Joint Project by

ETWA - DSN - OSMTH - Wilde Ganzen.

Status report January 2002

BACKGROUND:

The region of Lafaciisse is located in the Somali State (Region 5) of the Federal Republic of Ethiopia. The region has been the theatre of strife between Somalia and Ethiopia, has remained as a buffer zone and is grossly underdeveloped. The inhabitants are ethnic Somalians, who have little contact with outsiders (the only Ethiopians seen so far are soldiers). The population of Lafaciisse and surrounding villages is about 35,000, of which 2/3 are women and children. Perinatal mortality is very high. The nearest hospital is in Jijiga, a 2 hours journey from Lafaciisse by jeep.

NEEDS:

Clearly there is a need for a maternity clinic, adequate support and improved general sanitation.

There are 16 midwives in Lafaciise. They are uneducated and use inadequate methods to help delivery. The most elementary hygiene is missing. They need to be trained in appropriate clinic-based deliveries as well as home deliveries. The first object of the training should be basic hygiene, triage skills and simple deliveries not requiring surgery. The idea in this regard is to provide both didactic and participatory experience under direct supervision of the trainers on the initial patients presenting to the clinic. A subsequent object of the training should be to identify trainees with the best aptitude and dexterity, and entrust them with greater training in diagnostic and management of OB/GYN conditions. Training in clerical support and material management will be also provided. The trained midwives will thus be at the heart of the life of the dispensary, providing delivery assistance either in the clinic or making house calls at the patients’ homes in surrounding villages.

ACTORS:

DSN: Development agency run by expatriate Somalis and ethnic Somalis in the European Union. Proviision of administrative support and on-site control of progress, especially of construction. Local contacts, relationship with clan elders and regional government.

ETWA: Development agency run by the personnel of the European Patent Office. Provision of technical and financial support, coordination on building and annex facilities and related technologies (water tanks, sanitation).

Wilde Ganzen: Dutch Charity.Financial support for the building.

OSMTH: International Organisation providing inter alia humanitarian support. Provision of medical equipmentand training.

Ethiopian Government: Provision of long-term medical staff, if applicable.

Local population: Logistic support to clinic and basic sanitation.

DEVELOPMENT PLAN:

1. The first step was to provide better access to water. ETWA, DSN and Wilde Ganzen organized the digging or re-digging of four rainwater catchments (through a "Food for Work" program). Status: completed and operational.
2. The second step consists in improving the quality of the drinking water, a precondition to improvements in health care. ETWA will provide special pottery-based filters coated with colloidal silver to obtain sanitized water. Such filters have already been tested in another ETWA project, in San Isidro, Nicaragua, when the population was in need of sanitized water after hurricane Mitch. Status: in progress.
3. The third step is to build a dispensary in Lafaciisse, according to Ethiopian Government specifications. The dispensary will focus on non-surgical OB/GYN and post-partum, pediatric care where appropriate, and offer logistical support to local midwives.
   1. There is only one building in Lafaciise that is deemed "public". As it was built inadequately, it is now condemned and unusable for medical purposes. WG/ETWA have raised about 30,000 EUR to build a new clinic according to Ethiopian Government Specifications. Status: final stage of construction.
   2. OSMTH (Priory of Utah) is providing the first shipping of medical equipment/dispensable. The budget for subsequent shipping of medical expendables will be based on two primary factors that need to be evaluated when the clinic is operational. The first is what will be the rate of utilization and the average supplies expended per patient and the second is how much it will cost to acquire and ship on a recurring basis the expendable supplies needed. Status: shipment pending.
   3. (Priory of Utah) is organising training for the midwives. OSMTH will enroll and pay a team of doctors from Addis Abeba to go and spend several weeks in Lafaciise to train the midwives. Status: in progress.
   4. Long-term medical staff (physician and/or registered nurses) will man the dispensary and back-up the work of midwives. According to Ethiopian regulations, when a community builds (or someone builds for them) a functioning social structure such as a dispensary, the government is obliged to provide staff, in this case a physician and/or registered nurses. This service will ensure the continuation of the clinic. Status: guaranteed by Ethiopian Government.
   5. Cooperatives of local women will be formed in each village. The Cooperatives will foster solidarity, and under the guidance of trained midwives will form the core of a "sanitation commando" in charge of teaching all villagers the basics of hygiene.Status: being organised by the DSN official currently on site.

SUPPLEMENTARY ACTIVITIES:

• Simple data regarding birth rate and mortality/morbidity are being collected by the DSN official currently in Lafaciise. (So far, there were no registration procedures.) These data will provide a control to evaluate the utility and success of the clinic later on.
• Organization of trainers' arrival in Lafaciisse: The local population will be prepared to the arrival of the volunteers and involved in preparations and logistic support. Initiated, to be finalized by DSN official on site.

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K. Crawford, PhD, GOTJ Deputy Grand Secretary General IT Administration

The Knights Templar International Homepage Ordo Supremus Militaris Templi Hierosolymitani Swiss Reg. CH-660.1972999-4 -- http://www.osmth.org/

Launch Date: 6 April 2001 Copyright © 2000-2009 K. Crawford