Saturday, 05 February 2011 00:00 GFP Columnist - Helen Briton Wheeler

A handful of committed men and women are working to build a hospital and make childbirth safe in the arid Afar region of Ethiopia. Spearheading the initiative are the trio of Valerie Browning, an Australian nurse, her East African husband Ishmael, and her nephew Andrew Browning, an obstetrician and gynaecologist. Theirs is an inspiring example of what can be achieved by just a few individuals dedicated to a worthwhile cause.

The new 28-bed hospital is due to open in early 2011 and will provide safe, modern maternity and child care for the minority Afar people, who live in the impoverished lowlands of eastern Ethiopia. Here, infant mortality and, for women, death in childbirth and the disability of fistula are age-old problems. Valerie, Ishmael and Andrew and their small international team of supporters in the Barbara May Foundation – which Andrew set up in 2010 – are bringing hope, medical and financial assistance and starting a new chapter in health care for the Afar.

In November 2010 Sydney barrister Helen Cox, a director of the Barbara May Foundation, visited the hospital and project area in Mille, Ethiopia, and met Andrew Browning. She will report on progress to fellow Barbara May Foundation members in Australia at a meeting this February.

Helen describes the Afar region as the harshest in Ethiopia, an arc of dry-lowland, almost treeless, scattered with tough, spiky desert plants. The hospital will have its own well for water supply and its own generator for electricity.

The Afar people face poverty because of the harsh climate. Lack of education is another problem. Their language, Afar, was not written down until 1970 so that literacy is only now an emerging miracle among the population.

Lack of education plus harmful traditional practices have made women’s lives much harder. Female genital mutilation is the norm. Poor nutrition and an ignorance of hygiene are additional woes.The marriageable age for females has long been 14. This meant that many teenage girls, slow to develop because of a poor diet, were physically unready to bear children when they married. When they then struggled in obstructed childbirth there were no caesarean sections to save them from death. Numbers of those who lived suffered fistula, a large opening in the bladder and or bowel caused by destruction of tissue in a prolonged or obstructed labour. Continuous incontinence is the result.

The Barbara May Foundation works to prevent the causes of fistula and death in childbirth.

When in 1974, Dr Catherine Hamlin and her late husband Dr Reginald Hamlin established the Addis Ababa Fistula Hospital, known as the Hospital by the River, they provided treatment for Ethiopian women suffering from fistula. It was a major pioneering step, and they also established a midwifery school.

Andrew Browning has worked at this hospital and now supports his Aunt Valerie and her husband Ishmael in their work to prevent fistula among Afar women. Barbara May is the name of Andrew’s Australian grandmother, Valerie’s mother, known in the family for her philosophy of “justice for all”.

Valerie Browning has been fighting to improve the lives of all Afar people ever since she met her Afar husband Ishmael in Djibouti a couple of decades ago. She is a devout Christian, he is a Muslim, but neither faith nor ethnicity have kept them apart.

“Valerie is just like an Afar,” Helen Cox says. “She has completely embraced the culture and the Afar people have embraced her.” Helen goes on to explain how Valerie and Ishmael set up a self-help co-operative, the Afar Pastoral Development Association some 20 years ago to promote education, literacy, improved land care, pastoral practices and farming methods in the region. It is supported by overseas donor organisations and employs about 700 people.

Helen Cox comments on Valerie’s dedication. “A few years ago she had her two front teeth kicked out by a camel. She could have had dental treatment to replace them. But she said she’d rather spend the money on their projects, so she goes around missing two front teeth.”

The Barbara May Foundation will support the work of the Afar Pastoral Development Association. The hospital will rely on volunteer obstetricians and midwives from overseas and already has offers, mainly from Britain, Holland and Australia. It will also employ 28 to 30 local cooks and clearers, and women extension workers, who travel from village to village teaching about health, hygiene and the services the hospital will provide. These extension workers will identify possible problem pregnancies so that preparations can be made for the mothers to go to the hospital for delivery. There will be a residential section for mothers and perhaps a family member, before they actually take up a hospital bed.

Helen Cox is full of enthusiasm as she describes her visit. “Just to watch a nuggetty little Australian gynaecologist from Orange [a rural city] save the life of a patient by performing a caesarean was so memorable. And I went out by four-wheel drive on a field trip to see what’s being done in the villages by local women recruited as extension workers for the hospital. The temperature was about 30◦Celsius, it gets up to 45◦ in summer. Just to meet these extension workers and hear their stories of how their lives have changed since they took on this work was amazing. The freedom and respect their role has given to them.”

That empowerment is just one of the miracles emerging from the work of the Barbara May Foundation. Many more lives will be saved and changed when the hospital gets under way. What a testament to the power of three – and those who back them up.

The Barbara May Foundation can be contacted at: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Images Courtesy of Helen Cox - Intro Image: Afar women at a training session for female extension workers preparing to do ante-natal screening.

Image 2: A mullah talks to a woman birth attendant about harmful traditional practices. Muslim mullahs are actively supporting initiatives to improve maternal and child health in the region.

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