Author Archives: ethiohealthcare

About ethiohealthcare

Ok this is me, Registered Nurse plus I'm also in Computer Science by profession and currently working on IT/eEducation at EiABC, Addis Ababa University, Ethiopia. Ok and what's my intention of blogging - there are so many things i would like to say and i also think there are so many ideas we should exchange with each other towards the healthcare/health issues in our home country Ethiopia. Dear readers, i am not really a professional writer but i just put down what i feel like sharing with you all and i believe together we can learn from each other and improve things by dealing with it..... Enjoy!!

GREATEST EXPERIANCE : BRINGING YOUR BABY HOME

Brought my baby home, yeah!! That is why i disappeared from you my favorite readers – 3 months are passed already. Now i am back to work and all. I am posting this on March 8 – yes – because it’s woman’s day and it’s a day that concerns me as well. I am a mother and my little one is also female. So i dedicate this for this post for this day; March8, 2012 🙂

For me, i would say having a baby is/was one of the most wonderful and challenging experience ever!! I am sure i can not tell all my almost one year experience, challenges and the feelings i had with just some words but let me share with you some of them and of course if you have any questions/advice feel free to say something.

During pregnancy

Frankly, it is not that much fun. You know why? – You would hate the food you really loved. And you have to watch everything you do including the way you sleep. I was a type of person who enjoyed sleeping on my back and chest but for almost 5 months i didn’t get the chance to do so but only on my sides. Generally it is not comfortable to sleep so you would wake up two or three times in the middle of the night. The other thing that wouldn’t let you sleep is that you will have to go to toilet to pee so frequently and that you have to drink so much fluid. Generally you start living for your baby ever since he/she is conceived. You see as much it is hard for the mother it was also the same for the husband in handling things with all the hormonal and non hormonal changes. However, generally let me leave some tips and things to follow if you are pregnant or planning to have a baby :-

  • Make an appointment with a doctor when you are 9weeks pregnant and continue on seeing your practitioner every four weeks.
  • Avoid alcohol and cigarrates
  •  If your immunizations are not up to date, let your practitioner know. They will start the vaccine for tetanus
  • Drink lots of fluids, especially water (8 to 10 glasses a day).
  • Stick to a diet naturally high in folic acid (oranges, melons and dark green vegetables).
  • Eat plenty of iron rich foods(whole grains, beans, raisins and nuts).
  • Keep your blood sugar level elevated by eating lots of high-protein and high-carbohydrate foods such as breads, brown rice, potatoes and cheese.
  • Avoid medication and consult with your doctor before taking any.
  • Get plenty of sleep, and try to nap if you feel tired during the day.
  •  Exercise but moderately. Don’t start a new exercise regimen when you’re pregnant, and be careful not to become overheated for prolonged periods. For me i had follow up with Kadisco Hospital and they have regular exercises for both couple and just mothers.
  • If you’re a coffee drinker , cut back, switch to decaf or try herbal or decaffeinated tea.
  • Start budgeting for your new life with baby
  • Choose a place to give birth(hospital? birthing center? home?) so that your mind is already set and feel comfortable.
  • Consider starting a pregnancy blog or a diary and having someone take a picture of you (and your expanding belly) each month. Time passes really fast and before you know it it is over.
  • Consider refraining from getting perms and other hair treatments involving heavy chemicals.
  • Buy a few pregnancy books or go to websites like www.babycenter.com  or  www.whattoexpect.com or others and dive in.

Hospital experience

The previous night we were both very exited and very scared. And me, i was wondering about the pain, if i would have a healthy baby (one of the paranoia which is common specially if you are a medical professional) and wondering how how it would feel to hold her in my arms. You just have so many things coming to your mind. Actually ever since i started my 37 weeks of pregnancy i was very eager for the due date and got even very emotional ever since.

Unlike other Ethiopian woman going to deliver there was no one staying with me other than my husband and just parents visiting for a couple of hours during the days. However, i am glad we made that decision. For new parents like us,  it was the most important moment to be together with your own family . In my opinion it is important that no one visited at the hospital considering the facts from my experience that the mother needs to rest and needs her privacy. And, having visitors increases the chances of bringing bacteria/virus for the new born and it is emotional time for both partners due to postpartum depression which shown in studies with a prevalence rate 5% to 25% among women, but methodological differences among the studies make the actual prevalence rate unclear. Among men, in particular new fathers, the incidence of postpartum depression has been estimated to be between 1.2% and 25.5%.

