Sunday, January 10, 2010

To Addis

Been hectic here. Next Friday I go to Addis. Leave 9:30 AM, arrive 8:30 AM Saturday, refueling in Rome. It's a nice flight, time to sleep and read. I've vaccinated and medicined up -- yellow fever, typhoid, rabies, hepatitis A/B, DPT, anti-malarial, Cipro, lomotil and such. I lost part of my EMT kit this summer at a bike race, so I restocked -- new stethoscope, CPR mask, airways, saline, wound care, PPE, glucose, splints, occlusives, etc. I'm not sure, but I may have some EMT work during the site visit. We will be looking at some unsupported locations, folks who need care. It will be sad in some ways, hopeful in others.

I'm traveling as a volunteer for a 501(c)3 non-profit I helped start in December 2008, Ethiopia Healthcare Network (EHN). When my mother died cruelly from ALS in 2005, my father reflected that while he had personal monuments -- books, stories, a play about his work, -- there was not a memorial that represented Joan, though she did wonderful things. We asked her pastor and he guided us to support a clinic construction project in Dukem, about an hour south of Addis Ababa. Impressed with the mission and church, I signed on, helping to raise and contributing a goodly sum. Fortunately, in a way, before we sank funds into construction, we lost title to the rural land (due to a reportedly corrupt act). I helped refactor the program as a non-profit corporation focused not on real estate construction but on efficiently providing care to needful patients, disadvantaged women and children. In November 2007, we conducted a survey in Addis, including visits to several clinics. I was very impressed by one facility and its medical director, LeAlem Higher Clinic and Dr. Alemayehu Gebrehiwot. After the land problem, we reached out to LeAlem and requested a proposal.

With EHN support, starting in October 2009, LeAlem hired a part-time doctor, social worker and nurse to provide healthcare to disadvantaged women and children. Results have been promising. Here's a summary from November 2009: "LeAlem exceeded numerical benchmarks set by the grant, caring for 103 patients. Ninety-two percent (92%) of the patients had annual income below $100 US per year; the balance had annual income of $100-200 per year. Ninety-seven percent (97%) of post-school age patients were female. Without EHN support, all patients would not have had access to professional healthcare. Patient outcomes were largely positive, alleviating suffering, treating disease, and supporting improved pre-natal and infant health. Patients were treated for a diverse range of diagnoses, including pneumonia, head injury, reproductive complications, pregnancy, diarrhea/intestinal disorder, gangrene, hemiparesis, urinary tract infection, seizure, candidiasis, asthma, metastatic cancer, adverse reaction to anti-retroviral therapy (ART), and Parkinson's disease."

We cared for 168 patients in December and my sense is that patients and service capability will continue to increase, partly owing to this month's trip. Interest and activity is burgeoning. I've several letters and resumes from medical school students who want to work in Addis as summer volunteers. Individuals with high net worth are looking into the program, we're organizing a fundraiser at the Ethiopian Embassy in DC, and more.

The purpose of my trip this month is to review grant progress, develop case study material, understand how we can best help, and develop relationships and ideas for future work. With EHN's Board, I wrote a 30-page site visit plan, providing background, articulating survey questions, and identifying contacts, from US embassy staff, to NGOs, social service providers and other clinics and doctors. The plan will help make the trip productive and facilitate writing an assessment and additional media.

The situation in Ethiopia is grim. Famine is projected by monitoring organizations. [USAID] Four million children are orphans, 500,000 from AIDS. Under-5 mortality rates are high. Less than 6% of women have medical care when they give birth. Average per capita income is $630 US. [WHO]

What EHN and LeAlem are doing is a small initial step. Our vision, though, is broad and resources sound. As noted by the plan, EHN is fortunate to be headquartered in Foggy Bottom, Washington, DC, blocks from the State Department, international development organizations, and a major university and medical school. EHN's Board is an exceptional team of medical doctors, individuals born in Ethiopia, well-connected professionals, and individuals with long-term experience with innovative charities. We envision drawing upon resources in Washington and helping them deliver value, and we envision EHN clinics and projects across Ethiopia networking together and with regional resources, NGOs, government and other organizations to provide care, alleviate suffering and improve outcomes.

The trip will be one positive step followed, I hope, by many.

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