Survivors enlisted in Sierra Leone’s Ebola battle

An MSF medical worker feeds a child at an MSF facility in Kailahun on August 15 2014. Kailahun along with Kenama district is at the epicentre of the world's worst Ebola outbreak. (Pic: AFP)
An MSF medical worker feeds a child at an MSF facility in Kailahun on August 15 2014. Kailahun along with Kenama district is at the epicentre of the world’s worst Ebola outbreak. (Pic: AFP)

Hawa Idrisa was visiting her father-in-law in an Ebola ward in eastern Sierra Leone when his drip snapped out and his atrophying veins spurted thin, uncoagulated blood into her eyes and mouth.

She had been carrying her infant daughter Helen but luckily she had laid the child down, otherwise the baby would almost certainly be dead by now.

A single droplet of blood smaller than a full stop can carry up to 100 million particles of the deadly Ebola virus, yet one is enough to end a human life.

“The blood got all over me, and people were running away. So I took a bucket of chlorine and poured it over myself,” Hawa said.

She returned home to forget her ordeal, but a week later she began experiencing fever and headaches, the early symptoms of the Ebola.

Her 12-month-old mercifully tested negative, but her husband Nallo was infected and he and Hawa checked into the Doctors Without Borders’ (MSF) treatment facility in the eastern district of Kailahun.

Hawa spent four weeks drifting between life and death at the centre, in the district capital Kailahan city, a trading post of 30 000 in the Kissi triangle linking to Liberia and Sierra Leone.

“I didn’t know what was happening to me. I didn’t even know where I was. I don’t remember anything from that time,” she told AFP of the ordeal she survived.

Ebola kills more than half of the people it infects, putrifying their insides in the worst cases until their vital organs seep from their bodies.

It is highly infectious but not particularly contagious, meaning that once you are exposed, your chances of escaping the fever are extremely low, although it can only be passed on through bodily fluids.

The good news is that when patients are caught early enough, given paracetamol for their fevers, kept rehydrated and nourished, their chances of survival increase dramatically.

Hawa proudly shows off a certificate saying she has recovered fully, and she is preparing to return home.

“I know there is nothing wrong with my daughter, but my mind and heart will be at the centre with my husband,” she says.

Hardest-hit districts
Already more than 2 100 people have been infected across four west African countries, and 1 145 people have died, dwarfing previous Ebola outbreaks.

The epidemic is perhaps worst of all in Sierra Leone, which has registered 810 cases, more than any other country.

A sign warning of the dangers of Ebola outside a government hospital in Freetown on August 13 2014. (Pic: AFP)
A sign warning of the dangers of Ebola outside a government hospital in Freetown on August 13 2014. (Pic: AFP)

The hardest-hit districts, Kailahun and the diamond trading hub of Kenema next door, have been sealed off to ordinary members of the public.

Around a million people in the two districts are in effective lockdown, and locals say soaring food prices are pushing the region towards a crisis.

Local doctors and nurses are fighting not just the disease, but also the distrust of locals who fear modern medical practices.

Relatives have been known to snatch infected loved-ones from clinics to die in their own villages, exacerbating the spread of the virus.

They have even attacked treatment centres – as armed men did in neighbouring Liberia at the weekend – convinced that Ebola is a Western conspiracy against traditional African communities and that foreign healthworkers are in on the secret.

Some 1 500 police and soldiers have been deployed to prevent raids, but they are powerless faced with the suspicion and fear of poorly educated traditional communities.

Many tribespeople at the epicentre of the outbreak either don’t know how to prevent and treat Ebola or do not believe it exists at all.

This, says MSF, is where the survivors come in.

Survivors returning home
Ella Watson-Stryker (34), a health promoter with the aid agency, is part of a team taking Hawa and other survivors home to their villages.

She will gather their neighbours and family members around, answer their questions about the virus and try to reassure them that Hawa poses no danger.

“This is very exciting for us. It’s also really beneficial to the overall response to the outbreak because when survivors go home, they can explain about their stay at the centre.

“They give people hope that it is possible to survive and it really builds trust between the community and MSF,” she says.

Watson-Stryker also says that when survivors go back to their communities, people begin to understand that treatment centres are not just “a place where people go to die”.

They are surprised to learn that patients are fed, given unlimited soft drinks, access to toilets, showers and medicine, and that their families are encouraged to visit.

“We try to assuage the fears of the community, because there are a lot of rumours out there, that as soon as you come to the treatment centre you will just be left to die.”

