunisations. They also run a small clinic providing delivery services for expectant mothers along with inpatient and outpatient care. 

Without their vital work, many pregnant mothers would have been at risk of obstetric fistula, or even worse, may have lost their life or their baby. SMMMS are truly bringing life-changing care to those in need in the most isolated of regions in Ethiopia. We are very proud to support the transforming work they do.

Donate today to help SMMMS and our other partners in their goal to eradicate obstetric fistula and improve maternal health.

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