Supporting Rural Health Centres in Ethiopia

by Tropical Health and Education Trust (THET)
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia
Supporting Rural Health Centres in Ethiopia

In Ethiopia as in much of sub-Saharan Africa, high blood pressure is a common health problem. Which, if untreated, leads to severe illnesses including heart disease, stroke and kidney failure. Although the THET Ethiopia NCD Alliance (THENA) is involved in the effort to screen individuals for high blood pressure, a big problem is persuading patients to attend the clinic and take their treatment. Many patients abandon the clinic for a variety of reasons; there is a strong preference for traditional healers and the use of herbalists, holy water and the like.   

Story telling is a traditional and well-established way of communicating ideas in Ethiopia. WIth your generous and unwavering support, we commissioned the production of a short story written by the well-known Ethiopian author Daniel Worku (one of the country’s foremost children’s authors), and illustrated by an Ethiopian artist Gabreiyesus Asmare. 

Our objective was to produce a short, illustrated book (see picture 1) aimed at 10–14-year-olds - the next generation who are now in school, are about to join the workforce, and assume some of the caring responsibilities for older family members. This generation will also be that from which the next group of health workers will be recruited.

In producing this story our aims were for it to stand on its own by having a multiplicity of layers/strands that deal with aspects of life that are relevant to this age group; things such as the tension between tradition and modernity, gender differences and tensions, generation gaps and more. Needless to say, the message regarding the perils of ignoring the modern medical clinic is clearly articulated in the story and runs throughout it. We worked to produce a story that is indigenous in topic, and composition. With the hope that it might be adopted as such and be propagated, in time, from within the community itself. The aim is that the message embedded by us is not one that competes or contradicts indigenous cultural ways and beliefs. 

Having produced the book the next step is to gauge responses of both children and parents. This is underway, by Tsion Afework of Addis Ababa University and Daniel Worku, the book’s author. So far, we have done a public reading at a book fair at the Addis Ababa Exhibition Centre (see picture 2) and plan readings at I Care Ethiopia (a charitable organisation that provides homeless mothers with children with childcare day provision and assistance in starting up new small business enterprises), and within several private homes where there are children of the target group. After readings there will be discussions led by Tsion Afework (see picture 3). These discussions will be directed at getting a sense of the audience’s understanding of the story, the variety of topics involved and whether the story - text and illustrations - is one that engaged them to want to read it again and pass it on.  

We are keen to see how the embedded message regarding the dangers of ignoring what the modern clinic has to offer is received.

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Basic training at Maksegnet HC
Basic training at Maksegnet HC

Despite the social and political challenges facing Ethiopia, at the moment, the THET team continues to provide vital health systems strengthening services to aid patients with non-communicable diseases (NCD), made more vulnerable to COVID-19. We conduct training sessions and are developing telemedicine services, through providing telephone consultations, for those especially vulnerable or residing in remote regions/areas of unrest.

Whilst Ethiopia has managed the coronavirus pandemic with great success, preparations have focused on larger hospitals in Addis Ababa and the larger urban centres in Ethiopia, thus, THET has chosen to target central and northern Gondar zones. It should be noted that it is rural communities with poor housing conditions who are most susceptible to infection, as overcrowding and difficulties in maintaining adequate hygiene create a higher likelihood of infection. Those travelling from rural regions are facing barriers towards access to healthcare as national regulations have reduced passenger loads on vehicles and are curtailing movement, thus travel has been made difficult and expensive. To tackle this issue THET is promoting the use of tele-consultations.

It is only through your continued support that THET has trained 39 health professionals in COVID-19 preparedness, across three hospitals. Of the 39 health professionals, 13 will act as trainers who will further cascade knowledge to the wider healthcare community. This will greatly benefit patients as it means a greater improvement in the healthcare providers’ knowledge, and skill on management and prevention of Covid-19 at primary level with a focus on NCD patients.

The unrest occurring in Ethiopia has caused delays and logistical challenges towards delivering training sessions, yet the THET team is determined to pursue our goals. We sincerely thank you for your unfaltering support - without which our projects would not come to fruition.

Basic training at Enfranz Health Centre
Basic training at Enfranz Health Centre
Basic Training at Denbia Hospital
Basic Training at Denbia Hospital
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2021 has been a challenging year for health workers around the world, but none more so than those in LMICs. Health systems have been overwhelmed by not only Covid-19, but the increasing burden of other the persisting non-communicable, communicable, maternal and child health challenges.

Through your unwavering support, THET has been able to provide essential Covid-19 with a specific focus on protecting NCD patients who are so vulnerable at this time.

Those with NCDs have been impacted so acutely by this pandemic due to their extreme vulnerability in the face of the virus. One of the major problems in Ethiopia is that patients from rural areas have to travel long distances to access care for NCDs, as this is delivered in hospitals.The hospitals are overwhelmed, and often don’t have the resources to deal with these additional responsibilities.

