Southern Ethiopia - Gwent Health Link

The health centre was approached along an unmade road, which was little more than a track running across the land surrounding the centre. It comprised of five or six one storey buildings. Each building was divided into single or double rooms, with an occasional larger room that could be used for teaching family planning etc. to the local people.

The buildings appeared to be in a reasonable state of repair but needed cleaning and decorating. Lighting was provided by single electric light bulbs or very occasionally a single strip light. Water and electricity supply was unreliable and there was much evidence of exposed wiring. Pathways between buildings were unmade, and after the daily rains were reduced to muddy tracks that were quite treacherous.

We were introduced to the health officer who talked to us about the centre and the problems faced by himself, the other staff, and the patients.
1) Yirgacheffe health centre serves a population of 25,000 people, with another 110,000 people living in the surrounding rural areas.
2) Health problems encountered in the population comprised of the following,

• HIV
• MALNUTRITION
• MALARIA
• GASTRO ENTERITIS
• RESPIRATORY INFECTIONS
• TYPHOID
• SCABIES
• URINARY TRACT INFECTIONS
• INTESTINAL PARASITES
• TRAUMA
• PREGNANCY/LABOUR
• LACK OF SANITATION

3) Lack of transport. No ambulance or car is available to either bring in patients, or take the very ill referral cases to the nearest hospital at Dilla.

4) Bad working conditions .Poor environment creates a poor atmosphere and very little feel good factor for both staff and patients.

5) Lack of equipment and consumables. This included an incubator for sick or premature babies and laboratory equipment such as electric microscope, and haematocrit centrifuge. There was a shortage of bleach and disinfectant. Curtains were also needed to provide patients with some privacy during examination.

6) Lack of communications, internet or telephones.

7) Lack of housing.

8) Lack of physicians.

9) Lack of funding.

10) Control and disposal of infectious material.

The health centre had 26 staff, 14 male and 12 female. This included 1 health officer, 13 nurses, 1 midwife, 2 pharmacy technicians, 3 laboratory technicians. There was no doctor.

We visited the laboratory, the delivery room and the clinic rooms where they hold ante-natal care, family planning and general medical clinics. We were not shown the wards or the isolation area However Pam had visited these areas on a previous visit and conditions had been very poor.

The outside of the health centre was very untidy and not looked after. The inside was drab and not very clean. Women had to give birth on either a bare mattress on an obstetric bed with no bedding or cover. There were no curtains or screens to afford them any privacy.

The pharmacy had some painkillers but no antibiotics, iodine, bandages, gloves or disinfectant. They had a small quantity of savlon.

The centre had once been used as a baby feeding centre, but they had run out of baby food.

Patients have to walk up to 40 kms to get to the health centre. Women in labour have to walk, be carried or ride on a donkey cart. This can include women who for various reasons have a ruptured uterus which can be quite common in this area. These ladies need urgent medical attention. The nearest hospital to refer them to is Dilla, some 40 kms away.

RECOMMENDATIONS

The health link is trying to raise the health centre to small hospital status. If the place could be cleaned, decorated, paths made up, along with the road to it upgraded, the feel good factor would become high. Perhaps some tree planting for shade would be helpful. Also, possibly some cultivation of the land around the centre would provide funds or foodstuffs for the community. Curtains and screens would benefit patients and provide much needed privacy for intimate examinations. The appearance of the health centre upgraded, tidied, painted and cleaned would encourage staff and patients and the local population in general, to take pride in it.

The other most important recommendation is the provision of an ambulance to bring sick patients to the centre and for transfer to a hospital for urgent treatment not available at Yirgacheffe.