Ethiopia and the Quest for Modern Health Care Enawgaw Mehari, MD Consulting Neurologist St. Claire Regional Medical Center/University of Kentucky Honorary Staff BLH FM Addis Ababa University Founder and President People to People Inc. www.peoplepeople.org
Emperor Lebna Dengel 1508-1540 Appealed to the Portuguese King for… “ men who make medicine and physicians and surgeons to cure illnesses…” Joalo Bermudes: surgeon-barber (1520-1535) First record of a foreign practitioner in Ethiopia
Samuel Gobat (Swiss) treated numerous patients, including the brother of Wayzaro Wallata Teklit, the “First Lady of Gondar”
Emperor Sahla Dengel (1832-1840) 19 th Century Modern Medicine Expanded
Emperor Sahla Dengel (1832-1840) 19 th Century Modern Medicine Expanded Formal French and British scientific and diplomatic missions to Ethiopia in the late 1830s and early 1840s brought modern medicine to sizeable portion of the populations in Tigre and Shawa.
Emperor Sahla Dengel (1832-1840) 19 th Century Modern Medicine Expanded French physician Petit imported smallpox vaccine from Europe. However, the vaccine was “spoilt in transit”
Emperor Tewodros (1855-1868) 19 th Century Modern Medicine Expanded
Napoleon III sent a French physician,
Legard to Emperor Tewdros.
In June 1866 epidemics of cholera ,
smallpox and typhus broke out.
Understanding the infectious nature
of these diseases, Tewdros ordered
the move from Qorata to Begemder.
Emperor Yohannes 1872-1889 19 th Century Modern Medicine Expanded Although regarded as a traditionalist Yohannes accepted Western medicine Greek King George I of the Hellenes sent Dr. Nicholas Parisis who practiced during the smallpox epidemic in 1886.
Emperor Yohannes and Small Pox Vaccine First monarch to be vaccinated against smallpox - His commander, Ras Alulu - The Abun (head of church) - King Menilik of Shewa - King Teklehaimanoy of Gojjam - Many Children He forbid the OLD Practice of vaccination
Dr. Andre from Hungary specialized in the manufacture and repair of weapons made artificial arms and legs for bandits and thieves whom Emperor Yohannes ordered amputation and punishment Foreign missionaries were excluded by the Emperor from working in Ethiopia proper. Emperor Yohannes IV
1980s the number of physicians started to double every 5 years
1987 MOH began registering doctors. Since 1987, 5,743 have been registered. Of these, 76.5% were Ethiopian
1989 reached the peak with 1658 doctors of all types with 1:28,000 physician to population ratio
2006 Steep decline with nadir of 638 doctors in the public sector
2006 AAU, Gondar and Jimma graduated 3,728 medical doctors
2006 Physician to population ratio was 1:118,000
In 20 Years
73.2% ETHIOPIAN DOCTORS LEFT
DOCTORS and HEALTH PROFESSIONALS Berhan, J. 2008 Ethiopian Medical Journal 46:1-77
2005 139 hospitals, 87 public, 52 other 2006 The average physician to hospital ratios were: Tigray 3.6 Oromia 6.1 Amhara 4.3 SNNPR 5.3 From 76 Public Hospitals outside of Addis in 2006, there was no specialists in 36, and no doctor at all in 3. Brain Drain Hospitals Berhan, J. 2008 Ethiopian Medical Journal 46:1-77
We have come so far! Where will we go from here?? 2010