Ethiopia’s foreign minister praises U-M’s Ghana experience

Dr. Tedros Adhanom Ghebreyesus

We had the great honor to meet with Dr. Tedros Adhanom Ghebreyesus, Ethiopia’s former health minister who now serves as the country’s foreign minister. Dr. Tedros was one of the prime movers in establishing the partnership between the University of Michigan and St. Paul’s Hospital Millennium Medical College. He visited U-M three years ago and met with Joe Kolars, Tim Johnson and Senait Fisseha to discuss possible partnerships. He said U-M was an attractive partner because of the Johnson-led collaboration with colleagues in Ghana that has been working to improve health care in the West African nation for three decades.

Tedros and Fisseha

“What Michigan did in Ghana could be easily applied here,” the foreign minister said. “You cannot implement U.S. standards here, but a U.S. institution with experience in Africa really has more to deliver in Africa. Some of the things they did in Ghana can be replicated in Ethiopia. They know what they are doing. They don’t come with some illusion about the situation and what can be done. They have the experience, so they will come will come with the right understanding and come with something that is tailor made for you.”

 

 

Go tell it on the mountain

Boys sing in a church choir on the mountain of Entoto.

Studying HIV

Belen Michael, a graduate student in the School of Public Health, is spending her summer at St. Paul’s Hospital in Addis Ababa studying whether Ethiopian couples infected with HIV are interested in safer conception methods.

Waiting for customers

The shopkeep waits for customers at the museum gift shop in Haile Selassie’s former palace.

A new emergency room

Dr. Zerihoun in his new, smaller office at St. Paul’s Hospital.

Zerihun Abebe’s new office looked like a construction zone, with chunks of brick and plaster piled on the floor. Workers recently knocked a big hole in his wall, creating an entryway to his assistant’s office. The renovation is just one part of a much bigger expansion plan led by Abebe, the provost of St. Paul’s Hospital and Millennium Medical College – the University of Michigan’s biggest partner in Ethiopia.

His spacious old office has been converted to an emergency room that’s better able to handle the growing number of patients in the booming capital of Addis Ababa.

“Addis is suddenly full of traffic accidents, and we only have 12 to 14 beds. It’s crazy,” he said. “Everyday, there are 45 to 50 cases showing up that deserve admission, and for most of them we don’t have beds for them. Now, we will have 35 more beds – 50 beds in total.”

 

 

Alterations in a minute or less

In Addis Mercato, the largest open air marketplace in Africa, alterations are done right away by a team of men on sewing machines.

New hope for childless couples

Dr. Jenberu Meskelu in the Andrology Clinic

The inability to have a child is an extremely serious problem in Ethiopian culture, says Jenberu Meskelu, a physician at St. Paul’s Hospital Millennium Medical College in Addis Ababa.

“If you are a married person, you are expected to have a child,” Meskelu said.

Many couples who have trouble conceiving have to rely on traditional medicine, holy water or other remedies that waste their time and money. But now, patients are getting help at St. Paul’s, which last month opened the first andrology laboratory in a public hospital in Ethiopia.

About two months ago, Meskelu went to the University of Michigan to receive training in andrology, which focuses on male impotence and infertility. The training was part of a rapidly expanding collaboration between U-M and St. Paul’s.

“Before going to Michigan, I had only read about andrology,” Meskelu said. “I didn’t know how it was really done.”

After returning to Ethiopia, he wasted no time practicing what he learned. Two weeks ago, he performed his first intrauterine insemination, which involves taking a semen sample, separating the fast-moving sperm from the slower ones and placing them into the woman’s womb. He plans to do another IUI next week.

It’s too early to tell whether the procedure was successful, but Meskelu is hopeful.

His lab is basic, with a couple microscopes, a centrifuge and supplies that he rations because they can be scarce in Ethiopia.

“It’s a small lab,” he said, “but it will get bigger and bigger.”

 

 

 

Hitching a ride

A Rollerblader grabs on to a passing car for a quick lift.

An exciting time for doctors

Malede Birara

His parents, brother and even his wife think he’s foolish for not practicing medicine at a private clinic, where he could be making six to seven times more money. But Malede Birara has no plans to leave his job as a physician in the OB-GYN department at St. Paul’s Hospital Millennium Medical College in Addis Ababa.

He’s staying because he wants to continue doing research. “There are few private hospitals that give you the opportunity to grow in your academic area, “ he said.

St. Paul’s provides him housing. He owns a car. And he can easily pay all his bills.

Still, Birara’s choice to remain in Ethiopia is unusual among his peers. Brain drain has been a serious problem in the region. Many doctors have left the countries to work in major U.S. cities, like Atlanta and Washington, D.C.

Birara doesn’t believe money was the primary factor motivating doctors to leave Ethiopia. He thinks the most important thing for doctors is having a satisfying work environment – a place with good resources, equipment, training and opportunities to develop.

Ethiopia’s government is beginning to understand that now. “I see a bright future, “ Birara said.

During the past 20 years or so, the government’s top priority was the prevention of diseases such as malaria, tuberculosis and HIV, he said. Most resources went to lower-level medical staff.

But in the past two years, the priorities have shifted to developing hospitals and expanding specialty training, Birara said.

“In our OB-GYN department two years ago, we had three people,” he said. “Now we have nine.”

It’s an exciting and hopeful time for Birara. “We expect more and more.”

Feeling safe

Sarah Bell (left) and Sunasia Echols in St. Paul’s Hospital.

Sarah Bell isn’t new to Africa. Before beginning medical school at the University of Michigan last year, she spent a year in South Africa doing grassroots HIV education. Then she traveled to South Sudan for another year with a child-survival program.

This summer, Bell is working on a research project in women’s health at St. Paul’s Hospital Millennium Medical College in the Ethiopian capital, Addis Ababa. Her experience in Ethiopia is vastly different from her previous experience in South Africa and South Sudan. Ethiopia, she has found, is “far friendlier.” 

For example, while living in South Africa’s beautiful Cape Town, Bell never felt completely safe.

“My boss got stabbed five times,” she said. “My roommates got held up at knifepoint. I’d get my butt slapped if I walked alone on the streets during the day. Here in Ethiopia, people will say things, but it’s all very friendly. In South Africa, it was all pretty aggressive. I couldn’t go anywhere alone at night.”

In South Sudan, crime and harassment were less of a problem, but violence was a constant threat. “I was more concerned about land mines and rocket-propelled grenade launchers or the start of another war,” Bell said.

In Ethiopia, she’s found that people “kind of look out for you.”

“Today, my bag broke, and I was carrying bananas,” she said. “Some guy came up and gave me another bag. He didn’t want anything. I offered him a banana, and he said, ‘No, no, no.’ I never get ripped off by the banana seller. They treat you fairly. I’ve been so impressed with the people, both inside and outside the hospital.”