Team Ethiopia North: Hospital Days 1 and 2

Yesterday and today we got our first taste of life in the hospitals here in Ethiopia. It’s definitely a lot different than what we experienced during the summer at Hopkins, but it was extremely enjoyable and we learned a lot. All of the people are very nice and welcoming. We began by visiting Felege Hiwot Regional Hospital. The structure of hospitals in Ethiopia is as follows:

1)      Specialized Hospitals, of which Black Lion is the only one in the country

2)      Regional Hospitals

3)      District Hospitals

4)      Health Centers, which provide care for patients as well as support 5 health posts within the area

5)      Health Posts, which are run by 2 health extension workers who are responsible for providing basic care to 1000 total families

Within this structure, each level will refer patients up the chain if they aren’t able to provide adequate care or treatment. Upon arrival at Felege Hiwot we met with the CEO of the hospital to explain who we were and what we were doing at his hospital. He was very welcoming and said he expects big things from us in helping them fill some of their gaps. He assigned Sister Yeserash, one of the head nurses, to guide us around the hospital during the day. She proceeded to take us around to all of the units in the hospital to meet the staff and ask questions. The units included antenatal care, vaccination/family planning, pediatrics, neonatal care, general medical care, surgery, and maternal care. Personnel within each unit graciously took time out of their day to allow us to interview them in an effort to identify existing problems, as well as discuss some of the problems we are already aware of. The feedback we received was extremely valuable and everyone seemed to be excited that we were there. It was a joy to see how much the healthcare workers genuinely care for their patients and are actively seeking ways to improve the care they’re able to provide. They really do make the most out of the limited resources they have.

We also had the privilege of visiting the test lab and the pharmacy. The test lab had some relatively modern equipment that allowed for blood chemistry testing as well as hemodynamics. However, there are still many limitations and gaps the staff identified for us. Within the pharmacy the most significant problem seemed to be the expiration of drugs. It was unfortunate to hear that a lot of the drugs that are donated to the hospital are near their expiration date at the time of donation and expire before they ever reach the hospital. There is commonly a shortage of potent antibiotics and even things that seem simple in the US, such as saline, are in great demand here. The day was definitely an eye-opening experience. After hours of interviews (our translator, Sarowit, must have been exhausted from talking so much) we headed back to the hotel for some food and much needed rest.

During our second day at Felege Hiwot we were hoping to view some surgeries and deliveries since we had spent all of the previous day speaking with the hospital staff. Unfortunately, the hospital preferred that we did not observe these things. We were a little disappointed, but found other ways to stay busy. We hiked back behind the hospital and viewed the incinerator and the way medical waste is currently segregated and disposed of. The hospital is currently in the process of building a new incinerator, which is nearing completion. We also had the opportunity to observe a BEmONC (Basic Emergency Obstetric and Neonatal Care) training course being funded by Jhpiego at the hospital. The course is taken by nurses and midwives from health facilities throughout the region. The training consists of 3 weeks of classroom learning and simulated labor situations. We were able to meet with the trainers, who provided us with some additional needs specific to the training as well as general care. A picture of the training is posted below.

Before leaving we went back to pediatric unit and handed out some toys that we had brought from home. This was definitely the best part of the day. At first the children were a little shy and unsure of why the Ferench (what they call white people) were there. However, they quickly warmed up to us as we started handing out mirrors, squishy balls, frogs and coloring books. The kids and their families were anxious to pose with us and their new toys for pictures. 

They love to look at the pictures on the camera because they think they’re on tv. We said our goodbyes and thanked everyone who’d helped us at the hospital before heading out.

In the afternoon we went to the Merawi Health Center, which is about 30 minutes outside of Bahir Dar. This is two levels down from Felege Hiwot within the Ethiopian health system. We showed up unannounced, hoping we would be allowed to observe some things, and we were welcomed with open arms. The doctors and nurses at the center spent a couple of hours guiding us to various units of the center as we peppered them with questions (Sarowit continues to be our hero as a translator) and took pictures. It was interesting to compare the center with a regional hospital because the capabilities and resources are even more limited. Some of our needs are beginning to come into clear view across all levels of the health system here. At the end of our time at Merawi we presented the staff with a couple of the penguins and they were very excited and thankful.

We’re continuing to learn new things as well as gain a depth of understanding of some of the problems we have already identified. This is such an incredible experience! I apologize for the semi-long blog entry, but a lot has happened over the last 2 days. We have tomorrow off and hope to do some sightseeing on Lake Tana. Hopefully we’ll have some good pictures to post. Stay tuned!