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Current Projects
Addis Abba Fistula Hospital
The entrance arch to Lalibela Hospital

List of available services at Lalibela Hospital
List of available services at Lalibela Hospital

The 3-bedded labour ward
The original 3-bedded labour ward

Three couches in the delivery room Three couches in the old delivery room

The three-bedded immediate post-delivery ward prior to discharge
The original three-bedded immediate post-delivery ward prior to discharge

by contrast Addis Ababa Fistula Hospital
... by contrast, the excellent facilities at Addis Ababa Fistula Hospital

Addis Ababa Fistula Hospital grateful patients
Addis Ababa Fistula Hospital grateful patients

The old Kewabhara health post - the middle room onlyThe old Kewabhara health post - the middle room only

The new Kewabhara health post
The new Kewabhara health post

The new Kewabhara health post
Presentation of 2016 Rotary Paul Harris Fellowship awards to Norman and Carole

Donkeys walking past the new Lalibela maternity unit
Donkeys walking past the new Lalibela maternity unit

The out-patient area with family planning, consultation, scanning, laboratory and pharmacy rooms
The out-patient area with family planning, consultation, scanning, laboratory and pharmacy rooms on left hand side

The dividing aluminium door between out-patient and in-patient areas.
The dividing aluminium door between out-patient and in-patient areas. In-patients consists of labour and delivery rooms and two operating theatres. Also ante-natal, post-natal, caesarian section wards plus intensive care post-caesarian and neo-natal wards.

NEW  MATERNITY UNIT AT LALIBELA HOSPITAL           September 2014 - October 2017

In October 2014, Lalibela Trust agreed to raise funds for a new stand-alone maternity unit in the grounds of Lalibela Hospital to replace the current inadequate maternity facilities.
The total cost had been priced at 3,535,400 birr (£117, 847).  Lalibela Trust will pay 80% (£95,000).  Amhara Regional Health Bureau (ARHB), 20% (£23,500), plus all agreed equipment and supply and pay all staff salaries.
Ethiopian Government, Regional Health and local health authorities and townspeople are very supportive.  The Minister of Health visited the site, enthused and left saying "Just get on and build it!" - easier said than done!!  He believed the new unit will be a flagship maternity unit for small hospitals to emulate. 

Without the tireless commitment, enthusiasm, patience and determination of Norman and Carole and also Derebe, their Ethiopian Project Manager in Lalibela, this project would never have succeeded.


Stages 4 and 5 Millenium Development Goals aim to reduce maternal, newborn and children under five morbidity and mortality.  In the past decade, the Ethiopian Government has made huge strides in funding "compulsory" primary school education through the construction of schools - and building 38,000 health posts.  The latter, staffed by two females with twelve months` health training, each cover a rural population of 6-8,000 emphasising good nutrition, safe water, hygiene and sanitation - also pregnancy care, immunisations and family planning.

For centuries, rural women have known, experienced, suffered and feared the risks of childbirth.  Cultural, traditional, family and religious beliefs are very strong. Some still deliver on the floor of their huts, trusting in God, believing no outside help is available.

But times are changing.  Health posts and health centres are increasingly equipped with mobile phones.  In 2015, nine 4WD ambulances, specifically for pregnant women, covering a population of 500,000 in this mountainous area have made hospital admission a reality.  Caesarian section surgery is now available 24/7.

Ambulance accessibility is a major problem.  It may take hours to reach the mother.  Where there is no track, mothers in end-stage labour, must walk or be stretchered to an agreed meeting place.  Many reach Lalibela Hospital having been in labour for a few days, unable to deliver naturally, exhausted and dehydrated to undergo immediate life-saving caesarian section.  Caesarian section also reduces the risk of fistulas.

The challenge, need and demand is to build a modern maternity unit. The existing provision is two three-bedded rooms for labouring women and immediate post-delivery rest - and three delivery couches in the delivery room.  Ante-natal admissions (high BP, bleeding etc) are placed in a general (mixed sex) medical ward.  Post-Caesarian mothers share a mixed sex surgical ward with all the attendant risks of spreading diseases and infection. Likewise new-born share the general paediatric ward.

