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Last Updated: Friday, 21 April 2006, 09:33 GMT 10:33 UK
Hiwot's baby
The World Health Organization is following six women around the world to compare their experiences of pregnancy and motherhood. Here, Hiwot Abraham from Ethiopia describes life with her one-year-old child, Elizabeth.

Damiana Mamani:
Bolivia

Samah Mohamed :
Egypt


Hiwot Abraham:
Ethiopia
Renu Sharma:
India

Bounlid:
Laos

Claire Roche:
UK

Hiwot Abraham, 17, decided to look after her baby, after originally feeling she would be better off with her father's family.

"I just can't believe 12 months have passed so quickly.

WHO/Petterik Wiggers
'We are fortunate she is so healthy'

"Elizabeth is a very good eater. She will eat fish and meats. She also loves Ethiopia's hot pepper sauce called berberre.

"She can almost walk, although she likes to be carried. She can already say papi, mamie and ntaje - which means food.

"She also says sssh a lot - I think she learnt that from me!"

Hiwot added: "We are fortunate that Elizabeth is so healthy. Many of the children in our village often fall sick with malaria.

"Elizabeth sleeps under a mosquito net which has protected her so far. She has also recently been vaccinated against polio."

But Hiwot said: "I don't plan to have any more babies though, after all the trouble I've had with Elizabeth's father.

"This year has been a challenging one for Elizabeth and I, but it has also been a wonderful year - full of discoveries and surprises."

The WHO says Hiwot is lucky. In Ethiopia, 110 of every 1,000 children die before their first birthday.


Nine months old

"Elizabeth and I are doing OK. She has grown up a lot in nine months and is very strong willed.

Copyright - WHO/Heba Farid
'Malaria is a real problem where we live'
"She had a cold a few weeks ago and I took her to the clinic. They gave her some cough syrup and her cold cleared up quite quickly.

"She weighs about 10kg now."

Hiwot added: "I'm feeling a lot happier now than when Elizabeth was born.

"Her father and his mother take her whenever they can and have started to take an active interest in her life.

"Elizabeth can now sit up and crawl around by herself."

Malaria risk

But Hiwot said: "I'm working 12 hour days, six days a week in our cafe. I only earn 70 Birr a month (less than US$9).

"Elizabeth plays nearby while I work. My mother and I keep an eye on her."

'I am happier than I was when Elizabeth was born'

The family don't have any running water, but buy supplies from a neighbour for 20 centimes (about 2 US cents) per litre.

Hiwot said: "The water I buy is clean enough to drink and prepare food with. I wash Elizabeth in the morning and before bed every day."

She said malaria was a real problem in her area.

"Many children have died from the disease and I've already had seven bouts of malaria in my life.

"We have one bed net in our house which Elizabeth and I sleep under. I would like to buy more nets for our family but I cannot afford them."

In Ethiopia, only 17% of under-fives sleep under bed nets.


At six months

"Elizabeth is doing really well and now weighs 8kg.

"She is such a happy and active child - sometimes too active!

"I have stopped working in my mother's restaurant so that I can spend more time taking care of her.

"I have also stopped breastfeeding. Elizabeth now eats porridge, vegetables and cereals four times a day, as well as milk four times a day."

Hiwot added: "Elizabeth's father has found a job in a fertiliser factory. Mum helped him to get it. She tries really hard to keep the family together.

Copyright - WHO/Petterick Wiggers
'We're trying to keep the family together for Elizabeth'
"She wants to ensure that Elizabeth grows up surrounded by a large family."

Elizabeth has been immunised against polio, diphtheria, whooping cough, tetanus and tuberculosis.

In Ethiopia, 37% of infants aged six to 11 months are underweight. Six-month-old girls should generally weigh between 5.8 and 9.2 kg, while boys of the same age should usually be between 6.4 and 9.7 kg.

Elizabeth had a bout of diarrhoea last month, and a nurse at the local clinic prescribed oral rehydration salts free of charge.


Six weeks old

"I've rekindled my relationship with Elizabeth's father, and together we've decided that his family will take care of Elizabeth as soon as I have stopped breastfeeding.

"I will miss Elizabeth very much, but this way I can return to school to finish my studies, which are very important to me."

She added: "My mother and I had discussed the idea of putting Elizabeth up for adoption, but we finally decided to let her father's family raise her - at least like this I can still visit her whenever I want to.

"I plan to study at evening classes and work in our restaurant during the daytime.

"Eventually I want to study at catering school and find a job as a cook in a restaurant."

In Ethiopia, one in six children die before their fifth birthday, the majority from preventable and treatable diseases such as pneumonia, malaria and measles.


Seven days old

A week after her daughter was born, Hiwot said: "She is beautiful - my mother says she looks just like I did at that age."

Hiwot Abraham
'What I pray for most is that my baby will be healthy'

She added: "I am feeling more positive about my baby now. To be honest, before Elizabeth was born, I was ready to give her up for adoption.

"I really love Elizabeth now, although I do find it hard to look after her and work at the same time - especially as I breastfeed six or seven times a day."

Hiwot added: "My boyfriend doesn't seem to care that much about us.

"I'm lucky that my Mum is helping out. I really need her support right now.

"Sometimes I do feel I'm too young to have a baby. I wish I could go back to school."

The WHO estimates that in Ethiopia, 38 in every 1,000 babies dies in their first seven days of life from preventable diseases.


Childbirth

Hiwot said she appreciated the care she received from her doctors. But she said her hospital's facilities were poor.

"I was especially surprised that the hospital had no running water.

"The only water we had was from a bucket."

She added: "I'm happy that Elizabeth was born healthy and that we are finally home.

"But I must admit that being a mother hasn't come naturally during these first few days.

"I'm not getting much sleep. Life seems harder now. Sometimes I even wish I didn't have her."


Seven months pregnant

"I don't know if I'm expecting a boy or a girl. I hope it will be a boy, because boys are stronger. What I pray for most is that my baby will be healthy."

Hiwot's family have turned one of the rooms in their house into a little restaurant to earn some money to look after the new baby.

She added: "I wake up at 5.30am each morning to prepare breakfast for our customers and work until it gets dark."

Following a visit to an antenatal clinic, she said: "No one has told me what to expect during labour and that's the part I'm most nervous about."


Five months pregnant

Describing her relationship with her boyfriend, Hiwot said: "We didn't use contraception."

"When I became pregnant, I decided to keep the baby. I also decided to leave school."

Hiwot says her nearest antenatal clinic takes half an hour to get to.

She is due to have monthly check-ups there.

The WHO says Hiwot is lucky, because only 27% of Ethiopian women receive antenatal care during their pregnancy.

Complications from pregnancy and childbirth are the leading cause of death in Ethiopian women aged 15 to 19.

In Ethiopia, only 9.7% of women have a skilled assistant, such as a midwife, doctor or nurse, with them when they give birth.

The WHO says all women should have access to such care.


Where the women live


Photos courtesy of the World Health Organization.


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