I was still unconscious when the midwife was working so hard in latching my little one lying next to me and giving my lovely husband information how to do feed and change diapers. Which i think is a great job she did in starting as early as possible with breastfeeding. He was also really good with her and even thought me how to do it. Then, I struggled to wake up fast to see her and that was just the most wonderful moment for me. Just beautiful!!

Home with a baby

It’s something totally new. The first two days she slept long hrs so we both had a chance to rest. All that she used to do was nurse – burp – poop – sleep and after that she started crying is a higher pitched voice day and night and a lot. It was stressful specially for us as new parents. She was crying wanting to feed which was not being produced much and my breast was very painful. By the way for all mums out there – perfect oil for your nipple in such situations :- Calendula Oil and you can find it in any herbal shops. It helps for diper rash for your baby as well.

Then it has become easier and easier everyday. My sweet mum and mum – in – law was helping in the house and giving me so much love . Any ways, all i can say it that every time i hold her in my arms and i feel the love again and again and i ask my self if it is really possible that a human being could love this much?

Now our daughter is 3 month old and i am surprised how fast she grew up. Now less crying, lots of smiles and makes these sweet sounds, grabs my fingers when i feed her and all; JUST SO AMAZING!!


WHY DOES IT FEEL LIKE A PATIENT HAS NO RIGHT….

It’s amazing how many complains you would hear from the health care system and the service being given in hospitals in Ethiopia. Of course there is no question to how many people they/we are helping and saving lives but there is still so much more to be improved. One of those things is treating a patient as a human being and considering psychological health too. It’s like no patient has any right to know what his/her disease condition is, what the doctor’s/nurse’s plans are and possible expectations. Nobody is willing to explain about your disease and possible out comes at all sometimes. I believe all patients have the right to know. I can tell you so many stories like this from my experiences.

My relative was admitted in a hospital for Septicemia and the doctor ordered investigations and started certain treatments IV(Intravenous). His wife asked the doctor ” so what is wrong with my husband? Did you find something? What is the treatment for? What should we do? What shall we expect? ” and a whole lot of questions. One time his mum, another time his daughter goes to the doctor to ask wanting to know.  And the only reply they got was ” he is fine he just have infection we will just check his urine and blood.” And after the test results came he kept on telling his wife that he just has infection and it continued for a week with her wanting to know eagerly what kind of infection it was and wanting to know what possible things to expect and to do to help. So in the end no body knew for what kind of infection they were treating him till the last day of his death.

Amazingly most places, they do invasive procedures and tests like lumbar puncture, repairing intestinal perforation with out even informing any one in the family or the patient him/her self. In addition to this they don’t explain what they are going to do , advantages and disadvantages of the treatment they are giving, aim of the procedures, etc. It makes me sick knowing all these things being a health professional and not doing anything so far in preventing/stopping this other than trying to talk to those specific professionals on the spot. In most hospitals being a patient lying in bed sick and worried if you would make it or not nobody tells you about your situation. No one tells you as a patient why they are giving you a medicine and and what are the possible out comes and all.

There are so many days that i hear people saying ”i hope nobody gets sick here in Ethiopia since the health care system is horrible in many aspects”. I say,  at least let’s do what we could do with all our capacity in being a good health care provider than being ignorant on some essential things to our patients who is trusting us. Let’s give psychological comfort to the patient in involving them in their treatment too. After all the definition of health includes a complete physical, mental, and social well- being too right?


Barcamp Ethiopia 2011: Session on making good choices for ” Your Sexual Health ”

Well, i am asking you today one question. Who wants to attend such an interesting session? Ok, let me explain some about the event in general.

What is Barcamp 2011?

Barcamp Ethiopia 2011 is the second large Barcamp to be organized in Ethiopia, the followup to last years successful Barcamp at EiABC (Ethiopian Institute of Architecture Building Construction and City Development), Addis Ababa University.

What is Barcamp it self?

A Barcamp is a sort of “unconference” (BAR= “Beyond All Recognition”): It is organized and administered not by an institution or a company, but by an open community of interested individuals. It has no pre-structured program – everything is planned and coordinated through a web-based public Wiki  and other online tools where anyone can post ideas and participate actively through collaboration.

So far, over 400 Barcamps have been held all over the world with different thematic focus, also in several other African countries, but until last year, never before in Ethiopia.

Last year,  September 17 -18, 2010 there were about more than 300 people gathered sharing business and educational ideas, knowledge and people networking and all having fun as well. An amazing event with varieties of sessions was held at EiABC , Addis Ababa University where young people also went back home inspired.

