The Anglo-Ethiopian Society

Lecture - Thursday 6th March 2008

Making Ethiopian doctors since 1968

Given by - Prof Eldryd Parry

Reviewed by - Ann Russell

Professor Eldryd Parry OBE has had a long career in tropical medicine and in 2007 was awarded a Centenary lifetime achievement medal by the Royal Society of Tropical Medicine and Hygiene. His career has taken him from west to east Africa. After working at Ibadan in Nigeria from 1960 to 1963, he joined the Faculty of Medicine at Haile Selassie I University in 1966 and taught there for three years. In 1988 he started THET (the Tropical Health Education Trust) which supports training for healthcare in African hospitals and training schools, chiefly through catalysing links between them and their counterparts in the UK.

He divided his talk into four themes: medical education in Africa as a whole; in Ethiopia in particular; how medical teaching began in Ethiopia; and the work of THET and its plans for the future.

He pointed out that the pattern of medical education in Africa was led by University College, Ibadan, Nigeria, which was a constituent college of the University of London so that its first graduates in medicine in 1960 received London University degrees. While an international standard was thus attained, locally relevant training, alert to the local economic, social and health care needs, was less easily established.

Professor Parry moved on to look at the situation in Ethiopia in the 1950s. At this time the population of Ethiopia (then including Eritrea) was about 25 million, for which there were 80 doctors, very few of whom were Ethiopian. In the early 1950s major developed nations, notably UK, USA, France, Germany and Sweden, played a major role in laying the foundations of medical services and education. The first teaching institution established in Ethiopia was the Gondar Public Health College, founded in 1954 by UN agencies and USAID. The first graduates of the Public Health College were 12 health officers, 1O community nurses and 10 sanitarians. In 1960 there was a huge outbreak of relapsing fever, and 40 staff from the College and 25 from the municipality of Gondar worked together to manage the epidemic. Sadly, this fine example of a teaching institution working with, and within, the local health service was abandoned not long afterwards.

For Ethiopia the 1960s was an era of imperial power and splendour and Emperor Haile Selassie was intent on providing education for his people. In Addis Ababa, the Medical Faculty had started in 1964 at the main campus at Sidist Kilo, but clinical teaching began in October 1965 with students who had done their preclinical studies at the American University of Beirut. The teaching hospital was named after the Emperor’s daughter, Princess Tsehai, who had trained as a nurse at St Thomas’ Hospital in London. The first Ethiopian doctors graduated in 1968, and training continued until the Derg seized power in 1974, when the university, including the Faculty of Medicine was effectively closed, as students were sent for two years’ national service. By this time the Faculty of Medicine had moved to the former Duke of Harar Memorial Hospital, renamed as the Tikur Anbessa or Black Lion.

A dedicated group continued to practise medicine in spite of all the political upheaval. This group included Dr Teklasion Woldemariam, one of the first Beirut and Addis trained doctors, who was chosen by the Derg’s Ministry of Health to establish a pioneer medical school in Jimma in 1984. Thus Jimma’s excellent team and community based training were started and the seeds of Jimma University were sown.

Professor Parry’s continued involvement in medical education in Ethiopia has been through the work of THET, which has worked with the Ministries of Health and Education and significantly with the Jimma and Gondar medical schools through establishing their links respectively with Nottingham and Leicester hospitals and universities.

In the decades of shifting political and economic thinking, medical schools had been forgotten and even, in some instances, attacked as being irrelevant, only interested in their own affairs and not the wider needs of the people. Donors had thus forgotten them and it has needed reports such as Myles Wickstead’s Commission for Africa to reposition universities within a more balanced understanding of development. Another hindrance to the growth of training institutions has been the flight of highly-skilled professionals, especially medical doctors, either externally to industrialised countries, or internally by moving to the private sector or NGOs, which now pay four to five times the government salary for doctors.

He therefore emphasised how critically significant the work of THET is. The Trust has firm principles to be responsive, long-term in its planning, flexible and innovative. Thus, in seeking to answer the requests of the local leaders for development and further training of their staff so that they can give a service to their communities, it has facilitated links with UK universities and health authorities, including Cardiff University with Hawassa University, Leicester University with Gondar University, Nottingham University with Jimma University and a Sheffield Consortium with Mekele University. It has also promoted the links of two Welsh NHS Trusts, Gwent and Conwy & Denbighshire, with the SNNPR and with Hosanna hospital.

Some UK doctors fund themselves to spend part of each year working for THET in Ethiopia and other countries. Colleagues in Ethiopia find this professional support, stimulus and research collaboration extremely beneficial.

Medical training and health care are a long-term mission. The achievement so far is encouraging, but a lot is left to be done.

The Ethiopian Government has an ambitious plan to increase the number of entrants to medical schools substantially and thus to counter the loss of graduates overseas. This year the number of medical students nationally is to rise to a total of 200 in all five national medical schools, while further increases are planned; these numbers are in addition to the major programme of training health officers. THET is committed to maintaining and increasing what it does to support the medical schools throughout this demanding phase of their development, and thus to work with them to strengthen the health services and the care that they give to the most vulnerable.

First Published in News File Summer 2008

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