Juul Bakker contacted us in April as she was just ready to leave for a job in Gambo, Ethiopia. Half a year has passed and we recently asked Juul about her first experiences as global health doctor in Gambo General Rural Hospital.
Juul completed the postgraduate Global Health & Tropical Medicine programme in 2017 after a 6-month internship in Makunda, India, where she focussed mostly on obstetrics and paediatrics. ‘Here, I was able to train my clinical- and operative skills and work indepently, although supervision was always available. It was a perfect step-up to my first job as ‘real’ global health doctor.’
While in India, Juul started looking for jobs in the field and came across the job offer for a global health doctor for the Gambo Rural Hospital in Ethiopia, 250km south of Addis Abeba. As they required a doctor with a focus on maternal health the fit was perfect. Gambo Hospital was founded as a leprosy colony, but is now a general hospital with 150 beds. It serves a rural, mostly poor population. Juul works together with a local paediatrician and an internal medicine physician, as well as with Ethiopian medical students in their final year of training. Most employees are keen to work and the team is very close.
Juul spends her time predominantly in the maternity department. Here, she oversees antenatal clinic visits, helps patients with all sorts of gynaecological complaints and oversees both uncomplicated and complicated labour, conducting caesarean sections or assisted delivery if necessary. During out-of-hours shift she is also responsible for the paediatric-, surgical- and other admissions.
In Ethiopia around 350 women per 100.000 live births die (compare this to the Netherlands, where the mortality rate is 7 per 100.000!). To battle this, Juul and her colleagues are starting a community project. She explains: ‘About 25% of women still deliver at home with traditional birth attendants. Efforts to fight maternal mortality have to be conducted together with rural health centers and the birth attendants. Many complications are preventable. The last woman we lost for instance had travelled on horseback for three days, having passed several hospitals en route. If we work closer together in the community we hope that cases like this one, can become a thing of the past. The first step will be to get a feeling of how hospitals in our community approach maternal health. Then we will draw up a plan including supervised learning and (obstetric) clinical training sessions for all health personnel. ’