Monday, August 31, 2009

Berks County doctor helps Ethiopians set up nation's first modern trauma unit

Just running the Reading Hospital emergency department, Dr. Charles F. Barbera gets plenty of perspective on health care.

But he discovered even more this summer in Africa, helping to open the first modern trauma unit in Ethiopia's capital, Addis Ababa.

"I was one of several doctors who went with a South Korean Christian medical group to help with the center," said Barbera, 45, who has been chairman of the hospital's department of emergency for the past 10 years.

Barbera resides in Wyomissing with his wife, Mary, a behavior analyst, and their children Lucas, 13, and Spencer, 11.

"Ethiopia is probably more than 20 or so years behind as far as advances in medical treatments," said Barbera, who worked in the country with an international medical team at the Myungsung Christian Medical Center from June 18 to July 3.

"I had never been to a Third World country, so this was an eye-opening experience for me, to learn about the practice of medicine and health care needs in other places," he said.

What Barbera mainly learned is how lucky he feels being in the American medical system, because of its advanced diagnostic technology and medical treatments. That's true even with all of the most recent political tumult about the need for health care reform.

"First, there is a lot we take for granted in terms of the basics - food, water, shelter, electrical supply," Barbera said. "In Ethiopia, everything is pay in advance - in cash - for medical services.

"If you can't afford it (the care), it just isn't there. People will choose to go home and die."

Frustration and need

Barbera said life expectancy is about 45 years in this African nation of about 78 million people. About 8 million people live in Addis Ababa.

Diseases and illnesses are also much different from what is seen in the West.

"You don't have the heart disease and obesity there," Barbera said, noting that he was asked by a United Nation's contingent to serve one day at an Eritrea border refugee camp where he saw about 400 patients in a makeshift clinic with dirt floors and walls and a sheet metal roof.

"I was seeing malaria, typhus and bacterial eye infections that can lead to blindness," he said. "There were serious burns because of people commonly cooking over open fires, thyroid diseases and some autism and trauma.
"It was frustrating because only some of the things I could treat. I did what I could, but breast cancer, blindness I couldn't do anything about."

Ironically, in a country whose medical system is backward by Western standards, trauma suffered by victims in modern traffic accidents is a growing problem.

Increasing numbers of patients are transferred to Addis Ababa from more limited, smaller medical facilities throughout the country.

"The new trauma unit was already seeing up to 20 patients a day, many of them brought to the hospital days after the trauma occurred because there is no emergency medical transport system; everything is by private carrier, sometimes by animal," Barbera said.

The trauma unit is part of the city's 100-bed hospital, which has five beds in a room and no private rooms, Barbera said. The intensive care area is one room with three beds.

Nations work together

When the trauma center opened, Tadesse Haile, Ethiopia's trade and state minister, said his nation faces a lack of comprehensive medical services such as modern trauma units.

"There is a need to do more to establish such modern medical centers in the capital as it moves to be home for various people and international organizations of the world," he said.

According to Barbera, the new trauma unit, with highly sophisticated diagnostic equipment, will have comprehensive trauma services with trauma, neuro and orthopedic surgeons.

Officially opened in 2004, the Myungsung Christian Medical Center has been providing medical services in 10 departments, including internal medicine, surgery, obstetric, gynecology, pediatrics and neurosurgery.

"Keeping doctors there (in Ethiopia) is a huge problem, because when a doctor comes here to the U.S. to be trained, he will stay here - never go back," Barbera said. "Doctors there get paid about $600 a month, about 70 cents an hour."

Barbera credited the Japanese, South Koreans, Swedes, Italians and Americans with trying to upgrade Ethiopia's medical care system.

"It is a place where people often must bargain and negotiate for care, and waiting rooms are filled," Barbera said. "I hope to go back within a year - and maybe bring some of my colleagues."

Contact Bruce R. Posten: 610-371-5059 or bposten@readingeagle.com.

Friday, August 21, 2009

Sociocultural factors influencing HIV/AIDS caregiving in Addis Ababa, Ethiopia.

Sociocultural factors influencing HIV/AIDS caregiving in Addis Ababa, Ethiopia.
Nurs Health Sci. 2009 Sep;11(3):244-51
Authors: Aga F, Kylmä J, Nikkonen M
The sociocultural factors that influence care and caregiving vary from place to place, with both beneficial and harmful effects on the health of the caregivers.

