Elikem Archer

Elikem Tomety Archer is Director of Africa and Middle East Partnerships at AmeriCares.

International Day to End Fistula

Surgery repairs fistula and restores dignity and hope. Photo: David Synder

Today is International Day to End Fistula.  I’m glad that the international community is coming together to bring global focus on an issue that affects about 2 million women in developing countries, with 100,000 new cases each year.  The sad truth is, fistula is completely preventable with the right access to maternal care, trained birth attendants and availability of emergency obstetric care – in most cases a simple C-section.

When I think about fistula, I think about a young woman who received care in the AmeriCares fistula repair project at Bugando Medical Centre in Tanzania, with gift-in-kind support from Ethicon, part of the Johnson & Johnson family of companies.

Mercy* was 18 years old when she arrived at the hospital with a fistula she had acquired after 2 days of labor without medical intervention. Mercy lost her baby, but developed a fistula – a hole in her birth canal — which left her incontinent.  As a domestic worker earning less than $2 a month, Mercy could not afford curative surgery. But after learning about our project at Bugando Medical Centre which offers free care and a transportation fund to help impoverished patients like her, she was able to have her fistula reversed and her dignity restored.

This video, produced for Johnson & Johnson, was filmed in Ethiopia and Tanzania in March of 2013.

Mercy’s story is a common one in sub-Saharan Africa: a young girl living in poverty with no access to family planning gets pregnant and endures long hours of labor without the presence of a trained birth attendant.  Because most of these young girls have bodies not completely ready for birth, their babies have difficulties getting through the birth canal and often die – leaving the mother not only childess, but ostracized and stigmatized.  Many girls and young women just like Mercy suffer with this condition for years — even a lifetime — because of the lack of local awareness that fistulas can be reversed.

Today and every day, AmeriCares is working to change that.

In Tanzania, public service announcements on local radio get the word out that fistulas ARE reversible, and that care is available free of charge at Bugando.  We are also taking the message to the rural areas with outreach campaigns that not only inform the community about the cost-free curative surgery, but bring qualified doctors to conduct those surgeries to the local district hospital.

So one Mercy at a time, we’re providing hope and restoring dignity to fistula patients in Tanzania — something to celebrate on this International Day to End Fistula.

Learn more about our work in Tanzania here.

*Name changed

On being a mother…

My career in global health parallels my journey into motherhood.  I was heavily pregnant when I started working at AmeriCares and my first son was born six days after my first day on the job. I took my first trip to the field, visiting our partner in rural Malawi, my son was only seven months old.

Because of this parallel, I often see my work in the field through the eyes of a mother. On that first trip to Malawi, I saw a little boy about 18 months old who was severely malnourished. As a result, he was about the same size as my seven-month-old son. I understood the anguish of the mother who had walked several miles to the hospital with her son in her arms seeking care – for as a mother, I’d do the same.

Last year, on a trip to Liberia, the land of my birth, my heart was pierced when I heard wailing coming from the maternity ward – a wailing that only meant one thing: a mother had lost her baby. Having gone through the prospect of losing my son a day after he was born, I walked away haunted by that piercing cry and the thought that this mother could have been me.

For you see, the difference between me having two healthy sons and that woman crying in the maternity ward most likely lies in the fact that my son had access to emergency neonatal care. In the United States, four neonates die per 1,000 live births, while in Liberia, about 11,000 babies are dying within the first month of life. Think for a moment about how many mothers cannot celebrate Mother’s Day in Liberia without a hole in their heart because of this staggering number.

The need to address neonatal mortality in Liberia and across sub-Saharan Africa has become a matter of urgency. World Bank President Jim Kim recently said, “For most poor people, a good job is the key to escaping poverty. To get those jobs, they’ll need good skills, a quality education, and years of good health as they’re growing up and when they’re adults.” Kim is right, because children all over the world are born with the same potential.

I’ll never forget little Kofi* — a boy I met two years ago at a children’s home in Tamale, Ghana. He was about four years old then. Kofi was introduced to the iPhone by a visitor to One Child One World™  — a program which aims to reduce the incidence of malnutrition in 30 homes around the country. Within minutes, Kofi was flipping through the phone, looking at pictures and was as engaged as any child of his age here in the United States with a smartphone. In that moment, the potential that lay in Kofi was clear to me and everyone present. The question that remained unanswered as we left that home was whether he will in his lifetime have the opportunity to realize it. 

Kofi’s chance to get out of poverty depends on, among other things, years of good health. A journey that begins at birth and with a mother having the access to the health services needed to take him home healthy after delivery. That this isn’t the reality for most mothers in developing countries should give us pause on this Mother’s Day.

*name changed

Why We Wear White When Babies Are Born

I remember my aunties coming home after having a baby – they always wore white beautifully designed slit and kaba – the traditional outfits in Ghana.  Then seven days after the baby is born, there’s a naming ceremony where the baby is ‘outdoored’ or formally introduced to the world and given a name.  Before that the baby is referred to as ‘it’.  Everyone is in white at this ceremony and there’s a lot of celebration – drinking, eating and dancing.  One day, I asked my grandmother why we wear white after a baby is born and why we wait seven days before giving a baby a name.  Her response was that the white symbolizes victory – victory over death.  As the laboring mother had faced death and prevailed.  And we wait seven days to give a baby a name because we wanted to make sure the baby had decided to stay among the living before we gave it a name.

