The first time I saw open defecation was in a slum in Delhi. I was taken aback. I had always heard about open defecation, but until that point I had never seen it and couldn’t imagine it happening in an overly crowded urban area. It was also at that moment that I knew I had to learn as much as possible about the ways in which people use the bathroom, if they have one at all.
2.5 billion people lack improved sanitation and 1 billion people do not have access to a bathroom and must resort to the undignified practice of open defecation. There are 7 billion people on the planet.
Women who must defecate in the open and who also have to use the community toilets are at increased risk of violence and rape.
When I visit communities and families in low-income countries I always look for toilets and latrines to see the conditions in which people relieve themselves. Below are some photos of toilets I took in India, Ethiopia, Philippines, and South Africa.
In low-resource settings across the globe midwives are learning about the critical first hour after birth that can keep more newborns alive through Helping Babies Breathe training. In Yetoban, Ethiopia at Project Mercy midwives take skills labs classes that will utilize the NeoNatalie Newborn educational mannequin. Midwifery training at Project Mercy is through a partnership between Jhpiego, USAID, and Project Mercy that will feed qualified, well-trained midwives throughout southern Ethiopia.
The NeoNatalie Newborn educational mannequin can be filled with water or air and simulates a real newborn that needs to be resuscitated, an intervention that happens often during the first ten minutes of a newborn’s life.
Expectant woman, Ayelech Fikadu, and her mother, Zarge Badunga sit in a “lie and wait” house at Project Mercy outside of Butajira, Ethiopia. The house was recently renovated by USAID and Pathfinder.
Butajira is located in Ethiopia’s southern highlands where many live in the mountains. Women who live in the mountains have a difficult time delivering their babies at a hospital or health center due to a lack of facilities as well as the distance from them.
Ayelech came to this “lie and wait” house because she experienced birth complications. She will deliver her baby at the nearby hospital at Project Mercy that is literally up the street from the “lie and wait” house. Without these services women who experience pregnancy complications have a greater chance of dying during childbirth and their newborns have a decreased chance of survival.
This woman in Mosebo village, 43 kilometers from Bahir Dar, Ethiopia, holds her nine-day-old baby and quickly quiets him by breastfeeding him in her home.
Save the Children is working diligently with the Ethiopian Federal Government to properly train health extension workers and provide continuing education for the workers to help save the lives of vulnerable newborns. Through its widely-recognized, global program, Saving Newborn Lives, Save the Children has worked in low- and middle-income countries since 2000 to help newborns survive past the first month of life.
This is a young, expectant mother who lives near Butajira, Ethiopia. She was married at 13 and will deliver her first child at 15. She walked to this “lie and wait” house (pictured above) because of excessive bleeding. She lives 30 minutes up in the mountains of southern Ethiopia from the “lie and wait” house. She has never seen a health extension worker and has never been to a health post. Her experience, once again, underscores how difficult it is for Africans who live in the most remote areas of a country to access quality health care.
Her mother, who is now 38, was also married very young, at age 12. She now has eight children. Her youngest is three months old.