Working with the Ministry of Health, THET has been working to shift NCD care to health centres. We work to build not only capacity within these centres to screen NCDs, but to train staff to properly treat NCDs. As these diseases are often asymptomatic, patients are often not screened early enough, which unfortunately leads to complications and advanced diseases which cannot be reversed. Untreated NCDs can result in death or major disabilities that compromise quality of life, and cause patients to suffer physically, economically socially and spiritually.

In addition to this because of Covid-19, the existing care has been further compromised because of diversions of human resource and finance to fight the pandemic. Travel restrictions initially and fear of contracting Covid-19 has kept patients away from screening and care.

Last month, THET conducted training to 12 primary hospitals and health centre staff on Covid-19 infection prevention and control, how to protect their NCD patients who are one of the most at-risk, gender equality and social inclusion in their approach to prevent Covid-19 as well as to take care of NCD patients.

This training was delivered in a way which meant it could be cascaded to other health workers in the facilities, to have an even wider reach. The training also introduced remote telephone consultations which will help avoid frequent hospital visits. The early results are very promising, but if this succeeds further, it will enable vulnerable patients to receive the care they need in the safest possible way.

It is only through your support that this work has been possible. From the whole THET team, we wish you a happy and safe festive season.

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I am a medical doctor in Addis Ababa, as well as being THET’s Ethiopia Country representative.

With your support, over the last months we have been able to respond to the healthcare crisis which COVID-19 created. Ethiopia was one of the hardest-hit countries in Africa, and our healthcare system was put under immense pressure. Those with underlying vulnerabilities felt this most acutely, and much of the regular treatment and care that was needed was not available. As someone who has dedicated my career to helping those with NCDs, this was extremely difficult to witness.

In light of this issue, THET responded by ensuring NCD patients in rural areas could still access the care they needed without having to risk making long journeys to health centres. THET has been working with health workers and facilities to ensure they could provide patients with phone consultations. We have also been working with facilities and Ministry representatives to encourage longer prescription refills. This has been a lifeline to patients who need regular care, and will undoubtedly teach us lessons that can be applied during Covid and beyond.

We are now further scaling up our Covid response through additional training for healthcare workers on COVID-19 and NCD care. This training will focus on infection prevention and control, and has been adapted to ensure that it is inclusive to the most vulnerable in the community. The training will be delivered through a cascade model to ensure that the training can continue to be delivered after the project has ended.

With low vaccination rates and limited testing capacity, it is likely that COVID-19 will continue to affect Ethiopia for the foreseeable future. THET will continue to respond and adapt so that we can continue to reach those who need care most. We are grateful for your continued support.

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Health workers receiving Covid-19 training
Health workers receiving Covid-19 training

My name is Dr. Meti. I am 26 years old and I was born in the Oromia region of Ethiopia.

My life was stable until I was diagnosed with type 1 diabetes and was started on insulin. Soon after my diagnosis, my mother was diagnosed with breast cancer and started a battle against it. Finally after going through chemotherapy, radiation and surgical procedures she lost the battle.

I decided then to be a doctor and vowed to myself that all the mistakes I saw and mistreatments my mom and I got will never be repeated again.

I am a physician now and I am working at one of the health centers THET supports. I am happy I can help people like me, and make all the difference I could possibly can in their life.

When people stand bedside us, it means all the world.

I work in a health center, the lowest place in the health tier and it gets you close to the community. You will see the real financial and health problem of the society. As a primary health care provider you will meet with true face of poverty.

For me, a typical day starts with a wave of fear. The moment I open my eyes I battle with the thought that as a diabetic patient, I could get infected with COVID-19 and I may never make it out alive.

Every day is a battle like a soldier in a war, afraid for my life but thinking of those who need my help. I put my fear down and try my best to get through the day with a positive attitude. After all the worry and anxiety, I get up take my insulin and get off to work.

There are days where I feel hope full and try my best to help my patients with what little we have. Thanks to donors, we are able to screen most of our society for NCDs, helping us pick those at risk and who already developed the disease fast and act on it.

In a poor country like mine, the best way to help is prevention. If I am able to prevent or at least delay diabetic complications such as blindness and amputation, I will be helping my patient, his or her family and my country in some way.

I would like to show my gratitude to organisations for making this possible.

I know with the support of organizations such as THET, and with collaborative work of my colleagues we can make a small change in a world full of chaos.                                                                          

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Tropical Health and Education Trust (THET)

Location: London - United Kingdom
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Twitter: @THETlinks
Project Leader:
Kat Brassington
London, London United Kingdom
$27,446 raised of $35,000 goal
 
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