Ethiopiaid LIVE: A Chat with Meselech Seyoum

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Video transcript

Sharon Elliott:

Fantastic! Well, good evening to everyone. I think we've still got a few people joining our waiting room so we'll keep admitting people. But it's fantastically exciting to see all of you with us so far tonight. Thank you so much for coming along.

Before I continue I should introduce myself for those that don't know me. I'm Sharon Elliott, CEO of Ethiopiaid Australia and I'm delighted to have in the room with me Lisa Coulthard who you may have spoken to and - not quite in the room but close to hand - is Amy Franze who also works at Ethiopiaid.

And the other wonderful lady in the room I will introduce you to shortly... but can I just make one quick request before we get going? Very, very happy to see lovely faces so please feel free to either have your cameras on or off, but I really do ask that we'd please keep our microphones off and I'll come on to some other housekeeping.

But I'm keeping you all in suspense and would like to get straight onto the introduction to someone who's with us today that I hold in hugely high esteem... and I am going to unashamedly read my notes here because the list of credentials that go with her are too big for my memory. She has a Masters in Transformational Leadership and Change from the UK, a Bachelor of Sciences in Nursing from Germany and now over 21 years of experience in health, water and sanitation development in Ethiopia. AND, as if that's not enough, she is also the Country Director of our maternal health project partners, Healing Hands of Joy.

So please join me in giving a warm, virtual but let's make it warm - for anyone with hands out there do join in! - welcome to Meselech. Thank you for being here with us. It's wonderful to have you here and let me please hand over to you to give a better introduction.

Meselech Seyoum:

I don't know what more I can say, Sharon. It's been it's great. I'm so happy to join this group of people and really talk about the work that we do. As you said my name is Meselech and I've been working with Healing Hands of Joy since August 2016. So ever since, it's been an amazing journey and I will get to share that with you all soon. Thank you so much. Thank you for having me.

Sharon Elliott:

Wonderful, thank you, thank you again for being here. So, just a quick run through so everyone knows what to expect from today. I'll be putting Meselech under the pump with a live interview for about the first 30 minutes or so and then I'll be opening up to questions from everyone out there for the rest of the time. So please have your thinking heads on. If we're answering a question and you've got a burning question that you'd love to ask, please pop it into the chat on this. There's an option at the bottom of your screen so pop that into the chat. We will be able to see that there. Lisa is monitoring our questions and then we will get on to it at the end. So as I said, pop them in at any time and we will address as many as we can.

I know we've got a few people just coming in to join us now, so welcome to everybody. I won't go back into the full introductions but you haven't missed all the key questions. So you will get to know Meselech as we go along with those.

So firstly again thank you Meselech for agreeing to be here. I was really delighted that you said yes to taking part in this and I know there's an awful lot of our supporters that feel very, very strongly about the plight of women with fistula which of course is still a large problem in Ethiopia.

And I have to say I for one am certainly always really taken aback to hear how many people are still living with it to this day. So we're actually going to open this up to a quick poll in the room, just to get people thinking, just to get people engaged in what we're doing. So I'm going to pop this poll up now and it's to ask you how many people you think are suffering from fistula in Ethiopia now.

Do feel free just to pop your answer. It's okay; no one can see who's answering what. There is no judgment at all on any of it. And, of course, technology being technology I can't actually see right now if you're answering so I'm gonna hope that we've got plenty of answers up there on screen and we will share the results with you now.

But maybe you would like to actually share that with us Meselech, or share the correct answer with us as to how many people are currently living with fistula in Ethiopia?

Meselech Seyoum:

So, currently, according to a recent estimate by the Federal Minister of Health, over 142,000 women live with fistula in Ethiopia with an additional 9,000 new cases every year.

Sharon Elliott:

Sure that's - it's just staggering, literally. And I think the thing that really is something that makes it so much worse is, when you think about the fact that fistula is both preventable and for most part the time is also curable. And yet we have so many thousands of women living with the case.

