Slightly Shifted

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By: Yeabsira Mehari, Young Champion of Maternal Health

This blog post was contributed by Yeabsira Mehari, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. This is her final post about her experience as a Young Champion, and you can learn more about her, the other Young Champions, and the program here.

The field of maternal and child health has grown to encompass more than just the mother and child — it now includes whole villages, communities, and countries. We all agree that women’s rights are also human rights. Access to healthcare is a basic human right and, dare I say, a basic need. Whether the system is broken or whether or not one ever existed is an almost irrelevant question. The questions of what the issues are and how we solve them have been entirely dismissed from my head. The issues are right in front of us and the solutions are plenty. For the past nine months, I haven’t been focused on specific solutions to specific problems, but rather, I have been asking myself “How can we effect systemic change in the maternal health field?”

Initially, my aim to take part in ending obstetric fistula was the main push behind all my work. Then I moved to India and started working in a different field than obstetric fistula: HIV/AIDS. Though HIV/AIDS and obstetric fistula don’t have much in common, they do share certain traits that have a massive impact on the women who suffer from these ailments. Aside from the physical effects, HIV/AIDS and obstetric fistula patients suffer from psychosocial damage and face being ostracized by their communities. Education on what the ailment is, how it happens, and why it happens is lacking for both. Most believe both conditions are caused by an evil spirit, or by the woman being deemed unfit for motherhood by a higher power. Sitting through counseling sessions at ASHA, I was amazed to see how many women blamed themselves for bringing such a disease to their family — even though, eight out of ten times, it was actually the father’s infidelities that put them at risk. In a country where the act of sex or even discussing sex is a taboo, working in the field of maternal health is difficult. So it was in India that I learned the importance of knowledge. The force behind my work slightly shifted to … education.

During my time at ASHA, I spent time working in various departments. Whether it was learning about new HIV/AIDS antiretroviral regiments, sitting in on counseling sessions, working in the clinic, or reviewing hotline questions and answers, I tried to find ways to connect this work with my own project. My mentor had some great suggestions of ways I could borrow ideas from ASHA and apply them to my work on obstetric fistula. One idea was starting a fistula hotline. So, on a trip back to Ethiopia I spent time researching the viability of the idea. The hotline plan was shot down in an instant. Telecommunications is not privatized in Ethiopia, which makes this process that much harder. There is only one HIV/AIDS hotline and it is the only hotline in Ethiopia. When I asked how long it would be before another number became available, I was told they didn’t know. In time, I realized I would have to scrap most of my ideas. Most are skeptical of transplanting ideas from one setting to another, and I am too, especially because of how it can affect the patient and their communities. However, I was certain some of my ideas would work. The only problem was government interference and the number of hoops one has to go through to get anything done. And so, I learned about the beauties of bureaucracy, one of the (if not the) greatest obstacles when it comes to working on the ground. The force behind my work slightly shifted to … government and public policy.

The role of government in civil society became a hot topic of discussion among my peers. India seemed to be facing a similar problem, yet enjoyed certain freedoms Ethiopia did not. For example, in India, a country of over 1.21 billion, government-led health initiatives are working and there is a great amount of freedom for organizations to explore their fields. In Ethiopia, then, how can we create a better government? How do we get the voices of the oppressed heard? Our discussions showed us the different struggles countries go through. We came to realize how difficult of a process it was going to be. This usually left me feeling somewhat frustrated. The frustration was not because we couldn’t find a solution; in fact I was certain that if I devoted my time to public policy and public health efforts, I would succeed to some degree. The frustration was stemming from the fact that I couldn’t dedicate all my time. Starting an organization is more than focusing on my passion. It means time doing the paperwork (lots of paperwork), applying for grants, funding, and so much more. How can I make sure Mimidae can survive long term? The force behind my work slightly shifted again to … sustainability.

It takes nine months for a mother to give birth to her child, much the same way the YCMH program has nurtured and given birth to a more defined version of myself — a more certain individual keenly aware of her path. I know my destination. In fact, I see it. As I maneuvered my way through the last nine months, my goal was to figure out the best road to my destination. Along the way, I know I will continue to take some detours. My end goal is to better the field of maternal health with a special focus on ending obstetric fistula. My path to this dream has shifted. It has been an extremely transformative shift. Over the nine months, I’ve come to understand the need for education, the importance of the role of the government, the effects of a changing climate on a country, and how a lack of funding can hold back an organization from implementing successful programs, and I’ve gained a better sense of who I am and what role I play in all of this. I’m itching to hop on a plane and go back to India and continue this process of discovery. However, a question lurks in my head: “Is this the best path to your destination?” Yes, I feel more alive and focused when I’m on the ground, but I shouldn’t be focused solely on my feelings. Reminding myself of this question is helping me stay on track. Which track I’ll be getting on now that I’m back in the United States is the question. Should I prepare for medical school? Should I work for a few years? Should I move to Ethiopia for a while and get my projects going? Should I move back to India and work on my project idea there? Which of these plans will help me reach my destination successfully? The force behind my work has slightly shifted…

Note of thanks: I want to thank all the other Young Champions and the Young Champions of Maternal Health team. Thank you for your dedication, love, and support! You have been an inspiration.