Back at the MSF centre, Nallo enthuses about his future with Hawa and their baby girl, despite remaining in grave danger in the high risk area.

“At first people thought that when they got here, they were going to have all their blood removed and they would die,” he says.

“They have been giving me drugs and I am much better, so when I get back to my community I will tell people that if it ever happens that they get Ebola we advise them to come here.”

Role reversal as African technology expands in Europe

Africans have long used technology developed abroad, but now a Kenyan cash transfer network which bypasses banks is being adopted in Europe.

The M-Pesa mobile money transfer system which allows clients to send cash with their telephones has transformed how business is done in east Africa, and is now spreading to Romania.

“From east Africa to eastern Europe, that’s quite phenomenal when you think about it,” Michael Joseph, who heads Vodafone’s Mobile Money business, told AFP in the Kenyan capital Nairobi.

“I think that this is something the rest of the world can look at, to say that there are ideas that can emanate out of the developing world, and take it to the developed world.”

M-Pesa – or “mobile money” in east Africa’s Swahili language – was introduced in Kenya in 2007 by Safari.com, the country’s largest mobile telecommunications company, in partnership with British giant Vodafone.

(Pic: AFP)
(Pic: AFP)

Since then the service has grown exponentially, with about $40-billion flowing through the service in Kenya alone.

Part of daily life
In Kenya, the system has become a part of daily life, with more than 18-million customers, and is used by almost two-thirds of the population with more than eight million transactions daily.

The network allows customers to bypass the traditional banking system, using an application available on the simplest of mobile phones to pay utility bills, buy a drink in a bar, or send cash to family and friends.

Romania is the latest nation Vodafone is tapping, with its first European launch last March.

For Michi Carstoiu, an engineer in the capital Bucharest, M-Pesa complements established online payment services.

“Most importantly, I save time – plus I think the transaction fees are smaller,” Carstoiu told AFP, shortly after activating his mobile phone account at one of the 1 000 outlets already open.

The number of distribution points is expected to triple by the end of the year.

“Everyone has a mobile phone, and it is very simple to send and receive money or make payments,” he added.

Users can charge up their phones by paying in cash at mobile-money agency points, and often at one of the points where they are doing a transaction.

Similarly they can withdraw cash against mobile-money credits at an agency, or when settling a bill, much in the same way as customers in Europe can obtain cash at some supermarkets when using bank cash cards.

Agents are often found in the form of shops or street kiosks.

The outstanding credit can be sent via a special text message to others for a small transaction fee.

African countries using the system include Egypt, Lesotho, Mozambique and Tanzania, and it has also been rolled out in India.

A savings version has been set up as well, allowing those without access to formal banking systems to earn interest on their savings.

The scheme has largely succeeded in Kenya because it meets the needs of millions of people without a bank account who would otherwise operate strictly within a cash economy.

They benefit from a network of M-Pesa agents spread across the country.

Romanians reliant on cash
Officials said that Romania was chosen as the European launchpad because many people in the eastern European country still rely on cash.

“The majority of people in Romania have at least one mobile device, but more than one third of the population do not have access to conventional banking,” Joseph said.

He is targeting seven million potential Romanian customers who operate in cash alone, and the company aims to reach 300 000 customers by the year’s end.

More than $1.2 billion worth of person-to-person transactions are sent on the system each month worldwide, according to Vodafone.

In Kenya, transactions can be as small as a single cent or as much as $1 600, while in Romania up to $9 000 can be sent each day.

Moving beyond emerging markets means adapting to fresh challenges however.

The operator will face different regulatory environments, and consumers who already have access to a wide range of financial services.

For Kenyans, where the network is used for everything from paying for grocery shopping and restaurant tabs to sending cash to relatives in remote regions, the spread abroad has given some a sense of pride.

In a way, the M-Pesa system has taken banking full circle, back to the founding principles of Venetian banking when money changers began keeping ledgers of credits and debits for traders who did not want to carry gold and silver with them.

These money dealers set up networks of correspondents, or agents, who ran parallel ledgers, enabling traders who otherwise had no “banking” system, to settle accounts, paying in or drawing out cash only when necessary.

“Technology that started out in Kenya is being exported to Europe,” said 24-year-old Rhoda Kibuchi, who runs an M-Pesa outlet in Nairobi. “It’s good news.”

