Archive for 'Health'
Three Wives, 10 Kids Is Enough
Posted on May 3, 2010, by Hanna Ingber Win, under Health, India, International, women.
TENGATOLI, India — The air crackles as a team of medical staff and crew walk across a peanut field, lugging a big generator from their boat into a village of 850 people. Near a collection of thatchroof homes, the crew sets up a projector on the dirt floor of a small bamboo structure that also serves as the community’s schoolhouse. Well, it occasionally serves as a schoolhouse. The teacher lives on the mainland, a three to four-hour boat ride away, and only makes the journey along the Brahmaputra River to Tengatoli village in lower Assam to teach once a month. Sometimes once every two months.
Barefoot children and mothers holding infants trickle into the school-turned-cinema hall. The boat staff, part of a boat clinic run by the Centre for North East Studies and Policy Research with funding from the Indian government and UNICEF (see previous blog post on C-NES and the boat clinics), show a video on maternal and child health, including the importance of family planning.
Some of the video clips are in Assamese, and even though many in the crowd only speak Bengali, the language barrier does not seem to dissuade them from watching. Many who live on this island without electricity or televisions have never before seen a video.
One of the women watching is Anuwara Bezum. Dressed in a vibrant yellow, orange and red sari, she wears her head covered, an assortment of bangles and a nose ring. Bezum, who does not know her age but thinks she is about 30, grew up in a village on the mainland. Like many of the girls in her community, she got married at 12 or 13. She left her family and friends and moved to her husband’s village on the island. Bezum had her first child at around age 15, she says as she slowly rocks her fourth and youngest in her arms. This baby will be her last, she says through a translator.
Continue reading at the HuffingtonPost.
This reporting was sponsored by a grant from the Pulitzer Center on Crisis Reporting.
Learn more about this reporting project.
Follow Hanna on Twitter: www.twitter.com/Hanna_India
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On Remote Island Village, Health Worker Challenges Tradition
Posted on April 27, 2010, by Hanna Ingber Win, under Health, India, International, women.
AZIMOR, India — After a couple hours of cruising down the Brahmaputra River, the boat clinic arrives at a desolate mud bank. A fisherman nearby dips his pole into the water and pulls up a large net. Two community workers emerge from the boat and set off with a box of medical supplies towards the thatch-roof homes in the distance.
The doctors, nurses and I follow behind, zigzagging through the rain-soaked grass. We take off our shoes to wade through the flooded areas. The air feels fresh and crisp. With no roads or vehicles on the island, the only sounds we hear are roosters, cows and our feet sloshing through the water.
About 1,200 Bengali-speaking Muslims live in Azimor village. They have no electricity, toilets or clean drinking water. There is a primary school, which consists of a one-room structure made out of bamboo walls and a tin roof. The week before our arrival a storm had picked up the school and dropped it off in another part of the village.
Continue reading at True/Slant.
This reporting was sponsored by a grant from the Pulitzer Center on Crisis Reporting.
Learn more about this reporting project.
Follow Hanna’s tweets from Assam @Hanna_India
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India: The Orphans of HIV
Posted on April 26, 2010, by Hanna Ingber Win, under Health, India, International, women.
MUMBAI, India — Three teenage girls pull up chairs and form a semi-circle around me. Sabeena, whose pigtails and wide eyes make her look younger than her 15 years, carries a bowl of grapes and offers them to me. No, no, I tell her, I’m fine. “Take one,” she insists. I oblige.
Her friend, Amrita, also 15, tells me she is in her last year of high school. How long have you lived at this orphanage, I ask.
She smiles and puts her hand over her mouth. “One second, no?” she says and runs into the kitchen to ask the correct English word from Sister Shanti Remedios, the sister-in-charge of the HIV section at St. Catherine’s Home in Mumbai.
Amrita runs back and jumps onto her seat: “13 years.”
I try to ask the girls about life in the orphanage and living with HIV. I ask where they will go once they turn 18 or 19 and must move out. They do not want to discuss it.
“Which Hindi movie is your favorite?” Sabeena asks me.
Continue reading at GlobalPost.
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Assam: Boat Clinics Serve India’s Isolated Villages
Posted on April 23, 2010, by Hanna Ingber Win, under Health, India, International, women.
GUWAHATI, India — We load up in an SUV and make our way through the streets of Guwahati. It is raining, and much of this major city in northeastern India is flooded. Cars, men pedaling rickshaws and our SUV slowly edge their way through the water-filled streets. The water looks orange, stained from the clay that has eroded from the surrounding hills and clogged Guwahati’s drains. We are headed to meet a boat that will take a group of medical staff and us to visit a remote island on the Brahmaputra River.
