I have not been able to visit the project for a long time because of the state of emergency declared by the government in Ethiopia last year. In addition, communication via email was not always possible. For these reasons, during my most recent visit I was very pleased to see several positive developments. I will shortly list them for you in the report below:

1. Eight of the ten students that graduated in 2016 have found a workplace in the countryside.

We have visited two of them: Mergitu and Samuel. Both work in health centres that are a two-hour drive away from Wolisso, over unpaved roads and only reachable in a four-wheel drive car.

Margitu works together with another midwife and the centre where she works looks clean. Issues such as sterilisation of equipment and supply of medication all seem to be in order. However, there is no electricity or running water at the centre.

Samuel, on the other hand, is in a more difficult situation. He works alone, meaning he is always “on call”. However, this is not even the most difficult part of his job. What he misses most is the possibility to discuss with a colleague before making a difficult decision, for example the decision whether or not a patient needs to be transferred to a hospital. Furthermore, he fears that there will be some difficult cases he can’t possibly treat by himself. Samuel’s workplace is clearly not as pleasant, also because the staff that has been there for a longer time (such as the cleaning staff) do not always want to follow his instructions. As a result, he often has to clean his own workplace. He also lacks materials and means for research and maintenance.

During our conversation, and even now, my heart goes out to him. I realise that this is what we ask of our graduated midwives: to work in the countryside, under circumstances that are much more difficult than they are used to and with a big responsibility. Young people, away from the familiar surroundings of the St. Luke school and hospital, often alone and with little support from the government they now work for.

Together with Melaku (a teacher), we have discussed our students’ situations and advised Samuel to visit Mergitu, to see how things are organised at the centre where she works.

In addition, we have concluded that it is important for our students, including the ones that have already graduated, to follow a BEmOC course (Basic Emergency Obstetric Care). I will go into more detail on this point later in the report.

The good news is that by now, the government is convinced of the fact that every health centre needs at least one, and preferable even two midwives. This means that in the future, there will be enough jobs for our students. Especially since the midwife programme at St. Luke has a good reputation.

2. This year, all third year students followed the previously mentioned BEmOC course. In this intensive three-week Basic Emergency Obstetric Care course the students learn all the necessary skills for emergency obstetric care. They work in small groups of six students, supervised by a teacher specially certified to teach this course.

The six third-year students of the ‘Adopt a Midwife’ programme are the first to follow this course. They have all signed a contract, declaring that they will work in the countryside for at least two years. This is no problem for these six students, as all of them originally come from the countryside.

3. We are still discussing whether or not we admit new students for the year of 2017-2018. If we do admit new students, we would want to focus especially on the admission criteria. If we only admit students from the countryside, there is a higher chance that they will return to the countryside after they graduate.

4. We are also still discussing the idea of getting our own car. There are some difficulties associated with car ownership, such as high taxes, maintenance and safety. As a result, we might again opt for a two-year contract to rent a car with a driver.

5. Melaku (graduated ‘Adopt a Midwife’ student) is now in the second year of his teacher training, again sponsored by us. He travelled with us to the health centres and proudly presented us his results from the previous semester: ‘excellent’ in every subject. When I complimented him on his achievements he said: “I am doing my very very best”.

6. We have received a donation of underwear for mothers and small cups to feed the new-borns. The cups were immediately taken into use by the neonatal unit.

The graduation ceremony of our third year students will take place on 5 August 2017. If they all graduate, the total number of ‘Adopt a Midwife’ graduates will be at 36.

We would like to thank everyone who has supported us during this year!