And I know we've spoken about this many a times Meselech and I think you already know it's something that really gets to me personally, but it's the age that some of the women or - you know we call them women - are actually experiencing this.

So Meselech could you tell us a little bit about the youngest age or tell us about the youngest age of someone that you've encountered who's had - who you've come across suffering fistula?

Meselech Seyoum:

The youngest I remember Sharon is 13. Her name is Emabate. But her fistula was caused by rape. Someone close, a close member of the family, did rape her and she ended up developing fistula. This was a few years back and then luckily we were able to help Emabate go back to school. She got cured just with the first surgery and then went back to school. At the moment she's a grown-up, almost, and still going to school.

But the other one who is not much older, who is 16, her name is Sernai and she came to us a few months back. And she got married at 15. As you can imagine, no one goes into marriage by choice at 15. But she was given up to to a person, a man and she got married. And then at 16, she got pregnant and was trying to give birth but that didn't go well because at the time there was a conflict and the family was forced to go into the, you know, into the bushes and elsewhere to just take shelter. But then in the end they, her and her family, managed to shelter at church.

And then when labour came, she was in labour for about three days. And finally her father decided to take her to, you know, available help by health professionals. And she had a baby boy who was born live but then a few hours later the baby died and she stayed with fistula for a few months. But then was able to travel to Bahir Dar Hamlin Fistula Treatment Centre and did get cured. And now she's back home, happy.

So the ending of, you know, this traumatic experience for these young women is always something that really warms my heart and makes it really very personal. Because I am, as you know, a mother of two girls also and I always consider myself lucky because it could happen to anyone in a country like Ethiopia, that's possible. So the 16 is then the youngest to answer your question.

Sharon Elliott:

I think that's probably - I'm sure - very confronting to everybody in here right now. You mentioned a 16 year old... [they could be] in year 10, preparing themselves for those two big years to finish off school. That's what we'd immediately assume and that actually leads so beautifully on to on to my next question.

So we know that a lot of the time fistula really comes about because so many women don't have access to maternal health services. But could you describe to us the circumstances that could lead to a 16 year old girl to developing it?

So what sort of factors are coming in? Is it female genital mutilation? Is it through malnutrition? Is it early marriage? What are some of your thoughts or some of the lead things that you see happening?

Meselech Seyoum:

All of the things you said, Sharon, are contributing factors. So it's mainly like lack of awareness by people about what it would, you know, what the consequences of giving a child up for marriage would be. You know, both on the girl primarily and also the family. So the lack of awareness is one thing. You know, these girls are both physically and emotionally not in a position to have a child; they're practically children themselves. And that's one thing.

And the other one is, you know, the harmful traditional practices related to female genital mutilation that makes it even harder if she has to give birth early at this age.

And of course the facilities and access to those [health services] and nutrition. You know, all these girls are so tiny for their age. That's mainly also because they're not really well fed, so the malnutrition is playing another factor.

Of course, by law, no child under the age of 18 is supposed to get married but you can see practically that's not the case. Because families would have - for one, we don't know the exact age of the girl because we don't have any birth registration - and second because the families think that's a nice thing to do. They would be hiding the age of the girl; actually 13, 14, 15-year olds - they would just say she's 18, she's 19. Nobody is going to have anything to cross check whether or not that's correct. So that's one thing, the age, and the physical being is another. And then also female circumcision is prohibited by law but it is still being done.

So there is simply a lot of things contributing to this including the lack of awareness about what, you know, will end up happening to the girls when they are faced with obstetric fistula amongst other birth complications.

Sharon Elliott:

It's a very, very complex problem, you know, for sure. And I think... You know, obviously there are so many people that are still suffering and it must - to everyone, I'm sure to people here and to you a lot of the time Meselech as well - it must sometimes feel that it is just such a huge problem. But, you know, we know there is a solution and I've been very privileged to have actually seen the difference that it's made in coming out to visit the programs and everything. And I think what's so lovely is the solution is something that is sustainable and can happen and, you know, can make a real, ongoing difference.

