*Y.C.* Mimidae
Mimidae will empower young obstetric fistula survivors that have been ostracized from their villages. We will serve as a center for healing and self-empowerment. Mimidae's innovative model will provide living quarters for a period of three years during which time they will gain both classroom and hands-on midwife training, gain administrative/managerial skills, learn about family planning methods and the dangers of early childbearing. Following their train, each woman will be able to administer health care services and education in areas with high obstetric fistula rates. Trained midwives will provide infant and maternal care as well as education and job opportunities having high impact not only on the fistula rate but the root causes as well beginning a necessary shift in the cultural and economic perspective on women. Our program will not only strengthen fistula survivors and communities but also encourage women living in shame because of obstetric fistula to come forward. Mimidae uplifts communities by empowering women. Strong and healthy women create strong and healthy communities.
About You
Section 1: About You
First Name
Yeabsi
Last Name
Mehari
Website
Organization
Mimidae
Country
United States, CA
Are you an individual between the ages of 18 and 35 who would like to apply for a nine month Young Champions Program mentored by an Ashoka Fellow?
Yes
Section 2: About Your Organization
Organization Name
Mimidae
Organization Website
Organization Phone
703.302.9365
Organization Address
600 T Street NW, Washington DC
Organization Country
United States, DC
The information you provide here will be used to fill in any parts of your profile that have been left blank, such as interests, organization information, and website. No contact information will be made public. Please uncheck here if you do not want this to happen..
Your idea
Name Your Project
*Y.C.* Mimidae
Country your work focuses on
Ethiopia, XX
Describe Your Idea
Mimidae will empower young obstetric fistula survivors that have been ostracized from their villages. We will serve as a center for healing and self-empowerment. Mimidae's innovative model will provide living quarters for a period of three years during which time they will gain both classroom and hands-on midwife training, gain administrative/managerial skills, learn about family planning methods and the dangers of early childbearing. Following their train, each woman will be able to administer health care services and education in areas with high obstetric fistula rates. Trained midwives will provide infant and maternal care as well as education and job opportunities having high impact not only on the fistula rate but the root causes as well beginning a necessary shift in the cultural and economic perspective on women. Our program will not only strengthen fistula survivors and communities but also encourage women living in shame because of obstetric fistula to come forward. Mimidae uplifts communities by empowering women. Strong and healthy women create strong and healthy communities.
Website URL
Innovation
What makes your idea unique?
There are a handful of organizations that are focused on preventative care and maternal mortality rate reduction yet none of these organizations work with fistula survivors. Mimidae will be the first program that will solely work with fistula survivors in Ethiopia. No one can understand the plight of women and children more than these young women. We believe health care centers run by them will be most effective because they are familiar with the psychological, socio-economic and cultural impact of fistula. Further, they will be less likely to advocate for child marriages. We also believe empowering young fistula survivors will 1) decrease the rate of new and recurring fistulas 2) break the cycle of shame and dependence 3) inspire women who are living in shame with fistula to step forward and 4) change societal and cultural views of girls and child marriages consequently leading to a reduction in child marriage rates. These young women have survived fistulas and have been ostracized from their communities but they will be empowered through self-sufficiency and education equipping them with the necessary tools to ending obstetric fistula.
What also makes our program innovative is our implementation method. Each health care provider will serve a population within a small radius. This will prevent problems faced by other health care centers such as over flooding or lack of utilization. We will also have a higher impact because the midwife to population ratio will decrease. It is currently at 1 midwife to 100,000! (As reported by Dr.Sahlu Berhane of the Packard Foundation). Obstetric fistula statistics have increased over the past five years though more hospitals are being built. For this reason, Mimidae believes a comprehensive approach will have more impact.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
Mimidae is currently not on the ground. However, our impact has been on the level of awareness regarding obstetric fistula. Our most recent event brought over 100 people in. By a show of hands, over 90% of our audience did not know what obstetric fistula was! The men to women ratio was almost even. More men now know what obstetric fistula is. We held a panel discussion post event, and needless to say it was amazing. The discussion was open, honest and informative.