As a girl, I never understood the full impact of my grandmother’s words.  It wasn’t until several years later working in global health that I came to understand the perils of childbearing in Africa – and why it is indeed true that every time a mother in Africa comes home with a new baby, she has indeed faced death and triumphed.  The WHO has named maternal deaths in Africa as “Africa’s silent epidemic” and Africa has the highest rates of maternal deaths and infant mortality globally.  The sad truth is, for every woman in Africa who dies giving birth, there are 30 more who live with debilitating diseases like fistula due to complications during the birthing process.

There are a number of factors driving this:  lack of adequately equipped health facilities, lack of trained medical birth attendants, lack of medicines like oxytocin. There are also simple solutions that have proven successful such as working with traditional birth attendants to identify risk factors, quickly referring mothers to trained birth attendants, using community health workers to follow up on pregnant mothers in rural communities, and using cost-effective and sustainable techniques like Kangaroo care to provide needed warmth to low birth weight babies.

Africa’s story often starts and ends with the challenges, but today on International Women’s Day, I want to wear a white slit and kaba and celebrate with all the brave women I meet on the continent every day:  The HIV positive mother in rural Malawi who walks over an hour to get to the hospital each week to make sure her baby is receiving the ARVs needed to ensure that the disease is not passed on, the grandmother taking care of the double-orphaned child and tending the small garden so she has enough food to feed the child, the midwife who delivers five children a day with gloves she has to reuse because she doesn’t have a choice, and the pediatrician in Kumasi, Ghana working around the clock to save neonates.  I salute all these women because it is their commitment and dedication that ensure that countless women in Africa who face death every day in childbirth can leave the hospital wearing white.  So today, I wear my white slit and kaba too.



Malawi Field Report

A mother attends to her child being treated at the AmeriCares-sponsored therapeutic feeding center in Malawi.

Elikem Tomety Archer, AmeriCares partnership manager for Africa, worked extensively in Africa including health programs in HIV/AIDS, malnutrition and anti-blindness initiatives. Elikem shares her most recent trip and tales of hope, from Malawi.

We left New York on a chilly Thursday morning and finally arrived in Malawi on a sunny Saturday afternoon. As soon as our plane landed on the tarmac, we were greeted by our local partners and got right to work. We literally hit the ground running.

Help save lives in Malawi and around the world » 

On the Ground:

Malawi is heartbreakingly beautiful. The country was once the breadbasket of Africa. Sadly, severe droughts have made for a rapid decline. During times of drought, lush greenery is replaced by a constant haze of dust on the barren horizon. The country is still recovering from a devastating drought that sparked a famine that killed hundreds and caused severe malnutrition in 2002.

Malawi is one of the world’s least developed countries, ranked number 166 of 177 countries on the Human Development Index. HIV/AIDS is the leading cause of death with 14% of the population is infected and nearly 100,000 people dying each year. Despite the government’s commitment to improving health, life expectancy is barely 41 years.

The people of Malawi now face disease and crushing poverty on a daily basis – yet they treat every moment alive as a gift, knowing first hand how fragile life really is.

But even when Malawi’s children don’t contract deadly disease, they face major challenges and can suffer with chronic malnutrition. That’s why AmeriCares helped build a therapeutic feeding center in Malawi.

Urgent Needs:

Over the years, I’ve had the pleasure of visiting and working with our partners, which has been receiving AmeriCares support since 2002. I have consistently been impressed by the love and care I see among the people there. Despite the presence of well-trained doctors – many graduated from both local and prestigious Western medical schools – the hospitals and clinics have limited ability to provide care and virtually no diagnostic capabilities. They would have few medicines and supplies were it not for donations.

Equipment is out of date and much of it is in great need of repair. Supplies that would be discarded in the U.S. are often recycled and reused.

Most families in Malawi live on remote farms, making access to health care nearly impossible. The average patient must walk for miles to get care; people delay getting care, which only makes things worse. In response, AmeriCares outfits teams of health workers with medical backpacks and bicycles to bring health care where it’s needed most.

One of the most memorable workers, Victor, makes house calls to pregnant women at high-risk for passing on HIV/AIDS to their unborn babies. Their medicines are very complicated, and Victor patiently and carefully makes sure they take just the right dose at the right time. I was thrilled to learn that the program has a 97% success rate and that so many children are born free of the deadly disease.

But even when Malawi’s children don’t contract deadly disease, they face major challenges and can suffer from chronic malnutrition. That’s why AmeriCares helped build a therapeutic feeding center in Malawi. The child I remember most was a young toddler who arrived at the Center just in time. He was emaciated. His fragile mother had carried him the whole way from her home, walking for nearly a day to bring him to the Center. Being the mother of my own young son, my heart went out to them. Her son stayed on intensive feeding for two solid weeks. When we made a follow up visit, I could not believe my eyes! His chubby cheeks and smiling face showed us that he was now thriving – reminding me of my own healthy little boy.

How we can help:

When I see first hand the results of our work with the people of Malawi, I feel all the more inspired to help AmeriCares efforts thrive and succeed. Their dedicated doctors and health workers make the most of every donation we give. Among the supplies they need the most are basic pain medicines, antibiotics, bandages, syringes and needles.

Maternal health is of serious concern. Many women have high-risk pregnancies and 25% of babies at local hospitals are born by surgical c-section. To care for these moms, they desperately need anesthesia, ultrasound machines, surgical equipment and other supplies to help with difficult deliveries. I was glad we were able to provide some relief with a donation of epidurals (strong medicines that help reduce labor pain while allowing a woman to remain awake during delivery), but so much more is needed.

I look forward to the day when I can return to Malawi and see more families living longer, healthier lives thanks to help from AmeriCares.

Help save lives in Malawi and around the world »