So can you tell us - just, it would be lovely for people to hear from you - what exactly the work is that Healing Hands of Joy are doing and through that full cycle, so what is it that's actually working to then prevent it for the future as well as what's making that real, sustainable change?

Meselech Seyoum:

So Healing Hands of Joy does the rehabilitation and reintegration of these women. So to just make it clear to people, these women do get treated at fistula treatment centres. Healing Hands of Joy does not do treatment, so the treatment is being done by Hamlin Fistula Hospitals and University Hospitals in two places. But then these women would come to us.

We have rehabilitation centres and we would receive women, up to 15 at a time, to come to us. So the rehabilitation program focuses more on the psychological and emotional wellbeing and really helping these women gain their self-esteem back, because they have been in the dark depending on how long they lived with fistula. These women have kind of given up hope and on life, and some of them do even attempt to take their own lives, I mean commit suicide. So having these women come to us and really be able to help them individually based on their physical and emotional needs and as well as also, you know, the wellbeing that they have they're finding themselves in. So the rehabilitation support is one.

And during this time also we provide psychological support. We provide life skill support trainings and we also provide income generation or business creation/training, small scale that would fit to these women. Because almost all of these women have not had any schooling or they don't know how to read or write. So that's the training part.

And then these women, we will also make sure that they are successfully reintegrated back to their communities. We don't keep them with us; they have to go back home and when they go back home we might we make sure the local structures are ready to support their integration. So successfully back to their families, successfully back into their communities and really become a, you know, a member of that community as they were before fistula. So that's the reintegration.

On top of all that, these were women who have been known as a patient of fistula or someone who is leaking wherever she is going. She may be leaking urine, in some cases even stool, so this is the picture that they had within their communities. But now they would be going back as Safe Motherhood Ambassadors so that means then these women are in a position to help women who have not had a chance to be treated and also [raise] the community's awareness about, you know, the fact that fistula can be prevented and it can also be treated. So these women would go back as Safe Motherhood Ambassadors and create that awareness within their respective communities, in addition to the economic support that they receive and really make a living for themselves. And, for the first time for almost all of these women, for the first time in their lives, they would be having some money in a book - in a bank book - that is in her own name. That's like significant transformation of the life, before and after. So that's the rehabilitation program.

Which leads me to the identification of cases.

As I said, every year there is 9,000 women [developing fistula] and the Safe Motherhood Ambassadors are the most powerful means of finding women who have not been treated and have [not] had a chance to, you know, to go through the treatment process as they did. And the identifications for our Safe Motherhood Ambassadors is amazing. So they themselves go to every level possible. They would be walking for hours and hours just to find one woman that they could support to come and get treated. So identification is one, but the Safe Motherhood Ambassadors are not the only ones identifying the cases, which again leads to the bigger prevention aspect of our work.

So the prevention work again focuses on, you know, facilitating pregnant women conferences and, at the pregnant women conferences, bringing out Safe Motherhood Ambassadors who actually speak from their own experience and encourage pregnant women to continue to come to their prenatal care follow-ups and also give birth at health facilities assisted by health professionals. So when you see a Safe Motherhood Ambassador standing in front of a group of pregnant women and sharing her experience, the expression on the pregnant women's faces tells you that they're scared - and that is exactly what you want to create because they would continue to come and really give birth at health facilities and not face the same difficulty and challenge like a Safe Motherhood Ambassador does.

And then there is also the school awareness program. So we go to high schools. In high schools in our country, there are many media groups and there are a group of students who are active and engaging in, you know, whatever is happening in the school. So we make sure that this group of children or school children are introduced to what it is - what we are talking about and how they can be part of the prevention work of obstetric fistula. So the school awareness program is that and then the bigger program is the mass media and also, you know, the awareness creation supported by a minivan with a loudspeaker on it and going to marketplaces where thousands of people are coming and just giving them that information; distributing a leaflet explaining what it is, what fistula is and how it can be prevented, as well as where a woman should go if she feels that she has fistula, with clear contact details on the leaflets.