For further information on what was organized by community of those interested individuals  last year : http://barcamp.org/w/page/24618491/BarCampEthiopia

So this time it will be held at AAiT((5kilo technology faculty), Addis Ababa University.  It will  have sessions which will include interesting topics, more inspiring ideas and experiences worth sharing. Among those sessions there will an important topic focusing only ”on your sexual health”.  This including both Men’s and Women’s health. I am sure you will find it highly educational, interesting and enjoyable.

So please do come with experiences and knowledge to share and of course questions/doubts you have.

For further information on this year’s Barcamp: http://barcamp.org/w/page/40811139/BarCampEthiopia2011

Visit: Barcampethiopia.wordpress.com

When: September 23 and 24 2011

Opening Party: September 22 (tentative)

Where:  AAiT (5kilo technology faculty), Addis Ababa


ETHIOPIAN DECISION MAKERES IN MAKING A DIFFERENCE – SAVING LIVES

Ethiopia is now focused on minimizing death of mothers and children focusing mainly on the countryside.  It’s very hard for many people of Ethiopia especially when you get out of addis and other major cities to find a health care service.  It is amazing how many people are not getting enough, proper medical care or none at all. Ethiopia is now trying to solve these problems by different approaches, projects and programs with USAID and other organizations.

Article – every year, 25,000 Ethiopian women die due to complications of pregnancy, labour and childbirth. This represents a total of 68 deaths a day. 500,000 women also suffer disabilities related to child pregnancy and childbirth. The main causes of death are hemorrhage, sepsis, hypertension, obstructed labour and abortion. Other direct causes such as HIV/AIDS, malaria and tuberculosis also take their toll. From this article; Newborn deaths are also estimated as 118, 000 per year.

The contributing factors include:

  • Lack of adequate information and support to women to control their reproductive health.
  • Inadequate knowledge about danger signs.
  • Lack of adequate medical facilities.
  • Cultural, traditional and economic factors restricting women from seeking services.
  • Lack of skilled care, especially midwifery services during antepartum, intrapartum and post partum period.

According to Ethiopia demography health survey, skilled attendance at birth is only 6%. And Ethiopia has only one midwife and three doctors for every 100,000 citizens. This has contributed to high level of maternal mortality. Internal evidence shown that availability of skilled attendant at birth ensures prevention and prompt treatment of complications and making a huge difference in the lives of women during labour and delivery.

Due to the programs that are already implemented it is believed that the number of deaths will decrease in significant amount. I have also seen with my own eyes and was very impressed how much it is improving with impacts made by the programs like Accelerated Health Officer Training Program (AHTOP). It is a program coordinated by JSI and funded by USAID. What they basically did was a train a nurse in that specific area to become health officers and increase skilled health professionals in handling critical cases in health centers and hospitals. This played a significant role in minimizing death specially those that occur in referring them to other hospitals because of lack of skilled manpower. And I think they are doing an amazing job in saving lives in villages and countrysides where they are assigned.

The program generally focused on:

  • Improving the quality of university-level health science education in Ethiopia. This was accomplished through the renovation of health care facilities and the creation of adequate classrooms, libraries, and laboratories at seven universities.
  • Increasing the number of students training to be health officers. The majority of students in the training program were practicing nurses who received basic science education in the first year, followed by two years of tailored instruction at a training hospital.

It is impressive how much was done so far and I hope such efforts and programs continues to change and improve the rest of the problems that exist when medical care in Ethiopia comes in to discussion. Things like not having ambu bag for resuscitation, no oxygen available at the emergency room and many more equipment lack in delivery rooms too.


MEN : POSSIBLE SEXUAL PROBLEMS & WHEN TO SEE A DOCTOR

Both men and women are affected by sexual problems. Most commonly such problem comes with aging but it doesn’t mean it could also be there while being young. Why am i talking about sexual problems today? On a coffee discussion with friends about ejaculation in men; a friend shared one of his worries and if he has to go to a doctor or not; if it is normal or abnormal; how to still enjoy sex with no stress and all . You see in Ethiopia, it is also kind of against our tradition specially if you are a girl/woman to talk about sex. And, due to lack of open discussion, education and counseling services so many families are torn apart and so many people both young and older are exposed to HIV and other STDs, pregnancy and abortion and etc . I am sure every one who grew up in Ethiopia also knows how much the none family teachings affect us through out our lives in such and many aspects. Teachings like these are such a ” Norm” that you hide and learn from the consequences on your own. I am sure not all but most families are and were like this. As far as i know , living in Ethiopia almost my entire 26 years of life plus working in hospitals in such aspects i saw that most people are ashamed and shy to talk about anything that concerns sexuality and sex in general plus the consequences that comes with it if you are not careful. I will defiantly touch that topic another time since it is really a big issue here in Ethiopia but today i want to answer to the question that was raised over our coffee so i am talking about the possible sexual problems that could affect men and when we should start to deal with it.