Dear Zanu-PF, here’s my application for one of those 2.2 million jobs you promised

Dear post-election Zanu-PF (aka Government of Zimbabwe)

RE: APPLICATION FOR ONE OF 2.2 MILLION JOBS

With reference to your election manifesto, which excited even the MDC-T to splitting point and made me put a cross next to your name on the ballot paper, I hereby apply, publicly, for any one of the 2.2 million jobs you promised in Zim Asset. In case you have forgotten, this is that economic blueprint you came up with in October 2013, which is meant to “to provide an enabling environment for sustainable economic empowerment and social transformation to the people of Zimbabwe”.

July 31 marked exactly one year since I cast my first official ballot in the country’s elections, ending previous attempts at maintaining my political virginity. Now, there is some background I should give you. I do not bet or play the lotto because everything I put my bet on seems to lose. Even when I want my football team to win, I don’t watch the match. That is why I have not been voting all these years. I hated to see what I love losing. But last year, for the first time, I took the risk – and the jinx was broken! You won the election. However, looking back on my country, I’m concerned about whether the jinx was really broken. Could it be that in you winning massively, Zimbabwe actually lost quite a lot?

Forgive my rambling. With so many of my job applications gone unanswered, I do not know if it was my cover letter that failed me, or the comma that was missing from my CV, or if it’s just that none of the 2.2 million jobs you promised are on the market yet. But the issue at stake here is that I am looking for a job, and urgently so, because I am 31 and unmarried and cannot afford to be unemployed. One may ask why I am applying to you. Most of the companies I approached are either already closing down or downsizing staff, and employing me is an unrealistic dream for them. But I know you have 2.2 million jobs that you promised me in 2013, and I have come to claim at least one.

I am one of those “resources that gives Zimbabwe a comparative advantage over regional and other international countries is its economic complexity that includes the strong human resource base, which is an outcome of a deliberate educational policy instituted by the ZANU-PF Government at Independence in 1980.” Unfortunately, I have been trying to make myself a useful resource with little success, hence I’m approaching you so that you can employ me.

I hold a qualification in tourism and hospitality, among other numerous qualifications, and should be glad that tourism is one of your key target economic areas with huge potential. It’s just that I have not seen what you referred to in Zim Asset as “Quick Wins” or “rapid results yielded “in the shortest possible time frame (October 2013 – December 2015)”. Obviously I blame this on the fact that no initiatives have been implemented or “blitz interventions” made since I voted for you. Damn the sanctions, of course. Oh, I had forgotten that there are also sanctions-busting strategies. So damn the inaction. What have you been doing this whole past year?

Secondly, survival has taught me all these other vital skills and given me a great deal of experience, which will account for any gap periods in my CV. Like most others, I am now a serial entrepreneur, sometimes vendor, marketer, social media enthusiast, administrator, occasional job-hunter and writer. So, do not get me into the unemployed-experience-unemployed conundrum. I don’t deserve it, neither do millions other Zimbabweans who have faced desperate situations, including this economy, and lived through it.

And if there are any other things that you deem important which I do not have, such as a driver’s licence and a passport, please remember that I might not have been able to afford the $200+ required to bribe driving inspectors, or had the time to wait in unending queues at the Registrar General’s offices.

And lastly, if it turns out that all the other vacancies have already been filled by the numerous educated but unemployed youths roaming the streets – most of whom are thinking of leaving the country – I would like to become one of the officials in the Office of the President and Cabinet who will “play a leading and co-ordinating role as overseer of the implementation process to ensure attainment of set targets of the Plan.”

At least I know that vacancies still exist in this section of Zim Asset because, with nothing happening, my only guess is that no one is co-ordinating the implementation process of this brilliant document. My claim to employment in this section is backed by my qualification in monitoring and evaluation, and validated testimonies that I am discreet, patriotic and intelligent enough to meet your requirements.

Please note:

  1. Do not take this a joke; I really need a job and so do millions others. And the earlier you make those “blitz interventions” for “Quick Wins”, the better it is for all of us. December 2015 is not far away.
  2. At this point don’t refer me to non-working youth funds. I have tried those before. All I need is a job. A piece of land would be a welcome alternative though.
  3. Please ensure that I get a job in haste before South Africa and its post-election ANC deport the more than 3 million jobless Zimbabweans there back home.
  4. I can attend interviews as fast as the kombi you want to banish without an alternative can take me to the venue.