Therefore, this article presents the cultural and social structural factors that influence care and caregiving from the perspectives of the family caregivers of people living with HIV/AIDS in Addis Ababa, Ethiopia. Using semistructured interviews and participant observation, a purposive sample of six key participants and 12 general participants were interviewed in their home between December 2005 and January 2006. Four important sociocultural factors that influence care and caregiving have been identified: religious beliefs, economic issues, education, and social stigma and discrimination. The findings of our study underscore the importance of understanding the cultural and social structural factors that influence care and caregiving from the perspectives of family caregivers in order to provide culturally congruent care to those in need.

Saturday, August 8, 2009

Indian firm to build eye centre in Addis Ababa

By Groum Abate
Addis Ababa, Aug 8 (IANS) Indian project development firm Overseas Infrastructure Alliance (OIA), involved in diverse projects in Africa’s second-most populous nation, will build an eye care centre in the premises of the Zewditu Memorial Hospital here as part of its community partnership programme. The project has been lauded by Ethiopia’s President Girma Woldegiorgis.
Speaking at the groundbreaking ceremony for the hospital, Woldegiorgis said close to 2.3 million blind people live in Ethiopia, out of which 1.3 million are totally blind. He said there was a severe shortage of health facilities and eye care specialists that offer medium and large scale services in the country.

Girma expressed gratitude to Indian Ambassador Gurjit Singh on behalf of the people of Ethiopia for encouraging OIA to help set up the facility. The establishment of the eye care centre shows the ever-increasing people-to-people ties between Ethiopia and India, he added.

Addis Ababa Mayor Kuma Demekissa said Menelik II and Ras Desta Damitew Hospitals are the only hospitals in the city that offer medium- and large-scale eye care services and the new centre will help add up to the service given in the city.

Gurjit Singh said that the hospital would be the second hospital from the Indian people after the Gandhi Memorial Hospital that was established some 60 years ago. He said the facility would boost Ethiopia-India friendship.

OIA chairman V.B. Soni said the company will construct a state of the art eye care centre, outpatient service with modern diagnostic facilities, minor and major operation theatres, inpatient services, and administrative offices. The two-storey opthalmology centre on 2,000 sq metres will also be equipped with modern diagnostic, clinical and office equipment and furniture, he said.

OIA is also participating in sugar production expansion projects in Ethiopia after the Indian government extended a $640 million loan for the project. Besides, it is also involved in the rehabilitation of the Ethiopia-Djibouti rail link.

Friday, August 7, 2009

World Learning Launches an HIV Prevention Project in Ethiopia

July 23, 2009 (Addis Ababa, Ethiopia): World Learning Ethiopia announced the launch of a three-year project entitled “HIV Prevention in Large Scale Construction Sites in Ethiopia,” made possible by a $4.75 million grant from the President’s Emergency Program for AIDS (PEPFAR) through United States Agency for International Development (USAID). The project aims to reach more than 33,000 construction workers, 2,900 commercial sex workers and 200,000 surrounding community members from a total of 25 construction sites located throughout Ethiopia.

Ethiopia is undergoing nation-wide economic development efforts that include large-scale construction throughout the country. Many of these construction sites are in rural and remote locations where HIV prevention and care efforts are often lacking. Working in collaboration with key government agencies, World Learning seeks to create workplace interventions and policies that will reduce high-risk behavior and HIV infection for workers and community members.

Local partners, World Learning staff and community members attended the launch event. The day included a keynote address by USAID Deputy Mission Director Nancy Estes and workshops by Dr. Abeba Bekele, chief of the prevention project and Ministry of Water Resources representatives.

Nancy Estes observed, “…this project implemented by World Learning is unique in that it works closely with government agencies to help institutionalize HIV prevention policies and programs in the workplace.” She continued, quoting a famous Ethiopian Amharic proverb hande bertu hulet medhanitu meaning “two is stronger that one.” “I could not agree more,” Estes noted. “It takes partnership-between government and donors, NGOs and communities, to make a lasting change…we believe that without the involvement of the government and the community, HIV prevention will not be sustainable.”

World Learning Ethiopia Country Representative, Adanech Kebede, said, “It’s my firm belief that with the commitment and expertise we expect from (World Learning,) we will be able to achieve our objectives and contribute towards the betterment of our country Ethiopia”.