So these are the prevention works, in addition to engaging local stakeholders like religious leaders, Women's Affairs Officers and administration at the local level; whoever has a stake in what is happening, particularly in the area of health, is engaged in our work. And they're aware and committed to helping us work on that.

So in a nutshell this is is the program that we're doing and we're seeing, you know, such a big change in, you know, in a force that is now within the community. Over 2,800 women as Safe Motherhood Ambassadors - trained as Safe Motherhood Ambassadors - and again millions of people reached with visual messages. And all this is really the result of the work that we do. Of course we're not doing this alone; it's [with] all stakeholders in the different areas.

Sharon Elliott:

It's wonderful, it's wonderful to hear and I think everyone here knows the importance of education and how education - which doesn't have to always be academic education! - education is what's going to change everything. And I always love the stories of the women that have been living with fistula for a long time and then they do come across the Safe Motherhood Ambassador or they hear one of the radio broadcasts and they realise it's not a curse, so it's actually something that can be cured. It's - it is such exciting work, such exciting work that you're doing and really, really does make a difference.

Now, obviously, you've got always got lots of priorities and there's lots to do and of course you work across many parts of Ethiopia. But obviously there's been setbacks. COVID threw its spanners out there, but of course the civil conflict that Ethiopia is experiencing for two years has obviously been a huge a huge problem for so many people and organisations and of course is now leading to or partially leading to the huge inflation. If we think we've got inflation problems in Australia, we've got nothing on what you're experiencing there. And, of course, that's leading to a lot of food insecurities etc. with access to food, both growing and financially.

So what are your particular priorities over the next financial year and are there any sort of particular things that you now need to prioritise because of everything that has been or is being experienced?

(So you're on mute Meselech!)

Meselech Seyoum:

Yes, we will definitely continue the work that we do in terms of Rehabilitation, Identification and Prevention and all that. And in addition, you know, during the time of COVID we have learned a lesson. So one way of looking at the time of COVID positively is that we were able to learn something out of that, because we didn't stop working at the time because, you know, we heard from our local partners that more and more women are giving birth at home because of the fear of contracting the virus. So what we did was went around within the communities with our mobile van and telling people that the health centres and all the health facilities are still giving the service. And the health facilities were also short on some supplies like PPE, you know the protective gears that they need in order to protect themselves and the patients or the women they're serving, so we did provide the support with the PPE materials for health centres and then that actually - within a short period of time - has shown results. So more women were coming to the health centres and seeking service and giving birth instead of home.

So we said we will continue to do that and we are continuing to support health facilities not just with, you know, basic materials but also with training on how to properly diagnose fistula cases and also properly go through the prenatal care follow-ups for women that are coming to seek the service.

That's one thing and the other thing that we're doing is supporting maternity waiting homes. Maternity waiting homes are places where women with risk during their -expected risk during delivery - are called and told to come and take shelter at the maternity waiting homes for a certain period of time, so that she's not far away from a health facility when she gets into labour and needs assistance, you know, from health professionals. So that's one very exciting area of work. I'm really happy to say that this is something that we're very much looking forward will bear fruit and really help us reach out to many women. Because of the challenge too, you know, of transportation - lack of transportation - and the distance of health centres from where the women actually live, the maternity waiting home renovation is really a very good idea. And that's another priority that we have.

So, and as you said, because of the conflict that Ethiopia has faced, and really is in some places still happening, and people having difficulty to access health facilities, the number of women with fistula we expect is going to increase. We're already seeing that in Tigray where the actual conflict was taking place. That number is increasing. And other places in Amhara, some parts of Amhara where women were forced to stay home and give birth like Sernai, so that number is expected to rise. So, we need to be able to find these women and bring them to health facilities for treatment. That's the identification part of our work; still it needs to be enhanced and really get - we need to be able to reach more women. We start.