We continue to write to legislative bodies pushing for maternal health to be included in public policy agendas. Mimidae also attends midwifery conferences and university functions bringing maternal issues such as obstetric fistula to the forefront of conversations.
Problem
A condition eliminated in the US during the 19th century currently afflicts an estimated 2 million women, claiming the lives of another 800,000 each year in the underdeveloped world. An obstetric fistula is a tear between the vagina and bladder, urethra or rectum that occurs during childbirth. The result: incontinence and a broken spirit. The consequences of obstetric fistula can leave a girl physically impaired, emotionally scarred, psychologically damaged and socially ostracized. Lack of obstetric care plays a significant role- currently only 1 midwife per 100,000 people- yet child marriages remain the primary cause of fistula. In developing countries, fistulas are primarily a byproduct of child marriages. The strong correlation amongst child marriage, women's status and fistula suggests that an integrated approach focused on education, awareness and obstetric/maternal care will decrease fistula rates.
Actions
Midwives are crucial in a country such as Ethiopia, which has the lowest number of trained midwives in sub-Saharan Africa as well as one of the highest maternal mortality rate. According to a 2006 UNFPA report, there is only one nurse or midwife for every 62,000 Ethiopians. Organizations such as the UNFPA, EngenderHealth, and The Fistula Foundation agree that ensuring access to health care especially midwife & obstetric services, educating young men and women, empowering women to become self-sufficient and raising awareness will be critical steps in the fight to end fistula. To this end, Mimidae has designed a pilot program that aims to integrate health, education and self empowerment programs. After many years of research, Mimidae is ready to implement the pilot program. We are in partnership talks with the African Birth Collective, International Confederation of Midwives, the Addis Ababa Fistula Hospital as well as CSR Departments. Our team includes three doctors one of whom worked at the Addis Ababa Fistula Hospital, several midwives and volunteers. We are currently raising awareness as well as much needed funds to get our pilot program going.
Results
Our innovative approach will decrease gender inequality, maternal mortality and child marriage rates while increasing access to health care and education, promoting human rights and self empowerment, and providing economic opportunities for growth and development. We hope to have more concrete results once our programs implementation process has begun.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
Year One --Planning Phase
I. Framework Activities
A. Coordinate Resources
i. Secure Location
a. Assess condition of estate
ii. Set up center
a. Supplies from partners
b. Furnishings from contributors
II: Contact Partners
A. Addis Ababa Fistula Hospital
1. Recruitment and selection process
2. Develop evaluation report templates
B. Black Lion Hospital
1. Clinic day availability
2. Monitoring and evaluation reports
C. CSR Departments
1. Plan Donation Timeline & Logistics
2. Develop accountability & evaluation reports system
Year Two--Implementation Phase
I: Program Management
A. Coordinate volunteer teachers
B. Plan and Coordinate academic and clinic day schedule
II: Re-Contact Funding Sources
A. CSR Departments
1. Plan Donation Timeline & Logistics
Year Three--Pilot Program Launches
In the first round of our extensive program, ten fistula survivors that have been ostracized will join Mimidae. The women will live together, creating a healing environment that encourages openness and discussion. Each woman will complete a comprehensive midwife training program with an academic focus on the need for midwives, standards for care and concepts. Our women will observe ante-,intra-and postpartum, infant and maternal care, risk screening, emergency measures and follow-up procedures during their clinic days. Their time at the hospitals will help them obtain hands-on clinical skills and understand the administrative workings of an independent clinic. Upon graduation, they will pair up and select a village with a signficant need for maternal care where they will serve as a midwife and health care provider creating job and educational opportunities.
What would prevent your project from being a success?
The first and most obvious one is financing. Without financing our program will not be able to launch the program all together.
We do expecting illiteracy and cultural boundaries preventing Mimidae from implementing the program efficiently. However, Mimidae does not aim for efficiency but rather long lasting change.
How many people will your project serve annually?
1001‐10,000
What is the average monthly household income in your target community, in US Dollars?
Less than $50
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Idea phase
Is your organization a
Not registered
Is your initiative connected to an established organization?
If yes, provide organization name.
