The Anglo-Ethiopian Society
Medical Equipment for Rural Ethiopia
Author - Andrew Chadwick and Martha Mulugeta Berihun
Ethiopia, an ancient country with a rich diversity of peoples and cultures has remained backward in socio-economic and political development, and in technological advances.
Conventional health parameters such as infant and maternal mortality, morbidity and mortality from communicable diseases, malnutrition and average life expectancy, place Ethiopia among the least privileged nations in the world. In recent times the country has experienced severe calamities and political upheavals which have caused untold suffering to its people.
There are few roads in rural Ethiopia and 85% of Ethiopians rely on subsistence farming. People from these areas only seek medical attention in extreme cases, especially during times of planting or harvesting, and often need to be carried for three or four days to reach a basic health centre. On arrival there is likely to be no equipment for tests, to help with diagnosis, or for treatment. Even beds tend to be in a poor condition, if they exist at all, and patients often must lie on the floor. Despite having travelled long distances, patients cannot always get the treatment they need.
Since the mid-1970s, health, education and welfare provision in Ethiopia has deteriorated for want of essential resources. Rural health centres have had no investment for over 30 years, existing medical equipment lacks maintenance and much of that used in Ethiopia would be considered obsolete in any industrialised country. Medical staff lack the facilities to carry out the work for which they were trained and such services are now in steep decline.
International Development Partnerships (IDP), a volunteer-led charity, is working to improve access to health-care for isolated, rural communities by re-equipping run-down hospitals and health centres in remote parts of the country where medical facilities are scarce. This will increase the capacity of local medical staff to respond to the urgent need for health care among the local population.
To maintain the highest standards, medical equipment in the UK is regularly upgraded or replaced as a matter of policy. Technological progress and the need for reliability force the replacement of a great deal of perfectly good equipment, which then goes to waste. The potential for rehabilitating health centres in Ethiopia by recycling basic but reliable equipment from Britain, is enormous.
Our project benefits all members of the local communities it seeks to assist, but it is of particular advantage to women and girls who are frequently unable to leave their domestic duties to attend medical appointments, especially if referrals or follow-ups cannot be undertaken in one day. Here, reproductive health problems often receive no treatment until they become acute.
Local access to an effective health service leads to improvements in maternal-child health and the reduced risk of women having to carry out arduous tasks while unwell. They receive preventative treatment and health advice for themselves and their families when local facilities are better equipped to handle such cases. Patients no longer need to travel long distances, leading to more appointments being kept and an earlier resolution to medical problems.
Having acquired charity status in Ethiopia, IDP now operates under a tripartite agreement with the country's Ministry of Health and the Disaster Prevention and Preparedness Agency (DPPA). In all, the process took three years to complete and involved protracted negotiations with the Ethiopian Embassy in London, the Ministry of Foreign Affairs in Ethiopia, the Ministry of Health (both in Addis Ababa and in Bahir Dar) and the Ministry of Justice. These negotiations were made worthwhile when the Health Bureau in Bahir Dar accepted our proposal "enthusiastically", acknowledging, "this is just what we need".
Lack of adequate health care is of great concern in Ethiopia and our project was developed as a result of the expressed needs of local people and health professionals. Both rural and urban communities regularly convey their dissatisfaction through their local associations, religious leaders and village health visitors. Strengthening the provision of essential medicines, medical supplies and equipment forms a key element of the Ethiopian government's current health policy.
There is only around one doctor for every 30,000 people in Ethiopia but many of these are based in Addis Ababa and the ratio in rural areas can be as high as 1:140,000. Initially, we are working in the Amhara Region of northern Ethiopia where there is currently only one qualified surgeon among the region's population of 17 million.
Re-equipping these health facilities allows staff to carry out the work for which they were trained. It also helps stem the exodus of qualified health professionals from rural areas where they tend to migrate to the private sector or emigrate in search of satisfaction and reward. Despite recent salary increases, a general practitioner can get at least 85 times more annual salary working in the United States than working in Ethiopia. As of 2006, there are more Ethiopia-trained doctors living in the city of Chicago than those staying in Ethiopia.
The response from UK hospitals to our requests for redundant equipment has been most encouraging. We are now bringing our work to the attention of the wider public in order to raise the necessary funds to pay for the cost associated with collection and shipment of the equipment.
Having already shipped hospital beds, mattresses and uniforms to the north of the country, we are aware of the constraints and confident of the viability of this initiative. The basic equipment provided by the project is expected to last five years, at least. Shipping containers are adapted for use as health posts, where none yet exist, or as secure medical storage.
Our most pressing need is to establish a maintenance training capability to update the skills of Ethiopian maintenance staff and to repair existing stockpiles of unserviceable equipment - this will also extend the working life of project equipment for another five or ten years in many cases. We would welcome your support in raising sufficient funds to achieve our objective of supporting some of the most disadvantaged communities in Ethiopia.
Any contributions will help us raise further funds from grant-making trusts and will provide a vital boost to an influential project improving access to health care among some of the most disadvantaged communities in Ethiopia, with the potential for replication on a wide scale. The need is great and we welcome any support you can give.For further details, or to make a donation, please go to www.idp-uk.org