So, and at the same time, you know, in Tigray for example we trained over 600 women as Safe Motherhood Ambassadors and we need to find out where they are; and really finding out where they are, what the situation is that they're finding themselves in, and helping them, you know, with emergency food aid or support that they need - any kind of support - so that we get this force back to working as Safe Motherhood Ambassadors. So we need them now more than ever. So that's another thing that we do in Tigray.

Tigray infrastructure's all over the place, are really damaged so there is a lot that needs to be done. And, as for Healing Hands of Joy, the major challenge linked with that in addition to high inflation in the work that we do, there is resource limitation and that resource limitation is really limiting us from reaching out to many, you know, as many women as we wish we could reach during this difficult time. And that is to, you know, just simply to mention resource to go out and support these women both financially and you know with items that they might be needing.

At the same time, also vehicles for our work into, you know, expanding into the different parts of the different regions that we're working in. At the moment as you know we work in five regions and these are vast regions. You know, the country has this big region so it's hard to reach these people and these places with just one vehicle. So the resource limitation is a very huge challenge, like number one on our list Sharon.

Sharon Elliott:

And I think you made a podcast with one of the ladies from our UK office, I think last week, was it? You spoke with Anna so I know that's something that we'll have. You were talking to Anna in a bit more depth about the plans - which I've seen - the very good plans that you've got for Tigray and the rebuilding and reconnecting with your Safe Motherhood Ambassadors there. So hopefully that's something we'll have to share with the rest of the room a bit further. I know that was a very, very difficult time for you during that. We spoke frequently and your concern and fear for all the Safe Motherhood Ambassadors in Tigray was very difficult to hear. And I'm glad that, you know, that the rebuild is happening and there's work being done out there.

So to sort of wrap up the bits from us, we've got time for another question and I think we try and end on a sort of a nice note. And you may or may not be aware, Meselech, that this year our tax time appeal is talking about fistula and Healing Hands of Joy. And in the appeal one of the women we speak about is Rehima, whom you introduced us to... and I am, she says, technology allowing, going to pop this up on the screen.

Now I've got blank pictures in front of me, everyone, so I hope that you're going to actually see the photo... and hopefully this one will be... Oh, I'm sorry, nope, that's not working. I don't know if it's working. Okay, my apologies everyone I don't know this. I'm going to blame my - I can't stop screen sharing now [Sharon talking to colleague Lisa]. I'm not sure whether I'm having some [Sharon checking computer]. I would love to share some photos with you but I don't know if our internet here is just a little on the slow side and I can't actually see what my screens are showing to enable me to share them with you. I'm ever so sorry about that but what we have got is everyone's email that has attended here and we will pop them straight on the email to you afterwards. Because we have got some beautiful pictures of the lovely lady.

And, just a reminder for those of you who haven't seen it [our tax appeal], Rehima was a lady who had lived with fistula for five months after the birth of her fourth child. But she was identified by a Safe Motherhood Ambassador who then helped her find out how she could get treatment and then rehabilitation via Healing Hands of Joy. And obviously it was a big experience for her and life-changing and she then went onto train as a Safe Motherhood Ambassador, so that she could go and do exactly the same.

And that's something that I find very beautiful every time I talk to ladies who have been there; their desire to give back, how strongly they feel about what they've received and how their lives have been changed, their desire to give back and to help other people experience that is enormous. And, if I could share the other photo, I would be sharing a photo of her on graduation day. As I said that will come to you - I don't want you to miss out!

And we were very lucky earlier in the year; one of our colleagues, Emily, was out and she spent a couple of days with you Meselech and I know they were very sad but happy and wonderful days as well. A lot of emotions going on there. But she heard all about her story. And I'm wondering... Have you got any updates on Rehima and how she's going now that she's home and gone through her training and back out, back out in her community?

