It is the intention of the Ethiopian government to expand and fundamentally modernize the country’s health system. Our involvement in Ethiopia is the result of this government-led initiative. Since 2008, hundreds of health centers have been created and staffed with newly trained medical professionals as part of the Health Sector Development Program (HSDP). As a small organization with limited human resources, we see our opportunities in the creation of model projects.
Short-term, our work will focus on the following areas:
- Setting up central workshops for the repair and maintenance of medical equipment and
- Training technical staff
- Providing technical staff for clinics.
- This project is planned for the Mekele region.
- Linking private clinics, both physically and functionally, to hospitals
- This model was launched at the Bishoftu Hospital in Debre Zeyt
- Supporting doctors’ work by providing medical ‘contract workers’
- Establishing sponsorships of Ethiopian hospital departments by German hospital departments specializing in the same fields
This model is potentially an option for the Ghandi Maternity Hospital in Addis. It is also workable for other hospitals. It enables the creation of autonomous units that could be run at a low cost by German standards. The Ethiopian side would hugely benefit by having a constant point of contact and continuous support.
- Collecting and providing the most basic medical and other needed equipment
- Selecting institutions locally in Ethiopia as recipients of aid
- Transport and safe installation of donated equipment in situ
This has been going on successfully since 2009. A total of nine container loads of aid has been delivered to date.
Ongoing activities of our association in Ethiopia
Since 2009 Etiopia Witten has been participating in projects with hospitals in Bishoftu / Debre Zeyt, Addis Abeba and Mekelle / Tigray.
Our focus of work is currently in Mekelle, Tigray. An important reason for that is the competence and cooperation of the University of Mekelle and its president Prof. Joachim Herzig.
Our field of expertise is medicine and medical-engineering. The coordinators of these ongoing projects are Dr. Zerihun Abebe, dean of the medical faculty, in Africa and on the German side, Ahmedin Idris. Furthermore, several people in Ethiopia, as well as in Germany, are tirelessly participating in initiating our projects, maintaining and further improving them.
- We sponsored and supplied a CAT scanner, which had been put into operation at Ayder Hospital. MRA Beatrice Grunau will spend another year there in order to ensure further operating and to train colleagues. She will be supported by doctors from Witten.
- In the past we often experienced that in Ethiopia even little damages on medical devices were not fixed, therefore, the instruments could not be used any more. Thanks to the help of the staff of FH for Medical Engineering in Burgsteinfurt and engineer D. Grosse-Wentrup, a repair shop for medical equipment was established in the teaching hospital. The shop is unique in Ethiopia: Damaged equipment can be fixed and, additionally, experts for Ethiopia can be trained. Large medical devices were and still are being repaired in Tigray in context of our autoclave-project (in cooperation with Ayder Referral University Hospital, Senior Expert Service and the FH Münster).
- In order to interest young people in that important field, Prof. Hölscher had arranged a workshop for medical engineering with student engineers at the University of Mekelle.
- Additionally, after a detailed analysis of the situation, Prof. Hölscher developed a recommendation for medical engineering in Ethiopia in cooperation with Dr. v.d. Hagen. This recommendation is aimed at the health ministry, institutions that consider the supply and management of medical devices, and health institutions that use medical devices. Other NGOs that sponsor medical devices could also be interested.
We consider further development of medical engineering and training of educated staff in Ethiopia just as important as the facilities of medical establishments and hospitals with modern medical-technical devices. Advanced training of staff on-site and on the devices is an important component of the supply/donation of these devices.
- Currently the Ayder Referral University Hospital is our most important cooperation partner in Ethiopia. The relatively big Hospital consists of the following departments: cardiology, surgery, paediatrics, gynaecology and midwifery, but also dermatology, ENT, anaesthetics, radiology and dentistry. The house holds 417 beds and reports an increasing number of patients. Due to the lack of an efficient organisation, the Hospital cannot yet be run efficiently and economically. Theo Püplichhuisen, former chief of organisation in the Marienhospital Witten, has analysed the situation and trained an employee of the Hospital. This employee, Mr. Mengistu, will soon come to Witten in order to deepen his knowledge.
- The situation of hygiene management and HIV-management of Ayder Hospital has been analysed by Judith Cronenberg. She has developed a recommendation for experts on-site. The improvement of the hygiene standards is a necessary requirement for further projects, such as the development and upgrading of dialysis and bronchoscopy.
- Doctors of Etiopia were able to medically help and assist colleagues of Ayder Hospital, as well as other Ethiopian hospitals. Primarily, there was great demand for a qualified handling of medical-technical equipment. For details: Link
- Apart from the health sector, the association is also active in other fields: A cooperation in the field of business studies / economics was set up in the University of Mekelle. First reports were worked out and contacts with the education office were made.
The cardiologist Dr.Gabriele Wehr - Stuttart/Germany, member of Etiopia-Witten assiociation Germany, launched in March 2017 during her stay in Addis Abeba and Mekelle a comprehensive pilot project for Ethiopia for erasing Rheumatic Heart disease. It is in Ethiopia 100% fatal. The origin of the disease is a bacterial sore throat infection, which is easily treatable with penicillin. The project will follow the example of the successful example of the country Cuba.