Regards (because we are compatriots and I deserve better from you),
Lawrence Hoba

 

Lawrence Hoba is an entrepreneur, author and passive politician.  His short stories and poetry have appeared in The Gonjon Pin and Other Stories, Writing Lives, Laughing Now, Warwick Review and Writing Now.  His anthology, The Trek and Other Stories (2009), was nominated for the NAMA in 2010 and went on to win the ZBPA award for Best Literature in English. It tackles the highs and lows of Zimbabwe’s land reform. Connect with him on Twitter: @lawhoba

Ruka: An artistic exploration of the African hair braiding salon

The art of hair braiding has taken centre stage in pop culture in the past few months, from Chris Pratt’s surprisingly good French braiding skills to the return of the braid in Valentino to Vivienne Westwood Fall runway shows. In South Africa, a documentary by blogger Miss Milli B has served as a platform to discuss the politics of black hair in its various styles and textures. Most recently, Hollywood’s new darling Lupita Nyong’o highlighted hair braiding as a cultural practice in a video for Vogue.

Shot in a salon in New York, we see Lupita showing off her braiding skills on her friends’ hair. She learnt the technique from her aunt when she moved to the United States. She’s been doing their hair for years, and the camaraderie between them is evident.

Among Lupita’s group of friends is Nontsikelelo Mutiti, a visual artist whose recent exhibition Ruka (Shona for to braid/to knit/to weave) examines the social function hair braiding has apart from the aesthetic.

Mutiti is a Zimbabwean-born artist and educator who works across disciplines – fine art, design and social practice. Her Ruka project was exhibited at Recess, a non-profit art space in Soho, New York from June 3rd to August 2nd . It included an installation and an exhibition of hair braiding across traditional and contemporary contexts.

Black hair magazines from the 90s, African print fabric from Senegal and linoleum floor tiles are some of the materials that make up Nontsikelelo Mutiti's braiding salon installation. (Pic: Monika Uchiyama)
Black hair magazines from the 90s and African print fabric from Senegal are some of the materials that make up Nontsikelelo Mutiti’s braiding salon installation. (Pic: Monika Uchiyama)

I caught up with her recently to discuss the project.

What was the source and inspiration for Ruka?
I accompanied my cousin to get her hair done one Sunday afternoon in 2010. We went uptown to Harlem, New York. Upon arriving at the braiding salon I was struck at how much it reminded me of hairdressing spaces back home in Harare.

The bright walls, loaded conversations, hair dressing posters, the vendors coming in and out selling small items like socks, candy and makeup. It was fascinating for me to realise the way the women working in the space had created a facsimile of something ubiquitous at home. The women working in the salon were not from Zimbabwe; they were form different parts of West Africa.

Future visits to Harlem revealed the multitude of women that do this work in New York City. They line 125th Street, soliciting business from potential clients from street corners to the doorways of multi-story buildings shouting out: “Braiding? Braiding, Miss? I give you good price!”

What has been the reception to your work so far in the States, particularly in light of actresses like Lupita Nyong’o promoting the tradition of hair braiding in popular culture?
I was glad that Lupita chose to highlight this cultural practice through a platform like Vogue. Giving visibility to the craft and taking ownership of this skill is a powerful statement that assigns value to braiding and braided hairstyles. There was a wonderful sense of community on set. On and off camera we shared personal experiences, advice and memories. It was wonderful to get my hair braided by Lupita. She is very good and I know how long it takes to build up these skills.

Braiding is not just about beauty; it is also about perseverance, trust and creativity. It is also such a generous act, spending time with someone, working on them. I hope the audience learnt all these things from the video. These ideas were certainly reinforced for me.

The exhibition included a screening series of iconic braided hairstyles worn by stars. Here, Jada Pinkett Smith wears a braided bob. (Pic: Monika Uchiyama)
The exhibition included a screening series of iconic braided hairstyles worn by stars. Here, Jada Pinkett Smith wears a braided bob. (Pic: Monika Uchiyama)

What has been the biggest lessons you’ve learnt in the process of connecting with a theme so pertinent to black female identity?
When we speak of black female identity we have two important themes pressing up against each other – gender and race.

Braiding is a means of adorning the body. Because of my socialisation I tend to imagine it as something associated with women, but looking at a range of cultures we find that people that identify as masculine also wear their hair braided.

Whilst discussing braiding and gender during a studio visit, Andrew Dosumno (an acclaimed Nigerian film director), mentioned that there are tribes in Nigeria where men who are involved in certain spiritual practices can wear braids.

