Bill & Melinda Gates Foundation

Day 4 in Ethiopia: U.S. Nurses See Local Health Facilities Up Close

December 21, 2012

Last week Jennifer James was in Ethiopia to observe Save the Children’s work with frontline health workers. She, along with three US-based pediatric and obstetric nurses, visited health facilities in Addis Ababa and Hawassa.

“They do the best they can with the resources they have,” sighed Mimi Pomerleau, President-elect of the Association of Women’s Health, Obstetrics, and Neonatal Nurses, after visiting an isolated village health post that had no electricity or running water in the Ramada district in Ethiopia's southern region.

Time after time during our trip with Save the Children to observe frontline health workers, hopes were high after visiting health facilities in Ethiopia. The sheer dedication of the health workers who provide lifesaving care for their community was palpable, but the harsh reality remains: resources and equipment are needed in greater quantities in order to save more lives.

During our week in Ethiopia, we visited three community health posts, one health center, and two hospitals. In Ethiopia, the health care system is tiered. Community health posts are designed to provide care for 5,000 people by two trained health extension workers. When they cannot provide proper care for those with acute illnesses they are referred to a regional health center. Hospitals are designated for the worst illnesses that cannot be treated on either the health post or health center level.

Pomerleau, along with pediatric nurses Rosemary Livingston and Danae Ireland, recognized the failings of some of the tools, equipment, and even medical practices performed on patients. From the nurses’ vantage point, two of whom have already seen health settings and disparities in Haiti and Zambia, the lack of resources and education are largely the determining factors that prevent better health outcomes.

Coming from resource-rich hospitals in Nashville, Boston, and Washington, DC, the nurses could point out succinctly where equipment in maternity wards and even medical techniques for babies, for example, could be improved, but without increased funding to buy updated, top-of-the-line medical equipment and provide more health education, they knew the Ethiopian health workers were up against an uphill battle. Each community health post and even the health center we visited didn’t have running water although they were equipped with sinks. They also didn't have electricity, a problem when an expectant mother goes into labor at night. At one of the largest hospitals in Addis Ababa its NICU had three radiant warmers for premature babies, but sadly none of them worked.

“I just want to cry,” Rosemary Livingston, a pediatric nurse at Children’s National Medical Center in Washington, DC, said after visiting the NICU at Black Lion hospital in Addis, Ababa.

Although the disparities are clearly apparent between health care in the US and that in Ethiopia, progress is being made. Ethiopia’s Ministry of Health is committed to making changes to achieve the Millennium Development Goals and the Minister of Health, Dr. Tedros Adhanom Ghebreyesus, said at the Child Survival Summit held at Georgetown University in June, “We want to build a truly women-centered health system from the bottom up.”

Judging by the commitment of the health workers we met last week to maternal and children health I have no doubt that through new country-wide health efforts and partnerships Ethiopia will drastically improve the health outcomes for its citizens and save more mothers’ and children’s lives.

You can learn more about frontline health workers at Save the Children’s web site, Every Beat Matters.

 
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