The core of our program is improvement of the knowledge of health professionals about RHD and the treatment with penicillin. A second point is raising the awareness of the parents, the teachers and the public with the aim, that all ill children will get appropriate treatment.
Key point: Bring penicillin to the children.
It is a joint project from Etiopia-Witten, Mekelle University and Tigray Health Bureau
The head of the Ethiopian WHO branch in Addis Abeba confirmed the fact, that RHD is on a very high position on the agenda of the WHO in Geneva. He offered to support the primary prevention project for rheumatic heart disease within the possibilities of the WHO.
The Federal Ministry of Health (FMOH) is also interested in the RHD primary and secondary prevention programs within the already launched programs to diagnose and treat non communicable diseases in Ethiopia. The FMOH responsible support this project and recommends to continue the close cooperation with the already started program on RHD by the Department of Cardiology in Black Lion Hospital in Addis Abeba,
In case of interest in this progamm contact by email Dr. Gabriele Wehr: drwehr(at)t-online.de
Gastroenterology in Ayder Hospital Mekele
A close cooperation between the two gastroenterologists and the German colleagues Dr. Schmidt-Heikenfeld and Dr. Calderoni of the organization “Etiopia Witten” provides a functional endoscopy unit in the local university hospital.
In 2012 endoscopical equipment including upper and lower gastrointestinal scopes was given as a donation to the department of gastroenterology.
The local endoscopical staff was trained in terms of endoscopic diagnosis and to appropriate interventions by regular site visits and internships in Germany. The work was supported in the meantime by a German nurse with a focus on equipment preparation and training of non-medical endoscopy staff.
Procedures and standards are harmonized by the close cooperation and mutual appreciation over time . Another collaborative project started the last year in the St. Paul Hospital in Addis Abeba. It also exists a close cooperation and a professional exchange with the local colleagues Dr. Berhane and Dr. Michael . Recently a complete ERCP system could be set up and put into operation .
2nd Intensive Care Refresher Course for Nurses
Ayder Hospital Mekelle 23.1. – 21.2.2017
On request of the nurses of AICU and in agreement with Mrs.Hareya and Dr.Amanuel we (Sr.Teresa and I) conducted a 2nd intensive care refresher course for nurses in Ayder Hospital in order to improve the quality of critical care further.
After the experience of the 1st refresher course we chose this time less formal lectures and more practical exercises and scenarios.
Lecture topics were: Physiology of respiration
The other topics were each combined with scenarios and were:
SIRS – Sepsis – Septic Shock
Management of postoperative patients
Post angiography management in ICU
The restless critical ill patient including revision of analgo-sedation
Care for the cranial injury patient
CPR, preparation of emergency trolley
Fluid balancing, monitoring IV lines, CVP measurement
Team work in ICU
The participants of the course were all nurses from AICU and 5 nurses from pediatric ICU. They were again divided in 2 groups to have reasonable numbers for the practical exercises.
The organization oft he course was again taken over by Mrs. Hareya and her staff and was again perfect. Lecture hand outs were sent by me beforehand and distributed to the participants. Rooms for lectures and practical exercises were booked and tea brakes organized.
The teaching was like in the 1st course shared by Sr.Teresa Pastor and me.
The course started with an entrance examination (MCQ). Some questions were related to the topics covered in the 1st course and some to the contents oft he 2nd course. The results of the test were generally poor and it was obvious that almost all participants found it difficult to concentrate for 1 hour since the first half of the questionnaire was answered much better than the 2nd half. After the discussion of the test the nurses understood their various short-comings.
Both groups participated very actively and lively in lectures and practical sessions already from the 2nd day onward. (During the 1st course most oft he nurses were too shy to participate actively or to ask questions).
The results of the post test showed a great improvement since almost all participants scored 100-200% more compared to the entrance test.
At the end oft he course all participants and teachers were invited for dinner in a traditional restaurant. The certificates were presented after finishing the course due to a delay in printing.
I had the occasion to work with the participants of the course in AICU as well as in PICU for almost 3 weeks after the end oft he course. (Sr.Teresa had to leave earlier).
It was a pleasure to see how much the nurses gained from this course. What impressed me most is that in AICU is now an understanding that nursing care of critically ill patients needs continuous presence of the nurse on the bed of the patient. Most of the nurses did the weaning from ventilators, fluid balancing according to CVP measurements, supervision and adjustments of inotropic drug administration and sedation when acutely necessary on their own.
Also the documentation improved as well as the communication with co-nurses and residents. Still more improvement is needed for hand over procedures from shift to shift as well as in the active participation in the ward rounds.
Since AICU has now an own consultant (Dr.Kibrom) who will be almost continuously in ICU there is a very good chance that further improvements will occur in shorter periods of time. His presence will also be very advantageous for the training of residents assigned to ICU. As soon as the residents gain more practical knowledge and skills in critical care there will be less conflicts between nurses (who have more practical skills due to the repeated training) and doctors. At the same time the nurses will have continuous support from Dr.Kibrom which is very important to improve the quality of critical care further by a functioning co-operation between residents and nurses.
We (Sr.Teresa and I) plan in agreement with Mrs.Hareya and the ICU nurses to continue with a 3rd refresher course end of 2017.
Dr. Reintraut Burmeister-Rother 13.3.2017