It has been interesting to do this project at a time when people that identify as black in America are going ‘natural’. Braiding has become a very important grooming choice. There is something that feels akin to the ‘Black is Beautiful’ movement. People are choosing to sign their bodies with an aesthetic that refers to or acknowledges African heritage.

My observations have led me to consider how we read images of each other and what it means to emulate or aspire to a particular aesthetic. We are really using hair to mark our bodies and sign specific messages to each other: ‘I am proud of my ancestry’, ‘I will not be defined by western ideals of beauty’, ‘I am cosmopolitan’, ‘I am sophisticated’, ‘I have a range and breadth that goes beyond my traditional culture’. In the context of my home, Zimbabwe, we use braiding most often to add in new hair colour, texture and artificial length.

What has the audience reception been to your exhibition?
People coming into the space have really felt like collaborators more than an audience. The project emphasises community engagement and artistic research.

This piece - black and blue spray paint on black linoleum floor tiles - is part of an on going visual research project involving pattern and repetition of the braiding motif. (Pic: Monika Uchiyama)
This piece – black and blue spray paint on black linoleum floor tiles – is part of an on going visual research project involving pattern and repetition of the braiding motif. (Pic: Monika Uchiyama)

People have signed up for braiding workshops led by an invited facilitator. We have all felt empowered by the skills we have learnt. There are some of my older works as well as new sketches and collections of objects like combs, movies, fabrics and books, Nollywood and American movies in the space. The different elements that make up the installation have become wonderful tools for starting extremely meaningful, open conversations. Visitors have been very generous, sharing personal narrative or memories sparked by an object or image in the space.

Some people come in and are confused because they think it is a real hair salon. The project is playing with the boundaries between a few things. It is a salon and classroom and art studio, film screening room all at once. In essence that is what an African hair braiding salon is.

Will the exhibition be travelling to parts of Africa? How much more or less do you think it will it resonate with the audience here?
Doing this work in different communities is very important to me because I am not just making artwork; I am learning and sometimes teaching and sharing. I am sure the project will look and feel different depending on each iteration.The community have a big role in shaping what I make and get out of the experience. Because braiding has different connotations in different communities I am sure the work will read differently in different spaces. A range of interpretations makes for an even richer body of source material for continued research and art.

Have you found inspiration for your next exhibition?
The braiding project is ongoing. I am looking forward to starting a related publishing project and continuing to make new artworks based on different braiding patterns. I am also thinking of creating a dedicated space for continued practice and research around this craft.

I am developing a new series of video works titled Black Hair Aesthetic Study with my collaborator Shani Peters.

Jeanine Meyer, a colleague from Purchase College, is assisting me with coding online tools to teach a wider engage a wider audience in thinking and learning about the practice and cultural significance of braiding.

One project I am looking forward to is inspired by Dutch wax fabrics, another is about names.

My goal is to make work that can live in the world. It is wonderful to have institutional support for this type of work because it is not easy to fit all projects within a traditional gallery or museum setting. I look forward to other opportunities to share my work with people in formal and informal settings.

Ethiopia’s game-changing abortion law

(Pic: Flickr)
(Pic: Flickr)

After decades battling high maternal death rates – at least a third of which were due to botched abortions – Ethiopia took a stand: it prioritised newborn and maternal health, and in 2005 it relaxed its abortion law in an effort to save women’s lives.

Stopping short of legalising abortion, the new law decriminalised the act. It also allows women to terminate pregnancies that result from rape or incest, if the foetus has a severe defect, or if a girl is under the age of 18 and cannot care for the baby herself. Before 2005, a woman could only have an abortion if it was a matter of life or death.

“Anecdotally, I would say [the law] has had a huge impact on saving lives of girls and mothers,” said Addis Tamire Woldemariam, general director for the minister of health, but he said he did not have official numbers on the law’s impact. The latest statistics available are from 2008, which show that 27% of women who sought abortions in Ethiopia did so legally and safely. That still suggests more than 70% of abortions were done in unsafe conditions by untrained providers, but before 2005, that figure was much closer to 100%.

“Before, women would drink a tea made of plants to induce abortion,” said one health extension worker in the northern village of Mosebo. The women would then have extremely painful cramping followed by heavy bleeding – too heavy, she said. “It is much better now. We encourage them to go the health centres or clinics.”

