“I want to talk about the services I received from the Dangla Health Center with my family, friends and neighbors,” says Yalemzerf Birlie, a 30-year-old Ethiopian woman who recently got the emergency caesarian she needed to give birth to a healthy baby boy.

A second chance at having a child
Yalemzerf was one of the first beneficiaries of a new emergency obstetrics care unit at Dangla Health Center, a clinic in Ethiopia’s rural Amhara Region. Yalemzerf and her husband are primary school teachers at Gissa elementary school, located about nine kilometers from the health center. Twelve years ago, Yalemzerf’s first pregnancy resulted in a stillbirth after three days of labor. During this pregnancy, she wanted to ensure a successful pregnancy and delivery and made five antenatal care visits. During the antenatal visits at the Dangla Health Center, Yalemzerf learned a great deal about Dangla’s services—which she would need when she experienced sudden pain and ended up laboring for ten hours before being referred for an emergency caesarian.

Distances to emergency care makes the difference
In rural Amhara, people have, until recently, had to travel long distances—often on foot—to get medical attention. In emergencies, the distance often became not just dangerous but life-threatening. “Usually this meant that women—after laboring for many hours—were carried on a stretcher by their family members to the hospital, about 80 kilometers away,” explains Anley Dessie, IntraHealth International’s fistula regional training and program coordinator in Ethiopia. “If both the woman and baby survived that ordeal, it was a miracle.”

To address the problem of access to emergency services, IntraHealth has partnered with Amhara’s regional health bureau and the Addis Adaba Fistula Hospital to build and develop an emergency obstetric care unit adjacent to Dangla Health Center’s labor and delivery ward. This unit, which became fully operational almost two months ago, can manage caesareans and offer appropriate care in case of obstructed labor. IntraHealth supported the renovation of the building that houses the unit. It consists of a scrub area, operating/delivery room, recovery room with a toilet, and a storage room. IntraHealth also has supported training of two health officers (the equivalent of physicians’ assistants) in caesarean delivery and three midwives in basic emergency obstetric care, including assistance in caesarean delivery.

Dangla’s promising results in the first month
Each year in Ethiopia, over 25,000 women and girls die from pregnancy-related complications. Skilled care at birth can reduce this number—and it’s sorely needed in a country that has the lowest rate of skilled birth attendance in the world. The Dangla Health Center’s emergency obstetrics unit is already impacting lives: it has served 27 women in its first month of operation, through the end of October 2010.

IntraHealth’s support to this unit has been made possible through two USAID-funded projects: the Extending Service Delivery project, led by Pathfinder, and the Fistula Care project, led by EngenderHealth. For more information about IntraHealth’s work in Ethiopia, please visit the Ethiopia page on our website.