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Introduction 

The Health Status of the Ethiopian Population

Ethiopia is the oldest independent nation in Africa. It is a land of stunning natural beauty, a rich diversity of culture and geography with the mosaic of a people with over 80 different languages and as many cultures. Ethiopia is one of the poorest nations of Africa.The health status of the Ethiopian population is extremely low. The situation has deteriorated due to re-occurrence of drought and famine, civil war, overall shortage of food, the low socio-economic conditions of the country and HIV/AID pandemic.

HIV/AIDS in Ethiopia

AIDS is a global emergency and Africa suffers the worst insult in comparison to the rest of the world. One of the hardly hit African nations is Ethiopia. There are over 3.5 million Ethiopians infected with HIV and close to 1 million orphans due to HIV/AIDS. Every hour there are 75 Ethiopians infected by HIV and most will die in the next 10 years. Poverty as major and lack of adequate information on the epidemic and means of transmission and prevention contributed a great deal to the quick spread of AIDS in Ethiopia. The country lacked a collective responsiveness of the people and increased popular participation in combating AIDS which need to be triggered.

Impact of HIV/AIDS on the Country

Ethiopia as a poor nation has invested in education and training of its population is now loosing its precious resource, which sets the country back from its development agenda. The country cannot afford to waste scarce resources in investing in education, health services etc. AIDS has a significant impact on the workforce of the country. AIDS causes breakdown of households because parents who support families die, children are orphaned, drop out of school due to lack of support. It affects the workforce because the able ones are absent from work taking care of sick family members. The nation as a whole loses time from absenteeism etc. trained personnel die at the prime of their service giving age.

Silence as a cultural barrier in Ethiopia

HIV/AIDS is primarily transmitted through sexual intercourse in Africa, the fear and shame that is associated with any sexually transmitted infection is ever present, resulting in silence and denial. Ultimately, the result is the conspiracy of silence surrounding HIV/AIDS, which in turn impedes implementation of policies and programs to curb the epidemic. The widespread cultural reluctance and lack of know-how to discuss sexual issues among families, between spouses, among peers, and between generations in Ethiopia has been one of the factors aggravating the effect of AIDS. In the early stages of HIV/AIDS, the disease was often associated with promiscuity and loose sexual behaviour, implying that those who get sick are cursed. Denial and stigma can be dispelled only by open discussion.

HIV/AIDS among Ethiopians in diaspora

In the past 3 decades, the Ethiopian society has gone through a series of dramatic changes that has affected every sector of society. As a consequence, people have been dispersed to different parts of the world and for the first time in the history of the country a considerable number of Ethiopians are living permanently outside their country. Notably, a good number of these Ethiopians are in their productive age. Although exact figures are not available, the number of Ethiopians in the diaspora living with HIV/AIDS is estimated to be high. Moreover, the number of Ethiopians visiting their home-land has dramatically increased in the past couple of years. The fact that these Ethiopians are moving in to a society with high HIV prevalence may contribute to the further spread if infection among the Ethiopians in diaspora. It is therefore necessary to give education on HIV preventive measures to the Ethiopians in the diaspora so that they develop the correct attitude. However, it should be noted that the spread of HIV/AIDS among Ethiopians in the diaspora is directly related to the pandemic in Ethiopia and therefore strategies on prevention should be designed for both sites.

AIDS prevention

AIDS is causing the depletion of productive citizens in Ethiopia, therefore the major concern should be on prevention of the pandemic, as the cost of drugs has become unaffordable for the people. However, affordable care should be provided to the millions of Ethiopians already infected. The prevention campaigns at the grass root level must be conducted to have a lasting impact. For this to happen, first a "strong" government national policy against HIV/AIDS is needed and war on this disease should be declared by government as well as community and religious leaders of the country.

Role & experience of Ethiopian health professionals in diaspora

Ethiopian health professionals in diaspora can play a significant role and also have a professional obligation to participate in the HIV/AIDS prevention campaign in Ethiopia and among those living out side Ethiopia.

Experience from the association of Ethiopian health professionals in Sweden

The Association of Ethiopian Health and Health-related Professionals in Sweden (AEHHPS), was founded in February 1992 in Stockholm with the premises to enable Ethiopians engaged in health-care activities to work together in an organization free from political, religious, ethnic or similar affiliations. The membership includes all Ethiopians engaged with health-and health-related professions and residing in Sweden.

The primary objectives of our association by the time it launched were:

  • to give health-related humanitarian aid to the needy people of Ethiopia,
  • to study health-related problems in order to seek constructive solutions,
  • to establish contacts and co-operation with similar organizations elsewhere,
  • to spread health related information among Ethiopians residing in Sweden and,
  • to serve as a forum for mutual assistance between members in their professional lives.

Through time it became obvious that these objectives were so wide and therefore, the association decided to concentrate on selected objectives.

Launching a primary health care (PHC) operation in Ethiopia

AEHHPS started its operation in Ethiopia by collecting and sending medicines and other medical supplies to Hospitals in Ethiopia. Even though the hospitals had an enormous need for assistance, there are also administrative difficulties that hampered further co-operation. It was literally impossible for the association to penetrate the administrative obstacles in Ethiopia. Therefore, during January and February 1994, a survey was conducted by the AEHHPS on the existing health problems in Ethiopia and a commitment was reached to assist a primary health care operation in Ethiopia. For this operation an indigenous NGO known as the integrated holistic approach urban development program (IHA/UDP) operating in one of the poorest slum areas, near Teklehaimanot parish in Addis Ababa, with a population over 42,000 poor inhabitants of whom 50% are children under 16 years was chosen. IHA/UDPs integrated and holistic approach project intervention was unique to the country as a whole. The primary health care program was aimed at improving peoples health and quality of life through education and preventative health care. It also include safe and clean water provision, vaccinating all babies and children, mother and child health care, minor first aid, environmental health, family planning, and communicable disease control.

