Southern Ethiopia - Gwent Health Link

Please attend the next meeting on 16.01.2012 to discuss the future of the link. The meeting is open to anybody who has been associated with the link during its 12 years of existence or wish to see it continue its activities. Details of the meeting can be found here.

The annual report for 2011 by Biku Ghosh summarises the link's activities in the past year and can be found here. 

The link visit in November 2011 involved teaching and training, donation of equipment, evaluation & monitoring, standards setting and needs assessment.

Between the 4th and 19th November 2011, 14 members from the health link visited Ethiopia. During this period, the link members organised the following activities for over 400 front line health workers. Click here to read the complete reports.

Training/teaching

• Training the trainers programme for nurse tutors
• CME skills workshop in emergency obstetrics and neonatal resuscitation for midwives
• Training in Safe and Clean delivery and newborn care for the Community health extension workers (HEW)
• Emergency obstetrics surgery skills for MSc health officers and junior doctors
• Advanced gynecological skills for specialists
• Skills update for nurse anaesthtists

The link pathology team also supported Hawassa Referral Hospital pathology staff towards their WHO accreditation goals.

Support for the health facilities

• Donated 30 oxygen concentrators to hospitals in SNNP Region
• Paediatric, pathology, surgical and anesthetic equipment to Hawassa referral hospital
• Surgical instruments, suction machines, anaesthetic equipment and books to newly opened Adare Hospital Donated
• 5 electricity generators to 5 rural health centres in the Gedeo zone
• Workshop for setting minimum standards of care at all of the 32 HCs in Gedeo zone

Needs assessment and planning for the future

• Evaluation of link outcome in three exemplar HCs
• Neds assessment in Chelelektu and Chichu HCs
• Meetings to plan future activities with the HC staff, with the Zonal and Regional Health Bureau and Hawassa University College of Medicine and Health Sciences

It is with great sadness that we announce the untimely death of Peter Smith.  Peter Smith worked as a Biomedical Scientist in blood bank at Neville Hall Hospital in Abergavenny.
He also worked for many years with the link where his knowledge and expertise was instrumental in setting up blood bank in Dilla Hospital.

 He will be sadly missed by everyone who knew him.

Between the 6th and 19th November 2010, 8 members from the link visited Ethiopia.  During this period the link members organised:-

Training/Teaching
Training the trainers workshop for the nurse tutors from all of the 8 nurse/midwifery training universities and colleges - 23 attended.  Following on from initial two days of training skills in emergency obstetric and new born care, the participants were observed and supported in training midwifes for a further four days in emergency obstetrics and neonatal care.  All the colleges were donated with manikin and other training material.

CME skills workshop in emergency obstetrics and neonatal resuscitation for the midwifes - Total of 31 attended including the midwifes from each of the 21 health centres in Gedeo zone and from Dilla and Hawassa hospitals.

Training of Community Health Extension Workers (HEW) in safe and clean delivery at home and new born care - A total of 132 attended in Yirgacheffe Health Centre (HC).  In the last two years all of the 320 HEW's and their supervisors working in the health posts in Gedeo zone have now been trained by the link in these workshops.

Exemplar standard workshop - A workshop was held in Dilla involving the HC in charge and their respective Woreda health offices from all of the 21 HC's in Gedeo zone.  The workshop aimed to develop the idea of setting minimum standards in health care in these rural health facilities.  A total of 32 attended.

Training in maintenance of laboratory equipment - In Alaba, Wondogenet and Yirgacheffe HC's the link team organised training in maintenance of microscopes and other laboratory equipment.

Support for the Health Facilities
60 pedal bicycles were donated in memory of Dr Roger Pickford for the health posts in Gedo Zonal health office.  The link now in the last year has donated a bicycle each to all of the 144 health posts in Gedeo zone for use by the HEW's and their supervisors.  In Chelelektu and Chichu HC's 5th and 6th motorbike ambulances were donated in memory of Dr Roger Pickford - the link also donated a microscope each to Alaba, Wondogenet, Yirgacheffe and Chelelektu HC's.  The link also donate items including ambubags, laboratory reagents, glucometers, cleaning material, protective clothing and training material to each of these three HC's as well as to Chelelektu HC.  An oxygen concentrator was also donated to Chelelektu HC.  The link is hoping to adopt Chelelektu as an exemplar HC.

At Hawassa Referral Hospital the link donated, following request from the hospital, equipment for the paediatric unit including exchange transfusion sets, peak flow and meters, NG sets, lumbar puncture sets, bone marrow biopsy set, for the medical department; number of surgical instruments and essential items for the histopathology lab. 
Heaters for the neonatal unit donated by two students from Liverpool who visited Hawassa in August this year with support from the link, also were also donated at the same time.

At Dilla Hospital - The link team made needs assessment of the hospital with the local staff.  It was agreed that the link in future will try to provide support with training and in gap filling with urgent needs whenever possible.  The link donated 4 oxygen concentrators along with many surgical, obstetric and anaesthetic instruments and equipment to the hospital.

Evaluation and Monitoring
The link team conducted six monthly evaluations and monitoring at Alaba, Wondogenet and Yirgacheffe HC's as well as needs assessment in these HC's and Chelelektu HC.  The link discussed the findings in a joint meeting with representatives from all these HC's.