Lack of access
But one major reason women are not getting safe abortions is that most Ethiopians live in places even less accessible than Mosebo, which is just off a bumpy gravel road that stretches 43km to the northern city of Bahir Dar. Getting to a health facility that provides abortion care is extremely difficult.

In Ethiopia’s capital Addis Ababa, Dawit Argaw owns a Blue Star Clinic – a private health facility partnered with Marie Stopes, a global provider of newborn and maternal care, contraception and safe abortions. He explained that if he did not perform the abortions women sought at his clinic, they would just end up choosing a dangerous option. “The main reason that we do this is that we have seen so many complications [from abortions performed illegally], by [untrained] persons,” Argaw said. It used to be common that women would come to his clinic with puncture wounds or severe infections from botched abortions. “But since 2009 [four years after the new law was implemented], we have seen this maybe two or three times.”

While the vast majority of women seeking abortions are still getting them through unsafe means, in large cities like Addis, women can get to clinics and doctors more easily.

But women’s health is also helped by increased access to contraceptives, and the number of women who have unwanted pregnancies is in decline as more women use birth control. “Ten years ago, contraceptive prevalence was 6%, and the most recent figures are at 40%,” Woldemariam said.

Grateful for the service 
At the Marie Stopes Clinic in Addis Ababa, a woman sits in a small room with a desk, a bed with stirrups attached and a thin curtain. Here, she receives contraceptive advice. “We consult with her and have her choose a family planning method before she receives the abortion care,” Sister Tihish, the nurse, explains. The patient, who withheld her name, also did not disclose how she got pregnant, “but many of the cases we receive are because of rape,” the nurse says.

In cases of rape or incest, women are not required to give proof. Woldemariam of the Ministry of Health said making a woman relive the psychological trauma of rape by asking for evidence would be “immoral” and “inhumane”, so many abortion-providers have adopted a “don’t ask” policy. For many, that leaves a gaping loophole in the law and gives women a way to get abortions for reasons beyond what is legally allowed.

Dr Seyoum Antonios vehemently opposes the abortion liberalisation. The general surgeon explains the requirements are far too lax. “You look at the books at these clinics and all of them say `rape, rape, rape’ with no proof,” he exclaims. “My country is being painted as a land of rapists.”

But for 29-year-old Khadija Ali, who asked that her real name not be used, access to an abortion was a matter of life or death. “I was working as a housekeeper in Bahrain when my employer raped me,” she explains, wringing her hands in pain from cramps as the abortion pills she took a few hours earlier took their toll. “I became pregnant, and immediately returned to Ethiopia because no one could know it happened, or else I would be seriously hurt or even killed.”

Her friend told her about the Marie Stopes Clinic, which provides abortion care and contraceptive counselling. “I am very glad,” she said, for the service. Still, Khadija says she will never tell anyone – including her husband – what happened, and definitely not about the abortion.

Social stigma reigns 
Khadija is not alone in keeping her silence. “This is something very sensitive in the community,” Woldemariam said. “I mean people practice it, but they do not want to talk about it,” which is fine, he said, as long as women are getting the care they need.

The vast majority of Ethiopians are socially and religiously conservative within their respective beliefs. Orthodox Christian leaders, who have the most followers in Ethiopia, are willing to privately consult families on family planning but would never discuss abortions. That is the case with almost all communities, Woldemariam explained.

A local priest in Mosebo village said that is how he advises families and what he practices in his own family. “Children are a gift from God, but having more children than you can feed is an even bigger sin,” he explained. Magadesa Mugeda, a resident of Mosebo pregnant with her second child, agrees. Her daughter was born five years ago, and she used an injectable contraceptive to plan her family. “With our land and our resources, we could not afford to have more kids,” right away, she said.

When asked about abortions, Mugeda immediately tensed up. “I do not know or care to discuss these things.”

Abebe Asrat, a no-nonsense midwife at the Marie Stopes clinic agrees with Mugeda. “Do not ask me what I think of government policy,” when it comes to abortions she said. “Almost everyone is against abortions… but we do what we have to,” she explained. There are alternatives, she insisted: women should be encouraged to use contraceptives and family planning methods to prevent the whole ordeal.

Argaw said if he did not see that safe abortions saved women’s lives, he would have a harder time accepting how his work was conflicting with his religion. “Religiously [abortion] may be forbidden. Even in my religion it is forbidden. But for me as a human being I accept it [is necessary],” he admits. “So that is why I do it.”