From Addis to Afar: Epidemic Unveils Ethiopia's Health Challenges
By: Amanda Moore
July 23, 2009.
I arrived in Addis Ababa on June 29th and have since divided my time between the capital and the region of Afar. In terms of weather, the contrast between the two is striking – it’s winter and thus rather cold in Addis yet somehow still mercilessly hot in Afar. The residual Italian influence in Ethiopia from the brief occupation 50 years ago is surprisingly strong, even in Afar’s small town of Awash. Espresso machines abound, and if you want milk in your coffee you order a “macchiato.” The second staple after the local bread injera is pasta – in some restaurants you can even get pasta rolled in injera, a carbohydrate-junkie’s dream. Heapfuls of spaghetti and lattes every day? Ethiopia is my culinary dream.
In both Addis and Afar, water and electricity are in short supply due to the drought that has taken hold of the country and stubbornly refuses to let go. Talking with one of the staff yesterday, he said that he could not recount another time in his country when the electricity shortage had been this bad. It has affected every sector of society. The AMREF office in Afar is currently awaiting procurement of new office furniture, but production has been stalled for an indeterminate period of time because there simply isn’t enough power to make it.
I have to applaud the AMREF staff in Afar for their seemingly inexhaustible patience. A project officer might spend an hour waiting for a report to attach as an email file only to have it time out, forking over 10 Ethiopian Birr (the local currency) to the internet café nonetheless. They shuffle back and forth between the two sides of the town, divided by the main road that courses through it on its way to Djibouti, taking advantage of whichever side has electricity that day. The project coordinator has fashioned a makeshift desk and stool out of boxes of printing paper. In North America we have come to expect, and thus demand instant gratification, for whatever it is we need or desire. If nothing else, I know my time here will be a lesson in gratitude.
Epidemic Unveils Deep Rooted Health Challenges
An epidemic of Acute Watery Diarrhoea seems to be making its way across the Afar region, and by far one of the most eye-opening experiences of my trip thus far has been the opportunity to accompany the field staff to kebeles that have been most affected (kebeles are the smallest administrative units in Ethiopia, like city wards in Canada). The outbreak was first noted in May of this year, and has led to the proliferation of treatment centres (CTC) throughout several
districts of the region. AMREF has been visiting these centres to get a better sense of the exact extent of the outbreak, how it is being controlled and whether it is emergent enough to warrant an intervention.
I arrived at the first centre expecting a corridor of beds filled with patients, and was taken aback when the nurse on duty pointed to a seemingly abandoned tent on the far side of the property. Set apart from the health centre and roped off with surplus IV tubing to limit transmission and discourage the entry of unauthorized personnel, I had trouble concealing my shock when I stepped into the tent. The patients were lying on the ground, with nothing separating them from the dirt but a sheet, or worse, piece of cardboard. One man was being treated intravenously, another had an IV in his hand but the bag of much needed fluids had run dry and no one had yet returned to replace it. Every centre I visited thereafter was in a similar state.
It is difficult to get an accurate picture of the number of people affected by the outbreak, the conditions at the centres being so poor that they effectively dissuade people from seeking any treatment. It speaks to the incredibly limited resources with which the health staff is working.
These same limitations are visible elsewhere as well – brand new health facilities that are empty because there aren’t enough staff to fill them, others in which the staff who do work there are demoralized by budget constraints and lack of medicine and other essential supplies. I have to again admire AMREF for their tenacity – their seemingly superhuman ability to swallow the countless constraints with which they’re faced and plow through doing the work that is needed if better health is ever to be a reality in this country.
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