Meselech Seyoum:

Sharon, like you said Rehima was one of, you know, the active members of that group at the time when Emily and our Ethiopiaid colleagues were visiting. And Rehima is now back home and happily living with her husband and four children. And she is also back, you know, integrated successfully within her community, her neighbours and so on.

She's also very active in her Safe Motherhood Ambassador work. So she was able to persuade and help 11 women - pregnant women - to go really and do through prenatal follow-ups. And six of them have given birth at health facility. She was like on top of everything, you know making sure that they don't miss their appointments. And so successful delivery of six women. And then the other five are still on follow-up about their, you know, prenatal care.

And Rehima was a member of the choir in her village and she's now gone back and singing. She's really very happy and, you know, to reunite with her church choir. And Rehima is also one of the candidates for economic support that our team is facilitating to provide that economic support to her. So all good news about Rehima, Sharon.

Sharon Elliott:

That's wonderful news. I think - I I don't know about everyone else here - but I think hearing that she's singing that just conjures up a beautiful picture. That there's the sort of thing that does make everything worthwhile, doesn't it? As long as she - I'm sure she sings a lot better than I do! It doesn't really conjure up the thing otherwise!

Thank you Meselech for sharing all that. It's been wonderful. Are you happy for us to now find out what we've got in the way of questions, and answer some questions? And I might bring Lisa in to share the screen with me and share some questions with us.

Meselech Seyoum:

I'll be happy to.

Lisa Coulthard:

We're very high tech; we're just going to share the desk! Now I've had a few questions come in via email which we've covered off beautifully, I think, in relation to some of the challenges that you've had following COVID and also the inflation that you've talked about.

There has been one come in from the conversation tonight in relation to the spread of fistula cases around Africa. So you talked tonight about five areas that you work in; can you give us an idea of the spread of fistula cases across Africa, being such a vast space?

Meselech Seyoum:

The five areas are within Ethiopia, this is not outside Ethiopia, we call them regions. So the country is divided by region and we have about nine of them. So we work in five of these regions. But about the spread over Africa, I'm afraid I don't have the, you know, the full answer to that. But I know that countries like Uganda, Tanzania and I think it's the Congo, if I'm not mistaken, that this spread is quite huge in those countries as well. But that's an incomplete answer, I'm afraid, but that's all I know.

Lisa Coulthard:

Thank you. I'll just like to add to that question: How far do you think women in Ethiopia are traveling to be able to access your program?

Meselech Seyoum:

For our program, you know, it's best if we talk about how far they have to travel to access treatment centres for fistula - because they come from the treatment centres to us; this is within the same area, so no distance required because it's very close to each other. But they need to come for hours, to travel for hours, while having, you know, some kind of leakage and not being able to travel on public transport because public transport is really not safe for them, because people are reacting in a way they shouldn't. So it really makes them very scared. So they need to travel all that distance until they get to the nearest health facility, walking. So this could take up to five hours, six hours. In some cases they may have to spend the night somewhere and get to the centre.

But once they get there, we make sure that there is a facility or a transportation available so that they can freely come to the treatment centres. So those places would provide them with an adult diaper, so that they're not really very conscious of what's happening and very worried about what people might think. So once they wear that adult diaper and get that transportation that then brought to the treatment centres and the treatment centres will take care of that afterwards. Because that is a heaven to them, compared to what they have been, you know, facing in the communities, in the transport, in all these other places. So that's how far they have to go.

And, at the same time, I think it may be worth mentioning how far women need to travel for delivery, for getting, you know, assistance by health facilities for their follow-up and delivery. So that depends on how close these facilities are but it is very difficult because of the terrain in the country and people would have to carry these women on their shoulders, you know, with a cultural - we call it - a traditional ambulance. So they make a stretcher-looking thing and they put them there and they have to carry them. You can imagine like four or five people carrying you and when they are walking the movement that is created and how painful that would be for a woman who is actually in labour. So it's very, very difficult. So that's why, you know, the facilities like pregnant women or delivery homes need to be in a position to accept these women and keep them safe for when, before it's time to give labour.

