Image: M. Bennett
For 18 years, Mark and I had the privilege of serving as CMS missionaries in Egypt and Ethiopia. Along with my other roles, I was excited to be able to continue to work as a midwife. In Egypt, I opened a clinic that provided maternal health care, prayer and encouragement to refugees, predominantly from South Sudan, as part of ‘Refuge Egypt’. In Ethiopia, as a midwife educator I worked with nationals to start up a midwifery college. The Hamlin College focuses on selecting, educating, equipping and supporting midwives specifically for rural areas where maternal and neonatal mortality are high and provision of quality care is poor.
In July 2017 we were able to visit alumni from the College. Unlike many health graduates deployed to resource poor, rural areas, Hamlin graduates have had a strong retention rate. It was encouraging to meet with alumni working in various capacities throughout the country. They are leaders in their field: mentoring new graduates in rural areas, studying at the Masters level, working as senior midwives in teaching hospitals and/or teaching in universities.
While visiting we caught up with Alem, now in her 7th year as a midwife, whose story illustrates the amazing journey and challenges faced by the midwives and the College.
Alem grew up in a poor rural community in the Gojam region of Ethiopia. Her family scratched out a meagre living on a small plot of land. Despite being a bright student, Alem’s family arranged for her to be married at a young age. While we Westerners believe this practice to be cruel and inappropriate, with a life expectancy of only 40+ years, Alem’s parents felt it was important to arrange as good a marriage for her as they could before they died, knowing that in the event of their deaths, her prospects would diminish significantly. (I am not seeking to justify child marriage but to put it in cultural context.)
With the support of her older brother, unusually, Alem was able to convince her family that she should be allowed to complete her schooling. She was one of only a handful of girls in a class of over 1000 students who matriculated from her rural high school. Alem embraced the opportunity to join Hamlin College on the understanding that she, like all her fellow students, would return to her rural community to work in a government health centre for several years following graduation.
Initiating change and standing firm in the face of corruption were all challenges faced by the College team. The Midwifery faculty took some risks in endeavouring to challenge established ways of educating midwives in order to improve the scope, capacity and resilience of rural midwives and in turn improve maternal health. It was the students themselves, however, who took a leap of faith and entrusted their future careers to this untested model. There was much prayer as the staff moved forward in rolling out their hopes and plans.
Alem was one of a group of second year students who initially refused to enter the teaching labs after being told that the bulk of their new subjects would not be taught using traditional didactic methods. Rather, these shy country girls would be the first students in Ethiopia to learn new material using a ‘problem based learning model’ involving small groups working through challenging scenarios to be dissected, discussed and problem-solved as a team. Each learning group would in turn be required to teach their particular topic to the rest of their cohort. Students later reflected that this method of learning was the most influential and positive part of their development as midwives, enabling them to grow in their depth of knowledge, confidence and practise.
When the curriculum accreditation was delayed by a request to pay a bribe, the College staff were encouraged to experience our prayers, patience and steadfastness winning through in the end, showing them that they could play a small part in reducing corruption in their country.
Alem graduated top of her cohort and, following a demanding service period working as one of two midwives in her rural area, joined a teaching hospital where she currently works as a senior midwife and educator. She has built homes for her mother and siblings and also supports the education of her nieces and nephews. In their home villages these midwives are looked up to as leaders and many women and infant lives have been blessed through them.
Whatever you do, work at it with all your heart, as working for the Lord. Col 3:23
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