WHAT ARE THE POSSIBLE SEXUAL PROBLEMS OF EJACULATION

  1. Premature ejaculation – it is ejaculation that occurs before or soon after penetration
  2. Inhibited or retarded ejaculation – this is when ejaculation is slow to occur
  3. Retrograde ejaculation – this is when, on orgasm , the ejaculate is forced back in to the bladder rather that through the urethra and out the end of the penis.

WHAT CAUSES THEM

  1. PHYSICAL CAUSES – there are many physical conditions that can cause sexual problems like : diabetes heart and vascular diseases, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
  2. PSYCHOLOGICAL CAUSES – these include work-related stress and anxiety, if one person is concerned about sexual performance, marital or relationship problems,depression, feelings of guilt, and the effects of a past sexual trauma. For example anxiety can make a man become impotent at any time of his life, depending on external stress. The other possible psychological causes for being impotent could be :-
  • If  he worries too much about what his partner is going to think of him
  • If  has previous experiences that the man hasn’t fully resolved
  • Men who fear being judged by their sexual partner
  • If he fears being judged by his sexual partner
  • If his sexual partner is no longer attractive to them
  • If he worries about being able to maintain an erection
  • If he worries of the girl becoming pregnant
  • If he worries about his proper use of condom
  • If he feels guilty about the sexual relationship ( eg. when cheating on his wife or starting new sexual relationship after another has ended )
  • If he grew up in an environment where sex was seen as ‘dirty’ or where sexuality was often suppressed
  • If a man is depressed
  • If there are problems in the relationship as a whole
  • If a man is not confident in his sexual performance
  • If he has low self worth
  • If  the man is tired and works a lot of hours and become exhausted etc…

Treatment of sexual dysfunction by your doctor depends on the underlying physical or psychological problems. Which could include:-

  • Medical treatment – if it involves any physical problem.
  • Medications – to improve sexual function by increasing blood flow to the penis Medications like  Cialis, Viagra or Levitra.
  • Hormones – like testosterone replacement therapy for men with low testosterone level.
  • Psychological therapy – to treat anxiety, fear, guilt that may have brought an impact on sexual function.
  • Education and communication – Sex education and sexual behaviors, open discussion with your partner about your needs and concerns to help overcome many barriers to healthy sex life.

if none of the above mentioned problems are happening yet or staring to happen or no such experiences at all we should start preventing it by  limiting alcohol intake, quitting smoking, dealing with our emotional stress  (anxiety, stress etc) and by increasing communication with partner.

So, I leave the ” let’s deal with it” part to you and if such problems are already there i guess you know what to do now. And, if you have any experiences, ideas/advices to share to other men out there don’t hesitate to help out each other by sharing knowledge/experiences. Any questions/doubts?


AN ETHIOPIAN WOMAN DEDICATED TO SERVE HER PEOPLE!

Liya Abera, Director of Bala Health Center

Her name is Liya Abera Haile. A dedicated woman who impressed everyone in our team. You are probably wondering what her story is?! She was born in Alamata, studied in Mekelle Universtiy and now working in a small city called Bala which is about 25km from a city called Alamata (650 km from Addis Ababa). She was a nurse working in Alamata before  joining the AHOTP (Accelerated Health Officer Program). Now she is working as heath officer in this small city ; Bala as the head and director of the health center which has four health posts under the same health center. Her families and friends live hundreds of kilometers far from her but still dedicated to stay there in uncomfortable situation as a girl growing up in a bigger city. I know that this requires lots of commitment because being in the Health Profession my self as a Health Officer any one from different bigger cities in Ethiopia wants to stay in cities with a better paid NGO job even if we all promise on our graduation to serve our people knowing where the major problems are existing when it comes to health care.

The people living there tells that bala was known as a killer city because people get sick a lot and die before she begun working there. So people traveling past that city were not recommended to spend a night there at all because of the death and the disease situation there and also mainly known for malaria and communicable diseases. People of the village tells that so many things has changed since this woman came to that village. In my discussion over coffee with W/ro Tsega, a woman from the association of the ladies in that village being assigned as manager of the health education team told me that ‘’ there was even no toilet for the people but the commitment of this woman to saving people was amazing. The people love her so much that they said letting her go is like deciding on their death.

