Supporting Rural Health Centres in Ethiopia

Aba is 80 years old. He’s a farmer and lives just a 30 minute walk from Asendabo Health Centre. Two years ago he started having headaches and problems with his vision. His children urged him to attend the health centre and there he was found to have high blood pressure (hypertension). On presenting at the health centre, the chronic disease team started him on drug treatment – Enalapril – to control his blood pressure.

Now Aba has no symptoms and feels very satisfied with the care he gets at his local health centre. He is one of thousands of Ethiopians who are benefitting from our project to decentralise non-communicable disease care in rural Ethiopia.

Riyad is 20 years old. He’s a farmer and lives with his family 30 minutes from a health centre in Jimma. Riyad is illiterate, has never been to school and has epilepsy. Prior to seeking treatment at the health centre he first tried a traditional method of management for his condition.

He attended a local traditional healer who advised him to take a powder, mixed with water and drunk every evening after dinner for a total of seven days. Unfortunately there was no improvement and, as with preceding weeks, he had four seizures. This failure to improve prompted him to come to the health centre and be started on anticonvulsant therapy. He now agrees that attending his appointments can help him feel better and, after being a regular attendee and taking his medication, has been free from attacks for ten months.

Now that we have been fundraising through GlobalGiving for our work in Ethiopia for over three years, we think it is a perfect time to provide a more general report on progress to our donors.

Since 2013 we have trained 134 nurses and health officers to diagnose, treat and care for NCD patients at health centre level in the Jimma and Gondar regions of the country. They are doing a fantastic job of delivering these services under the supervision of Dr Yoseph and colleagues at Jimma and Gondar Universities. We have also trained 242 health extension workers to raise awareness about NCDs in their communities and to refer patients to their nearest health centres for NCD screening.

As a result we are delighted to say that we now have over 8,000 diabetic, hypertensive, epileptic and chronic respiratory disease patients registered at the health centres where we work. These patients are now receiving treatment and care for their chronic conditions, often for the first time in their lives.

We also continue to conduct research into these diseases in collaboration with our university partners in Jimma, Gondar and Southampton. This is allowing us to build a stronger evidence base about the causes of these conditions in the rural areas of Ethiopia, as well as how they are experienced by the patients themselves. In turn, this evidence is enabling us to improve the way we deliver our work, and to ensure it continues to benefit the rural communities of Ethiopia. Our most recent research into the reasons for patient default will be published soon.

You, the donor, is making this happen! We are extremely grateful for your generosity. Thank you.

Fatima, an epilepsy patient, is from a family of farmers in rural Ethiopia. Her younger sisters all got married at a young age, at 16 or 17 years old. Sadly, due to the stigma surrounding epilepsy, Fatima remained unmarried into her late twenties and was somewhat ostracized by her community. Many people in her village considered epilepsy to be contagious or the result of a curse that could be transmitted to family members and children.

One day just before Fatima's 26th birthday she attended a family wedding. A cousin, who had heard about her epileptic neighbour receiving treatment and getting better after going to the health clinic in Asendabo, told Fatima about the miracle drug which had helped her neighbour so much. Fatima had faith in her cousin and so went to the clinic to see what could be done to help her. 

Within a few months of starting treatment Fatima's seizure's were under control. Now, four years later, she has told us she is happily married and has two healthy little boys. She also intends to continue with her high-school education when her boys get a little older. 

A 16 year-old boy had been brought to Jimma University Hospital by his father, with the problem of weight loss and extreme thirst and hunger. He was subsequently diagnosed with Insulin-Dependent Diabetes (Type one) and after receiving in-patient training on how to inject insulin, he was sent back home with sufficient insulin supply for two months. He continued his follow up every two months.

Two years later I saw the boy drinking the forbidden Coca-Cola before his visit for his blood sugar check-up and insulin refill. After several hours of individual and group health education on diets harmful to a diabetic, I was very disappointed to see him drinking that. When he arrived to see me in the clinic, he was apparently unaware that I have observed him practice the ‘taboo’. I asked him about his drinks after few minutes of chat and physical check-up. He was taken aback and after few minutes of hesitation confessed to me the following story…

After making six trips from his home in the Shebe area (60 km from Jimma by vehicle and four hours of walking) to the hospital, his father was unable to support him further. After a painful discussion the decision was made that the boy should stay in Jimma, working at manual labour and going to the hospital every month for his insulin. The boy had very serious difficulties with completing manual labour, finding a safe place to stay and finding enough food to eat. One day he heard a fellow patient, how he drinks Coca-Cola before each check up to acquire more insulin vials. He then sells his extra insulin to buy food and pay for rent. After hearing that, the boy decided to follow in his footsteps and acquire more insulin than he actually needed, to sell and earn a living.

This was a shocking story, but also an eye opener. My job isn’t simply medical, it is hugely impacted on by economic poverty. From that day on I started work to organize patients in to an association and establish some kind of self-help funding, so that patients can be economically empowered as well receiving health education and information. I know that this will continue to be a challenge.