How long has this organization been operating?
Less than a year
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have a non-monetary partnerships with NGOs?
Yes
Does your organization have a non-monetary partnerships with businesses?
Yes
Does your organization have a non-monetary partnerships with government?
Please tell us more about how these partnerships are critical to the success of your innovation.
Partnerships will be vital to Mimidae’s inception. For example, CSR departments will donate furniture and old computers, International Confederation of Midwives will donate educational supplies and medical tools used for in class exercises. Certain partnerships will provide us volunteers through an internship program Mimidae is working to establish. Without these partnerships, Mimidae cannot come to exist unless Mimidae is given access to an excessive amount of funds. Mimidae believes that through creative and progressive collaborations, pressing health issues could be more readily solved.
What are the three most important actions needed to grow your initiative or organization?
1. Obtaining funds
2. Solidifying partnerships especially with the Addis Abeba Fistula Hospital because fistula survivors would be connected to Mimidae through them.
3. Connecting with communities to build trust and long-lasting relationships.
(not in order of importance)
The Story
What was the defining moment that you led to this innovation?
Having grown up in Ethiopia, I have witnessed the long lasting effects of socio-economic disparities on communities. With no running water, plumbing, electricity and safe roads being scarce, rural areas remained underdeveloped. Much of what I've seen stuck with me and the need to effect social change grew deeper. In 2001, I learned about obstetric fistula and was shocked by every fact and story I read. A memory of my father telling me I was lucky to have a good family "...you could have been one of those many girls that was be married off at 13" echoed in my mind. The connection to the issue was immediate. I decided that I would work towards building a nonprofit--once I knew how I was going to tackle the issue.
In 2007, I met two fistula survivors at a speaking event (Scaling Up Midwives) at the Woodrow Wilson Center in Washington DC. Their strength, humility and commitment to life despite having experienced extreme trauma was (still is) empowering. After our interaction, I thought that perhaps by working with fistula survivors, we would not only save individual lives but whole communities as well. After three years of research, development and preparation, Mimidae is ready to launch its first pilot program in Addis Ababa, Ethiopia.
Tell us about the social innovator behind this idea.
Born and raised in Ethiopia, she attended an international school from elementary school, all through high school exposing her to the various cultures of the world. Living in Ethiopia simultaneously exposed her to the many social ills that had riddled the country. She could not comprehend the stark differences that existed amongst the rich and poor. It is for this reason her life’s mission is to effect positive social change in any capacity. Yeabsira is a strong advocate for women's rights and maternal/child health (MCH). Currently, she is a very active co-chair of the United Nations Association LA Chapters YPIC (Young Professionals for International Cooperation). Yeabsira is also an active member of Feminist Majority Foundation, has served on the National Capital Ethics Committee board in Fairfax, VA and has worked with Help Uganda as an Advocacy Strategist for child soldiers. She is also a fellow at the StartingBloc Institute for Social Innovation. In her free time she enjoys reading, movies, learning how to play the guitar, outdoor camping and hiking, painting…and anything else that peaks her interest.
How did you first hear about Changemakers?
Personal contact at Changemakers
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Comments
Yeabsi,
I think this is a very interesting idea, and I think the concept of empowering fistula survivors to make change in their communities is an excellent ideas.
A few questions:
1) How will the women work to change the cultural factors that contribute to obstetric fistula? Will their training include work on gender equality and women’s empowerment? Changing longstanding attitudes about gender inequality is not easy, so more information about who you intend to reach out to and affect would be good here. For example, would you work with community leaders or parents to educate them about the dangers of forced marriage?
2) I would encourage you to broaden the scope of reproductive services beyond family planning. For instance, many women are married to much older (and more sexually experienced) men who may or may not have an STI. Women should be given information about the full range of reproductive health services they need beyond family planning and maternity care.
3) What action steps do you think are necessary to end early and forced marriage? Access to education? Community education programs?
(Read Below)
I think this idea is great and could potentially really help these women, however, I have some questions about how you think it will be recepted.
