A life-changing internship

By Alanah Duffy
Saturday, January 11, 2014
Brockville Recorder and Times

Emily Royal, who grew up in Brockville, has recently returned from a six-month internship in Ethiopia. From June until mid-December, Royal worked with the African Medical and Research Foundation (AMREF), and helped provide health programming to those in need in the African nation.

In this week's Q & A, Royal, a Brockville Collegiate Institute graduate, talks about her experiences in Ethiopia and what is next for her.

Q: What made you want to complete the AMREF internship?

A: I was doing some post-graduate work at Humber College in their international development program. Part of the third semester, in order to get your final credit, is to do a work placement with an NGO (non-governmental organization) to basically exercise the skills you've learned and put them into practice. I was looking online and came across AMREF. I applied for the program officer position specifically in Ethiopia and the rest is history.

Q: What kind of projects did you work on while you were in Ethiopia?

A: A lot of child and maternal health programming. One of the big projects was designing a project for midwifery training, which is interesting because I don't have a background in being a midwife, but I worked very closely with a woman on staff who was a midwife and is now doing a lot of project design herself. That seemed like a very daunting task, but I sat down with her and we designed different project activities.

Ethiopian-specific, it’s a bit of a difficult situation for health care. There's about 0.7 health workers per 1,000 people in Ethiopia, so less than one-third of the minimum requirement the World Health Organization has standardized for. So, the Ethiopian government started a midwifery training program. Although it's kind of made great strides, there's still a lot lacking. The child and maternal mortality rates are very, very high, so AMREF created this program to complement what the Ethiopian government was doing, with the idea of training more midwives so they could go out into rural areas and just do a lot of outreach into communities that didn't have access to the hospitals in the big city.

This proposal that I wrote complemented that.

Q: Were you right in (capital city) Addis Ababa the whole time?

A: I was living in Addis, and that's where I would say most of my work was done. But I had the privilege to visit the other project offices throughout the country. In the south, in a region called South Omo, I was there in July also visiting a maternal and child health project. That was very interesting, because there are so many different cultures in the south. That was interesting to see how AMREF conducted their programming there, because they had to be very sensitive about traditional practices going on in the different cultures.

I spent a little bit of time in the east as well, in the Awash office. That was also really interesting to see, because they were dealing a lot with pastoralists. So, a lot of nomads, people who didn't have a fixed address and were moving from place to place. It was interesting to see how they were doing their program there and how difficult it was to follow up … How do you track those people down after? They were putting health and outreach workers in the Saturday morning market, because they knew those pastoralists would come in that morning to sell items and chat with other community members.

Q: What were some challenges that you faced while you were there?

A: I think the fact that things sometimes are not predictable. You have to expect the unexpected. For example, we had a baseline survey we were supposed to conduct. About a week before we were to start it, the regional health bureau changed its mind about which region it wanted to focus on. So, all of the work that we had done for it had to be switched to another region. I was really excited to do that baseline survey with my co-workers and I said to my boss, “How can they just change their mind?” and he said they were kind of expecting they would do that, so he had a backup plan.

For better or for worse, they have really great risk mitigation and prepare accordingly for what could potentially happen. It was very impressive.

Q: Do you have a favourite memory from your time there?

A: In the last few weeks that I was in Ethiopia, my supervisor assigned me to do a sustainability report, so basically looking at the longevity of AMREF projects after they phase out. I looked at three different projects that had phased out … and saw if they were still going or not.

I met with one woman who was living in Addis, in a sub-city community. She was leading an association that was dealing with home-based care in her community. She had a team of people going into houses of people who were living with HIV who were bed-ridden or other vulnerable people in the community. They were given a start-up fund to provide this home-based care. Her inspiration was her daughter, who was HIV-positive and was bed-ridden. When AMREF came to the community and said they wanted to start home-based care, she was the first person to step up and say she will lead this group and would do anything possible to make this work and keep it going. She had turned into one of those ladies that everyone in the community knew, and if anyone had a problem, they would go to her. It was nice to see that, not only had this project been spearheaded by AMREF, but it was completely taken over by the community members.

Q: What's next for you?

A: I leave February 1 for Mozambique. I'll be with the Aga Khan Foundation doing similar work that I was doing with AMREF.

I think the themes and focuses of the two organizations are very similar. It's a full-time position and I'll be there for at least a year.