Having been impressed with the ideas and achievements of IHA/UDP and following the results from our feasibility study we considered IHA/UDP to be efficient in addressing the basic needs of the most neglected segments of the dwellers in the community and fulfil its set program objectives. Since 1994, AEHHPS together with Sida (Swedish International Development Agency) assist/take part in the primary health care program and has upgraded a small health post existed in the IHA/UDP into a relatively bigger health station/clinic. The clinic is operated today by 14 personnel, a full time legitimated physician, a nurse, a pharmacist, 3 community health agents, 4 sanitary guards and 6 traditional birth attendants.

Today the health station gives health service to over 42 000 inhabitants of the community with a capacity of assisting about 100 patients per day. The services include:

  • antenatal and post natal visits
  • child health care
  • expanded program of immunization against the major infectious diseases
  • family planning including contraception services
  • health education
  • preventive and rehabilitative program on STDs including HIV/AIDS
  • curative services

A significant achievement on improving PHC

100% of the children (0-4 years of age) in the project area have completed the full course of EPI vaccination compared to base line survey data generated before the Health station became operational. This is the highest figure ever recorded in the country as a whole;

  • More than 57% of the women in the community are family planning service users compared to below 10% before;
  • The total gross physical health status of children in the community has significantly improved.

Due to fund constrains and luck of laboratory settings to perform HIV test the preventive and rehabilitative work on STD including HIV/AIDS has been minimal. However, counselling was given to 500 people with STD and different opportunistic diseases; 329 family victims were visited by our counsellor nurses and 413 TB patients are under treatment and follow-up through home visits.

AEHHPS activity against HIV/AIDS in Ethiopia

Although the general health status of the people living in our project area has improved in recent years, the pandemic of HIV/AIDS is still alarming and the number of people affected is still progressively increasing. Therefore, AEHPS together with CBISDO have designed program on effective HIV/AIDS prevention and control strategies among the so-called, "window of hope", children of 5 - 15 years of age living in these deprived targeted communities (Wereda 3 kebele 30,41,41,42) and neighbouring communities (wereda 4 kebele 29 & 40).

The primary objectives are:

  • to provide information/education on STDs in particular HIV and AIDS to the "window of hope", children of 5 - 15 years of age,
  • to implement a rehabilitative program i.e. to accommodate the orphans of AIDS to other families within the community,
  • to give counselling the HIV-infected community members and their families,
  • to provide affordable treatment of AIDS patients within the community.

Awareness creation campaign to the Ethiopians residing in Sweden

To day, most of the Ethiopian elite residing abroad is steadily organizing itself in professional associations, informal groupings, as well as religious and non-religious organizations primarily to promote the interest of Ethiopians abroad and at the same time keep the Ethiopian identity alive in a foreign environment. Discussion on HIV/AIDS among these groups is practically does not exist and HIV/AIDS is still a taboo. Although, the prevalence of the infection is believed to be relatively high among Ethiopians residing in Sweden.

The primary objectives of AEHHPS are:

  • to increase knowledge and awareness of HIV/AIDS and STD among Ethiopians in Sweden,
  • to encourage the formation of "anti-AIDS circles" within the different Ethiopian groupings.

The activity of AEHHPS in Sweden is primarily focused on information and educational campaigns on HIV/AIDS. AEHHPS has been calling repeatedly meetings of the Ethiopian community and informed about the current HIV/AIDS situation among Ethiopians. Educational information (oral and written) on the nature HIV/AIDS, risk factors and its prevention methods has been given in the language which most Ethiopians understand.

Attempts were made to inform the community through the different local Ethiopian Radio and TV stations found in Stockholm. AEHPS did also promote its information and educational campaigns on HIV/AIDS, on the effect HIV/AIDS in Ethiopia and on the alarming situation prevailed in the country to various public gatherings that are organised by any Ethiopian groupings. Furthermore, progress reports from our HIV/AIDS project in Ethiopia has been presented to the different Ethiopian groupings so that the issue of HIV/AIDS be their agenda.

AEHHPS Current action on prevention of HIV/AIDS in Ethiopia

Currently, together with CBISDO AEHHPS is implementing a program on effective HIV/AIDS prevention and control strategies among the so-called "window of hope", children of 5 - 15 years of age living in these deprived targeted communities.

The primary objectives are:

  • to provide information/education on STDs in particular HIV and AIDS to the "window of hope",
  • to implement a rehabilitative program i.e. to accommodate the orphans of AIDS to other families within the community,
  • to give counselling the HIV-infected community members and their families,
  • through IHA clinic to provide affordable treatment of AIDS patients within the community.

Expected results

  • enhancing the knowledge on the danger of the HIV/AIDS and end the promiscuity of the epidemic,
  • to overcome the traditional taboo associated to HIV/AIDS in order to create openness, which could lead to free discussions and awareness,
  • to reduce the prevalence of new infections by HIV among the Ethiopians both in Ethiopia and Sweden.

Concluding remarks

The level of secrecy and stigmatisation surrounding the AIDS pandemic is still poses a great threat to fighting the scourge that is claiming about millions of lives daily in Africa. Therefore it is essential to help stop the spread of HIV by bringing prevention education to the community on the grass-root level and in a user-friendly way both in Africa and among Africans in diaspora. In this respect the African professionals in particular the health-related professionals could certainly play a significant role in reversing the HIV/AIDS catastrophe in Africa.

Send e-mail to  AEHHPS@hotmail.com