If these women are already ostracized from their community, is there going to be a problem getting people to actually go to a health center run by them? Are these women ostracized because because they are belittled or is there some belief that something is now inherently wrong with them?
(Read Below)
Thank you so much for your comments. I appreciate the feedback and questions. I started with a short background on fistula.
Quick Background on Fistula: An obstetric fistula is a tear between the vagina and bladder, urethra or rectum that occurs during childbirth. The result: incontinence and a broken spirit. Girls as young as 13 experience obstetric fistulas. A fistula occurs because the girl’s body is not fully developed and/or malnutrition and therefore is incapable of giving a successful birth. Often times, these young girls give birth on their own or with untrained traditional birth attendants. The consequences of obstetric fistula can leave a girl physically impaired, emotionally scarred, psychologically damaged and socially ostracized. Lack of obstetric care plays a significant role- currently only 1 midwife per 60,000 women but child marriages are the primary cause of fistula. Approximately 2 million women have untreated fistula, 100,000 women develop fistula each year, and 800,000 die.
To answer the questions:
Obstetric fistula is not a disease, but a medical condition correctable by surgery. It is true that much of the developing world measures a woman’s worth by the number of offspring she can provide and her value as a wife. Therefore, when a woman suffering from an obstetric fistula is ostracized because she does not meet the standards, one can see why she may not want to or is not allowed to return to her village. However, this is not the only reason fistula-sufferers are shunned. Obstetric fistula leaves women incontinent (urine, feces or both). Due to her incontinence, she cannot stop the foul odor that begins to permeate from her body. She often times is moved to an isolated part of the community where she lives as an outcast until she dies. This is also part of the reason why current statistics are not accurate. Most women living with fistula live in isolation and shame. They do not understand that the problem they are experiencing can be corrected. Often times, the nearest hospital is over a ten day trek—and that is not a long journey in some places. It is not hard to see why a lot of women do not step forward. Therefore, once our women complete the midwife training program they will be given an option as to where they want to work. We believe this will allow women to regain their dignity and confidence. I would like to point out however that not all fistula survivors are rejected by their communities. Some women have returned home healed and have been welcomed. It is also these women that re-experience fistula and find themselves going back for a second surgery. We hope our community programs will provide other alternatives. Mimidae’s main focus however is to provide opportunities for those that cannot or will not return to their villages.
Our implementation program begins with community building and community mobilization. While the women are in training, our focus is to create awareness and gain trust from communities we intend on working with. Through educational programs and incentives, we will teach the community about the dangers of early marriages both on the female as well as the community. Because child marriages are unquestionably linked to poverty, it is equally important to focus on building economic status; for example, providing scholarships to cover tuition and books and job opportunities for girls. This will delay marriage at least until the girl is 18. The International Center for Research on Women explains, “Expanding opportunities for girls and young women can help change social norms that view marriage as their only option, particularly in cultures where bride price and dowry are common”.
Mimidae does not want to push programs into communities but rather build community and keep members involved in the process. To ensure our program will be successful, we initially identified objectives and priorities broken into three categories (both long and short term progress): gender equity & equality, socio-economic progress and sustainability. In each, community leaders and members expressed their priorities, concerns and socio-economic needs ranging from the general (i.e. better income, employment) to more specific (i.e. clean drinking water, fuel wood). The aim was to get a holistic picture of a community’s needs to assist us in planning programs. (While our programs are completely scalable, each can be tweaked to the more specific needs of a community). (A post-implementation program audit will also be carried out using specific indicators to test our objectives and make necessary adjustments).
Initially, our programs will be serving in a limited capacity until Mimidae receives more funding. Our family planning program will provide services such as health and hygiene awareness, STD/STI awareness and testing, contraception options, encouraging women’s full participation in society, creating opportunities for education and employment, and raising awareness of women’s rights. One of our primary goals is to work with young girls who have already married. In international efforts to delay and prevent child marriages, the girls that have been married off are often forgotten. Mimidae’s family planning service will help educate them on the importance of spacing out their pregnancies, dangers of sexually transmitted diseases and infections as well as better infant health care options.
I hope I have answered all the questions. Look forward to hearing your feedback!
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