She convinced & gathered people of the village to work on issues like this together to construct simple toilets, supplying mosquito nets, HIV testing, health education and etc’’ I leave the the relation judgment between living situations with no toilet and possible health condition in a certain population plus achieving all these in just two years and 8 months as a single person with such facility deserves a reward. And, you might not see much from pictures and reading as much as going there and seeing all for your self but to give you simple highlight of Bala and the Bala Bealth Center take a look at the pictures at the bottom.

Basically ,what this health center focuses on prevention of diseases mostly on those which are pretty common in that area like malaria, oro fecal disease etc. And also focuses on minimizing woman and child death as well as woman health including contraception methods antenatal visits plus vaccination, etc. The health center is also working on raising HIV awareness and including home based health education, counseling and testing. They initiate people to know, accept and expose themselves plus teach others in the community. It is impressive how much change you see from the statics she had the health center posted on the walls. I am sure , if you go there as well,  you would go back home very impressed with what she is doing for people of Bala.

The Famous Restaurant in Bala.

View of Bala on a rainy day infront of the restaurant.

The Lovely Children of Bala.

Bala Health Center, Youth Group on Training ( working on HIV/AIDS ) and Welcome Coffee Ceremony for the Young University Students of Bala



Why Do More Men Commit Sucide? And Women Attempt?

It is really sad, we just lost an amazing doctor who used to be our doctor as well as our colleague. He was so amazing, hard working and a person who really cares about his patients. His family  must be so devastated specially his wife and his child. How is it even possible to tell this child when she grow up that her dad committed suicide? One thing is that it is one of the risk creating situation for the child to go for sucide too and the other thing is that she will always wonder why her dad choose to kill him self rather than being with her while she grows up. Or may be she will start thinking why she couldn’t save him or be there for him when he needed someone….hard staff!!

These days people commit suicide or attempt suicide very often and i always wonder why especially when successful people go for suicide. I think it is common to be affected by depression due to so much stress in their life if they don’t balance relaxation time with it. It’s really hard to give a certain explanation and bring out reasoning to it. It’s also not right to judge in my thinking….Very difficult!

Did you know that more than four times as many men as women die by suicide even if women attempt suicide more often during their lives than men, and women also report higher rates of depression. I used to have so many suicidal attempts when i was working in the Emergency room and most of the time it was more women who survived from suicidal attempts and more men dying. That was and is mostly because men and women use different suicide methods. Women in Ethiopia are more likely to ingest poisons than men. Of course in countries where the poisons are highly lethal and/or where treatment resources scarce like Ethiopia, rescue is rare and hence female suicides may outnumber males. But Men use highly lethal methods than women. Like strangulation or jumping from a building while women go for drinking poisons like Berkina which is used for washing cloths and most commonly used for suicidal attempts here in Ethiopia.

Normally persons who are planing to commit has certain behaviors you can see. Characteristically they have feelings of worthlessness, guilt, hopelessness that are so overwhelming  and they start believing that they are unable or unfit to live. However, the most common predisposing disorders that lead to suicide are depression and  bipolar (manicdepressive) disorder which encounters to  30% to 70% of suicide victims.

Who are at higher risk for suicide?

  • Young adults ( age 15-24)
  • Elderly
  • Terminally ill persons ( People diagnosed with Cancer, HIV,etc)
  • A person who experienced loss/stress
  • A person who have attempted sucide previously
  • Depressed persons
  • Substance abusers (eg. Cocaine/Crack,PCP,LSD etc..)

Suicidal Clues

Any one of these symptoms doesn’t necessarily mean that that person is committing suicide but most of these symptoms should send a signal to us for help:

  • Giving away personal , special and prized possessions
  • Canceling social engagements
  • Depression
  • Making out or changing a will
  • taking out or changing insurance policies
  • Obsession with death
  • positive or negative changes in behavior
  • poor appetite
  • Daring risk taking behavior
  • Poor appetite
  • Sleeping difficulties
  • Feeling of hopelessness
  • Difficulty in concentrating
  • Losing interest in activities
  • Telling as a jock that he/she intent to attempt suicide
  • He/she starts asking about poisons, guns or other killing objects

What to do when we think some one is planing suicide…

  • Don’t act shocked
  • Do not leave the person alone
  • Remove harmful objects around
  • Talk to the person and listen to him/her in nonjudgmental, caring attitude
  • Don’t swear to keep it a secrete
  • Encourage him/her to talk about feelings and to identify positive aspects about life
  • Encourage active participation in own care
  • Keep him/her active by assigning simple tasks
  • Ask straight forward questions again with out  being judgmental and try to find if he/she has specific plan designed how to do it.
  • Get professional help and don’t council the person your self

In remembrance of Dr. A