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Mobilizing the community to dispel myths about pregnancy and women's health in Dolo Ado, Ethiopia

Interview of Hamdia Mohammed, a Community Educator in the Bokolmayo refugee camp in Ethiopia.

In a context where the lack of access to knowledge combined with traditional beliefs restrict women from seeking health care, our project in Dolo Ado, Ethiopia, which is being funded by the United States Government, aims to raise the community’s awareness about the importance of seeking skilled health care during delivery and accepting Caesarean sections when necessary.

As part of this initiative, 24 women among the refugee as well as the host population have been trained as community educators in three different areas in Dolo Ado: eight women from Bokolmayo, six women from Melkadida, six women from Buramino and four women in the Dolo Ado camp.

During our last visit to the Bokolmayo settlement, we had the opportunity to sit down and talk with one of the community educators, Hamdia Mohammed.

WAHA – Hamdia, tell me a little bit about yourself...

Hamdia – Well, I am 24 years-old... I have four children... I left Somalia, my country, and moved here about five years ago... That’s how long I’ve been living in Bokolmayo [refugee camp] with my children and my husband.

WAHA – You are one of WAHA’s community educators...

Hamdia - Yes, I am... I have been living here for a long time so I know the community pretty well... I think that’s why I was chosen to become a community mobilizer. I’ve also worked with other NGOs on raising awareness on issues such as supplementary feeding and gender-based violence...

WAHA - When it comes to maternal health, what are the different challenges in your community? As a community educator, what are the gaps you are addressing?

Hamdia- Well you know, there are a lot of misconceptions in our community... People tell you that it’s not normal to deliver in a health facility... They ask you: “why would I deliver in a health facility when I can deliver at home? Isn’t that how our mothers and grandmothers have been giving birth?”... Generally, people are proud to say that they gave birth at home. If you don’t give birth at home, it’s almost as though you were not a “real” woman, you know?

And that’s not the only issue... when it comes to C-sections, it’s even worse... In our community, people say that getting a C-section is similar to being slaughtered. That’s the exact expression we use: “being slaughtered like an animal”. And of course there is the fear that, once you deliver by C-section, you will not be able to bear other children... Even when women accept to get a C-section, their husbands or their fathers will often refuse...

WAHA – Tell me about the training you received to become a Maternal Health Advocate.

Hamdia – It was two days of training with four other women from the camp and three women from the host population... the training sessions were organized in UNHCR’s compound. With our trainer, we discussed the different beliefs in our community regarding pregnant women and motherhood in general... And then, we reflected on what we can do to save the mothers... we worked on the messages we would convey: the benefits of antennal visits, skilled delivery, and C-sections. We also discussed how exactly we would carry out the community mobilization visits...

WAHA- What type of community mobilization visits do you carry out?

Hamdia –We carry out house-to-house visits. You know that the Bokolmayo camp is divided into 20 zones and there are more or less 300 houses in each zone. So each community educator is in charge of four zones. One community educator goes to 10 houses every day, and Fridays are dedicated to reporting. We mainly focus on pregnant women and lactating women.... So far, I have identified about 50 pregnant women in these four zones during my house-to-house visits. When I go to a house, I invite everyone living in that house, including the men, to gather around and then I start teaching. I insist that women should give priority to their health during pregnancy... I say to them: “you know, you should deliver in our Health Center. You will be very safe. They have doctors there. If anything goes wrong, they can do C-sections. They have computers and a lot of other things so it’s nothing like slaughtering an animal."

WAHA - Generally speaking, how do people react to your messages?

Hamdia – Well, most of the time, people are very skeptical. But I give them examples of women who have died in labor because they had refused to go to the Health Center... Some people listen to you, others don’t. But I go to the same houses repeatedly and I am starting to see slight improvements...

WAHA - What are the challenges you face?

Hamdia – Well, like I said, not everyone is receptive to the messages we share. That is because what we are teaching goes against very deeply rooted beliefs... But this doesn’t mean we should stop working. We are already starting to see some positive changes and I believe we have to come up with other initiatives... For instance, we are thinking of organizing monthly meetings for pregnant women. We can also organize community meetings and ask religious and tribe leaders to join us; they are even more influential than us, so people will open their ears for them... I have no doubt that change will come... it will be slow, but it will come.