When fighting destroys a health facility, a community comes together to reconstruct a bigger and better clinic for its youth.
Hope was one of things most easily lost when conflict arrived in BirBir, a community in northern Ethiopia, in 2020.
Aberaw Mamo, a 24-year-old nurse at the health clinic in BirBir, says the facility was ransacked and destroyed by fighters, leaving the staff incapable of helping people in need. The worst, for him, was when a 14-year-old girl who had been raped during the fighting and underwent an unsafe abortion arrived at the clinic in need of emergency assistance. “We could not aid her,” Mamo says, because the clinic had been looted and badly damaged. “We could only refer her to another facility, and she died before she could get there.”
The conflict in 2020 and 2021 was a low point for the clinic. “We were displaced and spent two years away, at first in Sekota, and later in Bahir Dar,” says Mamo. Unable to deliver any health care during the conflict, Mamo and other staff thought the clinic was closed for good. “We never thought this place would provide any more services.”
Rebuilding
Mamo works at a reproductive health clinic at the BirBir health center that provides a range of services to young people, including contraception, pregnancy testing, family planning, treatment for sexually transmitted diseases (STDs) including HIV/AIDS, counseling, and life skill training for youth. Before the conflict, he and one other nurse worked out of a one-room office/waiting room/exam room in the main clinic.
When it was all destroyed, the staff worked with Oxfam and Pathfinder International, with funds from the Canadian government, to construct a new, three-room building on its own concrete foundation separate from the rest of the BirBir clinic.
There is now an office, an exam/treatment room, and a room for youth to meet, read, and play table tennis. Twenty-five peer educators help provide life skill training, sexual and reproductive health information, and raise awareness about how to prevent STDs and early marriage.
“Since we got these three rooms we are really exhilarated,” says Bethlehem Feleke, a 24-year-old nurse who works at the clinic, who everyone calls Betty. “We can talk freely, there is some privacy, and the youth have a place to meet and learn,” she says.
“It was difficult to rebuild this place,” Feleke says. She adds that their hard work and persistence are starting to produce results, pointing to the data they are tracking on large sheets of paper on the wall of the office indicating progress in several areas. Mamo indicates one of the sheets: Teen pregnancy rates, once up to 19 percent in 2020 and 2021, is now down to 9.7 percent.
Atsede Bere, a 23-year-old married mother of two, stops by the office to chat with nurse Betty Feleke. She has an infant in her arms, and a big smile on her face. She says the clinic serves an important role in the community. “When we are sick, we get treated here,” she explains. “We also learn how we can plan ahead with our husbands, and we understand how to get contraception.” After having two babies close together, Bere says she and her husband consulted with staff here and decided to use a long-acting (three-year) contraception.
Hope for the future
Aberaw Mamo looks over a binder that documents all the equipment that this clinic lost during the conflict in 2020. He flips through the pages of lists: computers, wooden shelves, books, even the coffee cups and spoons.
“Everything was looted here,” he says.
“I felt really hopeless when I left,” Mamo says. “But when I came back and we started working again, it gave me hope.”
A sense of optimism is essential when working with young people, Mamo explains. “If you are hopeless, you can’t give hope to others.”