International Activity Report 2006

Ethiopia

International Staff: 62

National Staff: 704

Ethiopia remains one of Africa's poorest countries, with a very low income per capita and a population that is almost two-thirds illiterate. Its economy is highly dependent on agriculture, which in turn is largely dependent on rainfall.

Many Ethiopians rely on food aid from abroad — in 2005, the UN reported between five and seven million people dependent on food aid out of a total population of 77 million. In years of poor harvest, as many as 14 million people risk lack of food, therefore the drought of the past year was of particular concern to MSF teams located in the southeast of the country.

In Cherratti and Barre in the Ogaden, also known as the 'Somali Region' of Ethiopia, MSF started a therapeutic feeding program for severely malnourished children in March 2006. Because of the nomadic nature of much of the population here, the project was adapted to become ambulatory, with MSF teams moving around the region rather than operating out of a fixed location. Nutritional assessment missions were also carried out in the Afder and Gode Regions in January and February and monitoring continued throughout 2006.

MSF is supporting primary healthcare activities in Cheratti district, performing up to 100 consultations per day at the health center, and offering emergency, inpatient and birth delivery capacity as well as antenatal care and therapeutic feeding. In August 2005, the project expanded to include tuberculosis (TB) treatment and by the end of May 2006, 191 patients had been enrolled.

A second tuberculosis project is based in Galaha in the arid and remote Afar Region, situated in the east of the country. Like the population of the Somali Region, the Afars are nomadic, moving every three or four months in search of grazing areas and water for their livestock. Given that a full TB course of treatment takes six to seven months, with drugs administered daily, MSF has had to find an adapted approach for treatment. The solution was to create a village of 400 huts centerd around a health center. Patients are required to live in the village under close medical supervision for four months and are then provided with a further three months of medication they can take on their own. Since the project began in 2001, more than 2400 patients have been treated and the project enrols approximately 40 new patients per month.

Treating patients with kala azar

Whilst national treatment guidelines for kala azar (visceral leishmaniasis) are being reviewed, the disease remains a huge challenge in Ethiopia. There is still a very limited availability of the necessary drugs, even in areas where the disease is endemic. Transmitted by the sand-fly, the disease attacks the immune system causing fever, wasting, an enlarged spleen, anaemia and death if left untreated. Today, kala azar is still widespread in many parts of the country.

In the district of Libokemkem in the northeastern Amhara Region, MSF treated 1150 patients for kala azar in the last eight months of 2005. In Humera, a town on the border with Sudan and Eritrea, MSF focuses on patients co-infected with HIV and kala azar and treated 1823 patients in 2005. A third project is based in nearby Abdurafi.

Because much of the country lacks even the most rudimentary care, MSF runs primary health facilities in a number of locations. Malaria remains a big concern despite a recent change in Ministry of Health (MOH) protocol to more effective drugs. In Amhara and Tigray, MSF treated approximately 76,000 patients and then withdrew from most projects in 2006 with improved response capacity from the government. In Foguera district, Amhara, MSF continues to run a program that has supported the treatment of 49,448 patients with malaria.

Emergency interventions for meningitis and cholera

In January 2006, cases of meningitis were reported in the Welayita region of southern Ethiopia. MSF worked with the MOH to respond to this epidemic, providing medicines and treatment training to medical personnel at health centers. MSF also launched a vaccination campaign, reaching 25,000 persons before handing over activities to the MOH.

In the western region of Gambella, where up to 70,000 displaced persons in camps are in urgent need of medical assistance, MSF has established a fixed health center just outside the main town of Itang. A mobile team is ensuring the most vulnerable communities are receiving basic healthcare and referral for treatment. In May 2006, the team conducted an emergency intervention, treating about 2000 cases of cholera.

MSF has worked in Ethiopia since 1984.