Planning for the Future
Hawassa College and Hospital: The link signed a formal MOU with the Hawassa University College of Medicine and Health Sciences thus updating the previous MOU with Dilla University since 2000.
SNNPR Regional Health Bureau: The link had constructive discussions with Ato Kare, Head of the RHB and Ato Habatamu, Head of Training summarising activities and future plan in line with the Ethiopia Government health care policy.  Ato Kare again thanked the link for the important contribution our link is making in the region.

The link visit between the 26th February and 5th March 2011 involved teaching & training, donation of equipment, evaluation & monitoring, standard setting and needs assessment.
During this period the link organised

Training/Teaching

• Surgical and trauma skills workshop for the health officer MSc students in Hawassa University - 28 students attended
• Basic Endoscopic Urology workshop for the Surgeons in SNPP hospitals - 7 Surgeons attended
• Live demonstration and on the job training in endoscopic urology at Hawassa hospital
• On the job training in emergency obstetrics for the midwifes/nurses at Dilla hospital and rural health centres - a total of 46 trained
• Teaching medical students at Hawassa University Medical College

Follow up exemplar standard workshop

Follow up workshop for setting minimum standards of healthcare at all of the health centres in Gedeo zone - 22 attended.  Main problem identified in the majority of the health centres were poor/no water or electricity supply

Donation of medical/equipment

• 30 oxygen concentrations to all of the 17 hospitals in SNNP region
• Operating table, surgical instruments, suction machine to Halaba Hospital
• Endoscopic Urology equipment and instruments (worth £50,000) to Hawassa Hospital
• Microscope, antisera, surgical instruments and suction machines to Dilla Hospital
• BP apparatus, vacuum suction caps for delivery, baby hats, cleaning materials to Alaba, Wondogenet, Yirgacheffe and Chelelektu health centres (HCs)

Audit of patients' journey from home to hospital with obstetric emergencies

An audit of mothers' journey from home to hospital with obstetric emergencies who subsequently required emergency operations in Dilla Hospital.  Initial results of nearly 20 patients show that the main bottlenecks in emergency obstetric care in rural Ethiopia being delay in transfer and cost of treatment to the family.

Motorbike ambulances

All the six motorbike ambulances in health centres continue to work well and serve pregnant mothers with complications.

SNNPR Regional Health Bureau

The link has agreed to continue support training of HEWs in the region in safe delivery and newborn care.  The link has recommended that RHB should consider (1) as the Motorbike ambulances are making a huge difference in transfer of pregnant mothers with complications to requesting support with more of these from larger NGOs.  (2) Actively consider urgent introduction of MISOPROSTOL, to help reduce maternal mortality from PPH.  (3) To consider treatment completely free treatment at all stages of pregnancy at all levels.

Metasebia writes: "Tayech Ermias is a 25 year old primigravida. She lives 5km away from Shone health centre. She knew that last year one woman near her home died in labour. The woman could not get to the health center in time because of lack of transport. After many long hours in labour by the time her family could bring her to the health center she had already passed away."

"Tayech heard about the motorbike ambulance during her antenatal check up. When she went to labour around 4:00pm her family called to Eshetu, the motorbike ambulance driver, who came within 20 minutes and brought her to the health center. Dawit, the midwife (trained by the link in October 2009) helped her to give birth around 6:00pm to a 3kg healthy baby boy. She stayed at the health center for 3 hours. During these 5 hours the driver waited for her to take her back to her home. She is very happy with whole service and was keen to come back to the health centre to tell her story."

Dr Fitsum and Dr Eskedar, two female doctors from Hawassa College, started their short term clinical attachment at Nevill Hall Hospital in Abergavenny on the 19th of May. They are from the very first batch of medical gradutes to qualify from Hawassa Medical College which has been supported by the link since its very beginning with skills training, training resources and training of the trainers. Dr Fitsum and Dr Eskedar have arrived as a part of exchange programme between Hawassa University & Cardiff University British Council sponsored Institutional Link initiated by our link. They will spend 4 weeks in Wales including attachment at Cardiff University Hospital.  

Last week in Chobare village 18 year old Shemsia Sultan was going to have her first baby. Unfortunately her labour went on for many long hours without any progress and by the evening she was getting weaker. The nearest medical help was in Alaba health centre 40 kilometers away through poor road conditions and the nearest hospital was over 100km away. Shemsia’s family had heard of the recent arrival of motorbike ambulance in Alaba health centre and the training of the midwives there. They telephoned the health centre in the middle of the night and soon the motorbike ambulance was on its way. Later that night Shemsia gave birth in the health centre, with help from the trained midwife, to her 3kg baby girl.

Thanks to the Link donating the ambulance and training the staff, she did not become part of the statistics for maternal death, still so high in Ethiopia due to lack of adequate facilities and trained staff.

So far the two motorbike ambulances donated by the link to Yirgacheffe and in Alaba have made similar 50 journeys in the last two months. The third motorbike ambulance for Wondogenet is on its way to Ethiopia this week.

The link has completed another very successful trip to Ethiopia. 14 members from the link spent up to 2 weeks in Ethiopia to complete a range of activities.

This included two training workshops at Hawassa as well as a range of in-service training and donations at the exemplar health centres. The link has donated the first eRanger motorcycle ambulances in Ethiopia.

The Southern Ethiopia Gwent Health Link and the new Bryn-Y-Cwm - Yirgacheffe link received a commendation award from the Welsh assembly at the Cardiff Eisteddfod on the 4th of August 2008 for their excellent work and inspired contribution toward community partnerships between Wales and Ethiopia. The award was presented by First Minister Rhodri Morgan and United Nations Antipoverty Champion Edith Wakumire.