A dark cloud forms overhead, and we hope it doesn’t storm. If it rains too hard, the villagers are less likely to come meet the temporary clinic the medical staff will set up on the island. If it storms, our boat won’t be able to go at all. We – like the villagers – are in the hands of the rain.
About 3 million people live along the Brahmaputra, a massive river that stretches from Tibet to Bangladesh. The boat clinics, run by the Centre for North East Studies and Policy Research (C-NES) with funding from the Indian government and UNICEF, work in 10 of the 15 districts on the river. They have reached over 300,000 people since they began in 2005.
Continue reading at True/Slant.
This reporting was sponsored by a grant from the Pulitzer Center on Crisis Reporting.
Learn more about this reporting project.
Follow Hanna’s tweets from Assam @Hanna_India
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India Smoking: A Ban in Mumbai Sticks
Posted on April 12, 2010, by Hanna Ingber Win, under Health, India, International.
MUMBAI, India — The comedian wraps up his act, and announces a seven-minute intermission. Audience members rise and file towards the door. Seven minutes – exactly enough time to get in a smoke. A group of friends forms a circle on the street. All light up.
Such a scene is common in cities like New York, San Francisco and London. But this is India. It’s Mumbai, to be precise, a city not exactly known for its cleanliness and public hygiene.
In Mumbai — with 18 million people and not enough space for all of them — the masses eat, shop, sleep, spit, defecate and throw their trash directly onto the streets.
Many men do not look twice before spitting onto the sidewalk red juice from chewing paan, a leaf wrapped around spices, nuts and often tobacco. Drivers lean out their rickshaws, which carry stickers reading “Spitting causes TB [tuberculosis],” and hack phlegm directly onto the road, often less than a foot away from other cars and pedestrians. Some people open the windows to their cars and houses and casually chuck trash outside.
When a ferry reaches Alibag, a coastal town south of Mumbai, passengers gather their garbage and throw it into the water. Children in slum areas squat over open sewers. Even in middle class suburbs, it is not unusual to see naked street children defecating on the side of a busy road.
But not everywhere.
For all the grime on the outside, step into one of Mumbai’s restaurants, cafes, bars or even discos, and you find another world: a fresh and clean one.
Continue reading at GlobalPost.
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Chasing Ambulances in Mumbai
Posted on January 31, 2010, by Hanna Ingber Win, under Health, India, International.
Here’s my GlobalPost article on the lack of emergency services in Mumbai.
MUMBAI, India — Dr. Saeed Ahmed gets a call – a patient at Noor Hospital in South Mumbai needs to be transferred to another hospital with better medical equipment. The doctor, his assistant and driver load up into the ambulance, turn on the siren and head downtown. A similar scene could have taken place in New York.
But there is one glaring difference: During the approximately 30-minute ride not a single car, taxi, bus or person moves out of the way for Dr. Ahmed’s ambulance.
Not one even pauses.
Continue reading here.
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Mothers of Ethiopia Part III: Battling Pregnancy Complications
Posted on October 1, 2009, by Hanna Ingber Win, under Health, International, women.
This has been cross-posted on the HuffPost. Go there to see the photo essay.
Editor’s note: Hanna Ingber Win, the Huffington Post’s World Editor, was recently invited by the UN Population Fund to visit its maternal health programs in Ethiopia, which has one of the world’s worst health care systems. In the U.S., a woman has a 1 in 4,800 chance of dying from complications due to pregnancy or childbirth in her lifetime. In Ethiopia, a woman has a 1 in 27 chance of dying.
This is the third of a five-part series on what she learned on her trip.
MEKELLE, Ethiopia — Dima Yehea’s two-year-old son has large brown eyes and a sweet, carefree smile. He sits on his mother’s lap wearing only an old T-shirt. Dima, dressed in a loose hospital gown, looks at me with intent, studious eyes. Her baby turns towards her, grabs her left breast with both hands and nurses for a few minutes. As the baby focuses on his meal, Dima concentrates on me, a Westerner in Ethiopia.
Dima also wears a big smile on her face. Her hair has recently been styled, pulled back in tight braids, in preparation for her departure from the hospital and trip home to her rural village.
A young woman living in a country with one of the world’s worst health care systems, Dima has experienced needless, preventable pain and tragedy. Yet she appears happy to share her story. To an American, it is a story of the poor state of women’s health care in Ethiopia. To Dima, it is a story of triumph and hope.
Dima was 15 when her family prepared a wedding ceremony and married her off to a man she had never before met. Soon after getting married, her husband forced himself on her.
