The National Health Policy emphasizes core principles of democratization and decentralization of the Health Care System of Ethiopia. Preventive, promotive and curative components of health services in the country have shown a remarkable improvement, meeting equitable and quality health components of health care for all parts of the population and encouraging private and nongovernmental organization participation in the health sector. Cognizant of this fact, MSD has been implementing more than five projects containing health components. Among these are the two existing mega projects of MULU HIV prevention and Yekokeb Berhan for Highly Vulnerable Children program targeting most at risk populations and vulnerable children, respectively. MSD has also started new initiatives on sexual reproductive health, maternal and child health, and nutrition.
Mahibere Hiwot for Social Development (MSD) has been implementing the EXPANDING and EXTENDING MEDICAL SERVICES project at Janamora, Debark, Beyeda, Adi Arkay, and Tellemt since August 2015 by the financial support from an international NGO named Simien Mountains Mobile Medical Service.
The people of the Simien Mountains live predominantly by agriculture but many also own some livestock. Over the years the human population has increased beyond the productivity and carrying capacity of the land, at least what can be realized through traditional agricultural methods. Land holdings for each family are now very small and many households are food insecure and receive food or other assistance under the Government’s Productive Safety Net Programme. The human population has, however continually grown over the years. In 2013 a voluntary settlement has been made to an area called Keyit and few selected places which are a little bit far from the park. There are about 8000 households who are settled around the Simien Mountains. Government has constructed one health center to reach the people who settled in and at the edge of the Simien Mountains. Those who are living far from this center like the Keyit Kebele have to travel 4 – 6 hours on foot to get any service from this center. Girls had nowhere to go if they get pregnant. Abortion in traditional herbals is common which took the lives of girls and women. Spacing and delaying is unthinkable in the area due to access of health service delivery sites. Taking all these into consideration, an international NGO named Simein Mountains Mobile Medical has been working in accessing mobile medical service to rural girls and women in particular and the community in general since December 2012.
Girls and young boys are getting married at early age even before age of 18, which is legal age of marriage in Ethiopia. The first responsibility of a young girl after marriage is giving birth. Though, these days, people have better information about family planning, the only means what they can use is the natural birth control method on which men are not happy to practice it. To use the man made family planning commodities, they are forced to travel 4 – 6 hours on foot. The fertility rate of this target area is quite far from the national average. There are families who have 11 children. The minimum size is 6. Most girls and women are dying at time of delivery due to over bleeding. In General the settlers at Key it were vulnerable to communicable diseases with no any heath service delivery site
Ethiopia has one of the highest maternal mortality rates in the world. It is estimated that every year, about 25,000 mothers die and 400,000 more suffer long-term disabilities due to complications during pregnancy, delivery or postpartum period. The leading causes of death are abortion, sepsis, hemorrhage, and obstructed labor. The majority of these deaths are preventable with affordable interventions (MOH). The situation of mothers and children at Keyit and the nearby kebeles at the catchment of the Simien Mountains is worse compared to the national MMR.
Assuming that establishing clinic and delivering free medical service for the community will increase health status of the people at Keyit and the nearby kebeles, Simien Mountains Mobile Medical Service has taken over to run the clinic and equipped it with relevant materials. Currently SMMMS is working with MSD in running the established clinic which has one nurse, one mid wifery, one volunteer doctor abroad (who will stay for a month), mobile Nurse , Janitor and Guard. The clinic is delivering all emergency medical services including delivery and minor operation free of charge.
This project has deployed mules, saddle aid and mule handlers to serve as ambulance to those who are critically sick and also means of transportation to mobile nurses who are giving medical service traveling long distance from the clinic.
Currently mothers are giving birth safely supported by professional mid wifery. The clinic delivers one complete cloth for the new born at time of delivery and at the 42nd day when they come for vaccination. These mothers are accompanied by the rituals through coffee ceremony in the presence of their relatives and neighbors on the 1st and 6th day of delivery. The 6th day was preferred not to miss mothers for follow up and motivate them to visit the clinic. All these medical services and birth rituals are free of charge from clients.
The clinic is delivering service to an average of 70 person each day.