The new plans show a stand-alone self-contained maternity unit divided into out-patient ante-natal rooms and in-patient wards.  The out-patient area has a consulting room, scanner room, pharmacy, laboratory and family planning room.  An "abortion ward" has also been added. The in-patient section comprises a labour and delivery room plus two operating theatres. Additionally there are ante-natal and post-natal wards plus a post-Caesarian section ward and two intensive care wards specifically for gravely ill women and the neo-nate. No longer shared mixed sex wards, no longer shared facilities in a poorly built inadequately equipped building but a new unit recognising that quality health care is the right of every mother and newborn child. 

October 2014  Agreement in principle              July 2015 - Plans for maternity unit accepted.               March 2016. Foundations laid. 

November 2016 - Building 60-70% complete. All internal and external walls in position and roof finished. Building on schedule.  Unexpectedly confronted with demand for eighteen additial requirements for the maternity unit amounting to £51,000!  Following negotiation, we agreed eight of the eighteen items, some Government requirements, some deemed necessary amounting to £22,500. Ceramic tiles replaced terrazzo tiles in both operating theatres and aluminium, not metal, doors and windows was accepted.  Building restarted after ten week delay.

March 2017  Ceilings 90% completed, plumbing pipes in place and electricity wiring well advanced. Unfortunately a torrential rainstorm swept dpown the road and entered the MU.  Lalibela Trust paid the cost (£5,500) of a concrete diverting ditch and other works to prevent a recurrence.

July 2017  All ceramics finished - all internal wooden doors in place - aluminium doors and windows on site.  The roof has been painted red to match the other roofs and the outer walls have been painted. The top soil has been removed from the car park prior to concreting; the retaining wall is under construction.

OCTOBER 22ND  2017.  OPENING CEREMONY  The Head of Amhara Regional Health Bureau - covering a population of 21 million - specifically flew to Lalibela for his first visit to open the unit. He announced that the new MU, equivalent in size to two tennis courts, has upgraded the whole hospital from general to district status resulting in automatic access to more equipment and professional staff.  We, together, cut the ribbon.  The opening ceremony was premature to coincide with our visit.

The final cost of the building is £162,000. Lalibela Trust contributed £135,000 - an increase of £40,000 over the original sum. 

A few days later we learnt that the builder had not been paid all his third stage payment.  It later transpired that the hospital director had used £15,000 of his due payment for flood relief work!  The hospital director has been severely censured.  Regional Health have indicated they will pay the £15,000 in September 2018.  In the interim, the out-patients remains open but the builder has locked the in-patient sector until paid.

Our absolute main priority remains the optimal performance of both the new maternity unit and ambulance service.  Regional Health has contracted to provide new maternity equipment but it is likely more will be necessary to meet the anticipated higher demand.  Secondly, the "ambulances" are basically 4WD taxis.  Dr Chris Howes, Managing Director of Festival Medical Services, Somerset and Nich Woolf, a very experienced first responder will visit Lalibela Hospital this October to appraise the current situation and input their expertise.  Finally, the Sub-Dean of Royal Cornwall Hospital, Treliske is keen to organise medical student placements in Lalibela Hospital. Our hope is that qualified staff will later visit on a regular basis



HELPING HEALTH, EDUCATION AND WATER SUPPLY - NORMAN AND CAROLE

Norman and Carole`s primary involvement since 2000 has been spring improvement projects around Lalibela usually in the more remote areas where NGOs and charities do not operate. They also manage the construction of new health posts.  
The contract depends on the local Government Department paying 20% towards the final cost.  They must also provide and pay, in the case of health posts, the two female Health Extension Workers who will staff the building. The local community must provide the unskilled labour and transport all locally available materials such as sand, gravel, building stone and wood free of charge. Our commitment is to pay what they cannot provide - cement, corrugated metal, pipes, windows etc - and the local skilled Ethiopian builder who manages the local community workforce.  Without these strict conditions and understanding, there is no contract.