“Did you understand what he was doing?” I ask her.
Dima’s smile slips away. She slowly shakes her head. “I was a kid,” she says through a translator. “I didn’t know what was happening.”
The sex was painful, but her husband did not stop.
Dima soon became pregnant with her first child. She was living in a rural village called Late about 145 kilometers from Mekelle, the largest city in northern Ethiopia.
Like 94 percent of Ethiopian women, Dima went into labor at home without access to a skilled birthing attendant. Too young and undeveloped to be giving birth, Dima’s body could not handle the labor. The baby’s head pushed down on her pelvic bone, not yet wide enough to let the baby pass naturally, for 48 hours.
Dima eventually gave birth, but the baby had died during the protracted labor. Plus, the prolonged pressure caused the tissue between her bladder and vagina to die. A hole called an obstetric fistula formed.
Obstetric fistulas are practically unheard of in developed countries because women give birth at a later age and therefore have more developed bodies - plus, even more importantly, they have access to medical care. If a woman has a complication during pregnancy, like about 15 percent of women do, she can have a Cesarean section.
Dima had no such luck.
In Ethiopia, where such surgery is rarely an option in the rural areas where women like Dima live, obstetric fistulas plague about 100,000 women, says Karen Beattie, the project director for Fistula Care, a project managed by EngenderHealth and funded by USAID. The exact number of women living with fistulas — like the exact maternal mortality rate — remains unknown due to lack of good population-based statistics, she says.
About 2 million women in the developing world currently live with untreated fistulas, according to the UN Population Fund.
“The whole problem lies in detection of difficult labor and appropriate referral to emergency obstetric care,” says Dr. Melaku Abriha, an obstetrician and gynecologist who runs the Mekelle branch of the Hamlin Fistula Hospital.
The hospital’s facility in Addis Ababa opened in 1974 and has treated more than 32,000 women, according to public relations officer Feven Haddis. The Mekelle branch opened in February 2006 and has operated on around 600 women from rural villages surrounding Mekelle. Ninety-one percent of the surgeries have been successful, Dr. Melaku says.
Dima’s fistula caused her to leak urine at all times. The uncontrollable discharge left her uncomfortable and smelly.
Still just a teenager, Dima became so embarrassed of herself that she stopped seeing her friends.
“I felt like they were talking about me behind my back,” she tells me.
Dima told her husband that she did not want to have sex with him. She felt unhealthy and uncomfortable. But he insisted. After having a second child, the little boy now sitting on her lap, Dima began refusing to have sex. Her husband divorced her and married another woman. Dima moved back home with her parents.
Her baby stops nursing and turns to watch me. Dima’s bare breast rests on top of her gown. She explains that she stayed at her parents’ house, without any contact with the outside world, until a local non-governmental organization visited her village and found her. The group, Relief Society of Tigray, helps women who have developed fistulas. They brought Dima to the hospital in July, and Dr. Melaku performed surgery on her to repair the hole between her uterus and bladder. The surgery cost about US$400 and was paid for by the hospital.
The surgery was successful, and Dima will return to her village the day after I meet with her.
I ask Dima how she feels now, and the joy returns to her face. Her eyes open wide, and she starts talking fast and loud. “I am happy!” she says, pounding her chest with her clenched fist. “I will start to talk with the neighbors and community. I will look for a new job, and I will start a new life.”
She says that she cannot return to farming because after living with a fistula for six years and undergoing surgery, she does not think her body will be strong enough for the intensive work. In general, women who undergo fistula surgery can return to farming once they have fully healed, says Karen Beattie of Fistula Care.
Dima also no longer has a husband to help her with the farming. Instead, she says, letting out a laugh, she will become a businesswoman.
“My plan is now to change my life,” she says. “I will do business and earn some money for me and my baby.”
It is unlikely that the number of fistula cases in Ethiopia is decreasing. However, more places like the Hamlin Fistula Hospital are opening and serving more women, says Beattie. Furthermore, increased attention by the international aid community over the past 10 years on the issue of fistulas has led to greater awareness about the problem of both this medical condition and women’s maternal health in general.
Despite the gains, only about a third of the 9,000 fistula cases that occur in Ethiopia each year get treated, according to the UN Population Fund.
“Fistula is a marker for what is happening for maternal health more generally,” Beattie says. “It has shined a light on the need for more access to emergency obstetric care.”
Tomorrow: Visiting a rural health post in Ethiopia
Read the first installment on one woman’s journey to find a doctor in rural Ethiopia, and the second about girls fleeing child marriage.