Lisa Coulthard:

Thank you. Would you like another question? Do we have time?

Sharon Elliott:

Yeah we've got time for another question.

Lisa Coulthard:

Another one that's come up tonight is how many fistula cases do your Safe Motherhood Ambassadors find each year?

Meselech Seyoum:

So that number differs from year to year but it goes up to 100 a year in those different regions. 100, 120 that's the range of numbers that they identify.

Lisa Coulthard:

Thank you. One more? This one's come in from email from someone who couldn't be here tonight. And they wanted to ask you personally if there was anything that you would like to share as a proudest achievement of the program for Healing Hands of Joy?

Meselech Seyoum:

I mean there are many. So if I'm allowed to share one is, like, the work is transforming the lives of these women. It's just like one woman at a time, you know, changing for the better. And at the same time again, when it is one woman that is identified by a Safe Motherhood Ambassador, it doesn't stop there. We have women who have identified up to 20 cases. Just one Safe Motherhood Ambassador, she's amazing, she just keeps on, you know, targeting these women. And this is a woman, a Safe Motherhood Ambassador, who is not fully cured, meaning she's still living with some kind of incontinence.

So she has this ripple effect and the women that she identifies go out and make sure they identify other women. So that's - I don't know what you call it - that branching out of Safe Motherhood Ambassadors going out hunting for women who are not fully treated, I mean, not treated and need the support is amazing.

It always amazes me to see these women, the strengths that they have and the commitment that they have regardless of them being fully cured or still living with some kind of incontinence. So that's the Safe Motherhood Ambassador approach and model that is really very unique in its nature. It's nowhere [else].

Sharon Elliott:

Wonderful. Thank you. Thank you so much. I think that's about all we have time for today. There were some wonderful questions. Thank you so much and thank you to everyone of course for being here and a lovely to share that. It is great that we can connect with you all the way over there in Addis. And we'll be going to our evening in your mid-morning for you; there's still lots of your day ahead.

If there's any questions, we will check all the questions and we will get back to anybody that we've missed. And we will be sending out a link with this recording in it as well as those missed pictures that I promised everyone. That will all be coming out to you.

And it's really been a joy for me to be here, both with you Meselech and with everyone else in the room. It's always lovely getting the chance to speak to people and to see some faces as well. That's very special for me too. And I think we've all come away - I've been at Ethiopiaid for six years now and every time I speak to Meselech I learn something new. So I'm sure we've all taken something away from tonight. If is there any closing statement, any closing words that you have for us, Meselech...?

Meselech Seyoum:

I just really want to thank you, Sharon for really facilitating this meeting with everyone in this meeting room. I'm so very happy and very pleased to see each and every one of you and for your interest and for your time to really learn about what we do here. And I really would also like to emphasise on the point that Healing Hands of Joy's partnership with Ethiopiaid - is actually a partner, so with its real definition of partnership. It's not a donor/receiver kind of relationship that we have. I cannot emphasise enough about the friendship, the partnership and the collaboration that we have between each other. And I know that there will come the time where, you know, fistula will be eliminated in Ethiopia and I am really very [Meselech's internet cuts out].

Sharon Elliott:

We've been doing so well there with internet and we see - oh - Meselech, you're back.

Meselech Seyoum:

Sorry. The quality decided to give up on me just at the right time! So just really want to say thank you and, really, for all your support Ethiopiaid, Ethiopiaid supporters, everyone that has come across this program and really interested in supporting in one way or another. And I'm sure we will see the time when, you know, that we force ourselves out of work when there is no fistula in Ethiopia. So hopefully that will happen in my lifetime and I'm so very grateful. Thank you again, Sharon.

Sharon Elliott:

Wonderful. Thank you, what a beautiful wrap-up. Thank you again Meselech. Thank you everyone for being here and take care everyone. We're leading towards the weekend so have a good one when it gets here and thanks again for being here. Good night everyone and good day to you, Meselech.

[Participants say goodbye]