Annie Hylton | Longreads | October 2017 | 12 minutes (3,250 words)

It was a Tuesday in the district of Merhabete, in central Ethiopia, and the smell of burning spices infused the air. Hundreds of people — men and boys herding donkeys and goats, and women cloaked in white cloth with baskets atop their heads — lined the gravel roads leading to the government-run health clinic; some had walked for hours to trade and sell goods at the weekly market.

Yeshi estimates she is 37, based on the age of the eldest of her six children. She and her husband left home around 7 a.m. that morning. For a few months, Yeshi had been unable to perform basic tasks. She was too weak to visit the neighbors and bled profusely, like she was menstruating, every time she drank coffee or water. She had lost weight and was concerned she was dying. But on this Tuesday, the day her husband would make the hour-long walk to sell bananas at the market to earn the $7 USD that would sustain their family of eight for the week, Yeshi would accompany him to the village. If she were able to make the trek, she would visit a doctor and nurse from Marie Stopes International, a non-governmental organization that provides sexual and reproductive health services around the world. One of Marie Stopes International’s 12 mobile outreach teams in Ethiopia, funded by the U.S. Agency for International Development (USAID), would be at the village’s health clinic. They would offer family planning consultations and perform what they call the “permanent method” — vasectomies and tubal ligations.

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