Project Zero rolls out in a second woreda

Following the completion of the incredibly successful pilot of Project Zero in Ale Woreda (district), the next phase of Hamlin’s ground-breaking program to accelerate the eradication of obstetric fistula is now being implemented in Didessa Woreda.

The second woreda: Didessa Woreda

Project Zero launched in Didessa Woreda in the Oromia region of Ethiopia on 13 February 2024. This woreda covers an area of 632 square km, with an estimated number of 18,208 rural households.

Prior to the start of patient identification and awareness-raising activities, meetings were held with key stakeholders in the woreda to discuss the implementation of the program. This included the Head of the health office, the woreda administrator, the Head of Women’s Affairs, the Head of the Education Bureau, religious and community leaders and health care providers.

An initial baseline assessment was conducted to determine levels of awareness of obstetric fistula and maternal healthcare utilisation. This was done through in-depth interviews and focus group discussions at community and health centres.

A baseline assessment was carried out for four health centres in the woreda (Dembi, Yembero, Cello and Ogo) using a Hamlin Standard checklist. The assessment results are used to identify specific areas in which the centres need to improve to provide better healthcare services to their patients.

Each centre was evaluated on nine criteria including leadership and management, patient and community involvement, clinical care and infection prevention and control, among others. All four centres rated very low overall so there is significant work to be done to improve the quality of maternal healthcare services.

So far, Hamlin Fistula Ethiopia has provided equipment and supplies to two centres, including a Haemoglobinometer, beds with mattresses, pillows, linen and examination beds and commenced refurbishment of the clinics.

The pictures below were taken during the health education session for health care providers and other officials, woreda-wide awareness raising for community and religious leaders, steering committee establishment and meeting and during the handover of equipment from the Ale Woreda pilot of Project Zero.

Five women found with childbirth injuries

At the start of March, 31 Health Development Armies (HDAs) and health extension workers started house-to-house surveys in two kebeles (neighbourhoods) to find women hidden with untreated obstetric fistula injuries. In the coming weeks, house-to-house surveys will continue in nine further kebeles.

In the first two kebeles 1,073 households were reached, identifying five women with childbirth injuries and transferring them to Hamlin’s Metu Fistula Hospital for treatment.

Fasika is one of these women. She suffered the trauma of fistula for 18 years.

She was found by the Project Zero team during house-to-house surveys in the Didessa Woreda. She was transported to Hamlin’s Metu Fistula Hospital for life-changing surgery.

Read her full story here.

Raising awareness

Project Zero staff wearing special PZ t-shirts are conducting awareness-raising activities including distributing leaflets, engaging with people at large gatherings and using a loudspeaker tied to the top of a car to spread the word.

The key messages being conveyed are how to identify fistula, what the causes and consequences are, how to treat it and how to prevent it.

Training is given to community and religious leaders, woreda health officials and health care providers about the causes and prevention of obstetric fistula and other birth injuries.

So far, activities have been conducted at:

• 13 marketplaces, reaching an estimated 3,000+ individuals.
• 5 schools
• Many other public gatherings such as churches, community centres and pregnant mother conferences.

Mentoring healthcare workers

Hamlin Midwives have so far provided mentoring to six midwives and two nurses working in maternal and child health services in four health centres in Didessa Woreda. Improvements have been made to the labour, delivery and maternal waiting rooms as well as in areas such as antenatal care and family planning.

Implementation of Project Zero is planned in the second half of 2024 in Fedis Woreda in eastern Ethiopia and Serahiti Woreda in the Tigray region.

Project Zero will transform women’s healthcare outcomes and finally realise Catherine’s vision of eradicating fistula in Ethiopia. Forever.

From 2025, Project Zero will begin to declare, woreda by woreda, that no woman is suffering with an obstetric fistula.

Click here to learn more about Project Zero.