SPRING IMPROVEMENT PROJECTS

Each SIP costs a minimum of £3,300 but very much dependent upon the proximity to reasonable access.  An existing spring is opened out to maximise its water bearing capacity.  A concrete "box" structure is built around to contain and collect all the water and pipe it into a nearby stone and concrete downhill reservoir typically 3 x 4 x1 metres. The reservoir is built where it is easily accessible and acceptable for local people.  On the reservoir, three taps provide the clean spring water for local people, one pipe from the reservoir fills an animal drinking trough, and another feeds into four concrete trays used for washing. In this way, the drinking water is kept separate and clean, directly from the spring. SIPs complement well our activity with health posts, where many of the patients will no longer suffer from water-borne diseases.  It is probably the best £ for £ investment leading to an immediate reduction in morbidity and mortality of the local community from gastrointestinal diseases.  The cattle are also healthier!



LALIBELA HIGH SCHOOL

Millfield School has established links with Lalibela High School. 2017 was the fourth October visit by Millfield pupils to Lalibela. 

Three large primary schools in Lalibela (5,650 pupils in total) and thirty-nine smaller rural primary schools feed into a single new secondary school built in 2005.

2,200 pupils attend the secondary school which consists of twenty classrooms, a staff room, segregated lavatories and a few storage sheds. Two three tier classroom blocks built by the Government were added in 2010. However, the finances did not stretch to classroom desks, chairs and ancillary equipment. There are no recreational or sports facilities.

Attendance, because of huge numbers, is on a half-day basis. There is a stiff entrance exam for the large number of boys and girls wishing to continue their education.  Girls are more successful than boys in the entrance exam.  

In the last two years, the indigenous NGO Save our Holy Land has built a girls` hostel adjacent to the school to accomodate girls from distant areas.  In the past, these girls would be forced to seek accomodation within the town.  Many have minimal finances, many would prefer to stop their education and many parents would never allow their daughters to risk abuse and unwelcome attention.

 
“When you educate a boy, you educate an individual.
When you educate a girl, you educate a community.

In 2006, following our approach to Plan UK, a £35,000 project was set up to provide classroom furniture (1,000 desks) and equipment, library books, IT equipment and teacher training for the secondary school. This project was completed in 2007.

2006: Millfield and Millfield Preparatory School (MPS) pupils donated £6,750 towards classroom furniture and computer equipment

2008: Millfield & MPS pupils donated £4,540 towards classroom equipment and textbooks. Each year we have taken out a large quantity of Millfield sports clothing and sports equipment to soccer clubs and schools. Their sports facilities are non-existent in this soccer-mad country and Millfield's contribution is so much appreciated.

2009: - £1,600 donation from MPS and Millfield Pre-Preparatory School pupils.  2010: - £500 from MPS pupils.  2011 - £1,000 from MPS pupils
   
2013 - £4,100 from Millfield School pupils to construct 100 bench desks for new classrooms at Lalibela High School.

2014 - £6,000 donated by Millfield pupils to provide 1) new water tank reservoir and safe drinking water. 2) electricity installation for two new three-storied classroom blocks to activate dormant teaching plasma screens. 3) 1,000+ text and reference books requested by Lalibela High School.

2015 - £6,000 to refurbish and update the school`s IT provision - training and education, new systems, many more computers - a complete revamp and upgrade.

2016 - £6,000 to construct third IT room, computers and projectors.

2018 - anticipated construction of female latrine.  Lalibela High School apparently is the only secondary school that has no female latrines.  Many girls do not attend during menstruation.  Millfield has indicated that the female latrine must go ahead.  If not, they will move their charitable work to another school.
 
African poem:

I have a dream that when my daughter grows up she will be known for her contribution to the world, not by the size of her hips nor by the number of children she has.

 

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