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
Picture 1
Picture 1

Meeting the health extension workers

 

Picture 1:HEW from Seka

The Health Extension Workers (HEW) are the community health agents working on health education, prevention and promotion of health in the community. We have used this opportunity provided by the health care system to reach rural people and raise awareness among their community on some of the risk factors of non-communicable diseases as well as identifying symptomatic cases, screening for raised blood pressure and also tracing patients who have been lost follow up at Health Centres. These are early days for our developing the skills of the HEWs; we hope to report on their progress in the community as our work with them becomes more mature. But we are delighted to enlarge the range of care for rural patients; it has never been done before and so is a significant step forward for training.

 

Picture 2: HEW from Serbo 

 

Semira is a HEW from Shebe catchment area, sitting in the middle in picture no 2. While looking at an educational video of different seizure types she remembered a case from her village. This was her description of what apparently looked like an absence seizure.

 

‘A 10 year old boy has an attack of absence with looking upward and showing the white of his eyes. He continues to do whatever he has been doing, like walking or eating, but appears to be “absent” and thus he continues to do whatever he has been doing as if never interrupted ’

 

 

Picture 3:HEW from Shebe area

 

The health extension workers are given a three days orientation about features of epilepsy, diabetes, hypertension and heart disease. They are also oriented on how to deliver educational messages on risks, preventive measures and how to deliver lifesaving first aid in case of crisis until appropriate referral can be arranged.

 

Picture 4:HEW from Omonada area

 

 

Picture 5 Community involvement, a new approach for chronic disease prevention and care

 

 

Health extension workers in Gondar area are now important and recent members of the team (specialist doctors, nurses, pharmacists, laboratory technicians) caring for chronic disease patients. These are a contemporary health cadre in the Ethiopian health care system primarily engaged in preventive interventions. They are recruited from among their community for a short training and then they return to their home area which is the reason for their high commitment. They have thus been responsible for a number of high impact outcomes in vaccination and in making people aware of their access to health care. Most of them aspire to develop a career in health care such as nursing, pharmacy and environmental health worker.

 

The HEWs are also be useful for increasing the awareness of the community about chronic non communicable diseases. They can help in early detection, prompt referral and tracing of those who have been lost to follow up. In the chronic disease programs in Jimma and Gondar we are reaching out to HEWs and orienting them on the most important Non Communicable Diseases declared by Ministry of health (diabetes, heart and respiratory diseases) and also in epilepsy. The Health Centre nurse second from far left (brown shirt) would receive referrals from her team of HEWs, confirm diagnosis and start treatment according to standardized protocols and training delivered to her at Gondar University Hospital Chronic disease clinic.

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Picture 2
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Picture 5
Picture 5
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Dr Yoseph, the Ethiopian physician in charge of this Rural Health Centre project, has sent two case studies of the treatment of children with severe cases of epilepsy by a health centre in Maksegnit which is in an isolated area of Ethiopia. The two reports show how the centre in this rural area of Ethiopia is managing to treat these young children suffering from epileptic seizures and as a result bringing positive life changing improvements for them. This would not have been possible without  the access to healthcare where it was previously unavailable and these case studies demonstrate that  the funding that has been raised through this project is directly benefitting some of the most isolated rural poor in Ethiopia.

The report and photographs included are shown as we have received them from Dr Yoseph himself.


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Dr Yoseph, the Ethiopian physician in charge of this Rural Health Centre project, has sent the attached report. Dr Yoseph's work brings him into daily contact with people affected by life changing conditions such as epilepsy. By setting up these Rural Health centres he is bringing access to healthcare where it was previously unavailable. The funding that has been raised through this project is directly benefitting some of the most isolated rural poor in Ethiopia. The report incuding the positive case studies, shows the evidence and value of this approach.

The photographs attached to this report are somewhat distressing but this is how we have received them from Dr Yoseph himself.


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We received the attached report, including photographs, from Dr Yoseph. In it he describes the impact of diabetes on young women, in rural Gondar:

 

EMERGENCIES in Diabetes

 

 

A young women from Rural Gondar, farming is type 1 diabetes and on high insulin dose. She had developed hypoglycaemia and came in coma. The health centre nurses were trained in emergency and were able to save her life. Type 1 diabetes is common and patients often develop acute crisis, which is often a cause of premature death unless emergency interventions are possible and delivered promptly.

 

Patient may miss their meal , or do rigorous farming work ,or take a higher dose of insulin by mistake this will lead them to low blood glucose level which may lead to fainting or at worse coma and if not addressed promptly, this is fatal outcome of treatment. Health education is given to patients to never miss a meal, and always to carry a piece of bread even while working in the farm field

 

Training of health centre nurses with practical management of emergencies such as the above case saves lives, here discussion is being made the reason why the patient went into coma and how to manage her and whether she needs a referral to hospital. In this case it was concluded she had a hypoglycaemic attack due to high dose prescribed and also rigorous physical activity of the young woman. She was managed with intravenous glucose and after regaining consciousness information was given to her and family on how to prevent such episodes again, Insulin dose was reduced and patient given referral to check with her physician in 3 days to review the dose of insulin administered.

 

Dr Yoseph Mamo

4 April 2014


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Stories from Jimma and Gondar chronic disease projects

 

  1. The burden to a mother of a diabetic son 

Zahara is mother of a 12 years old Type 1 diabetic boy who was not diagnosed until one day she came to the medical OPD with symptoms of urinary tract infection. Her mouth was full of Khat, a green stimulant leave. Khat has similar effect to Amphetamine, a psycho-stimulant herb commonly used in Jimma area. I asked her why she is doing this in the clinic and expressed my disappointment and something about her not being a good example to younger people. She apologized and started to explain with tears welling up her eyes. Zahara is a single mother who supports herself and her diabetic son by selling vegetables at the village Market ‘Gullit’. There is very little income and to put enough food on the table for the whole family, hence the mother eats little to save for her son. She has gone on with little or no food for days as her 12 year old son is so hungry and eats up whatever is available in the house. She feels so much pity for him and tried to suppress her hunger with whatever is available and Khat she found out blocked her appetite better than anything else. I told her this could be diabetes and to bring her son for check-up. He was confirmed with diabetes and was registered in the paediatric side for free insulin supply until the age of 18. Her misery was over as soon as he started follow-up and treatment.

 

Dr Yoseph Mamo

January 2014


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Tropical Health and Education Trust (THET)

Location: London - United Kingdom
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Project Leader:
Kat Brassington
London, London United Kingdom
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