seminar presentation in the history of modern medicien in ethiopia

1. Seminar presentationSeminar presentation
History of medicine in
Ethiopia
Presented by - mikruT.
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2. Out line of presentationOut line of presentation
 Introduction to the Medical History of Ethiopia
 Is it important to us knowing history of medicine
 Indigenous Healing Practices in Ethiopia
 The Evolution of Modern Medicine in Ethiopia
 Overview of Health-Delivery Service
 History of Epidemics in Ethiopia
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3. Introduction to the Medical History of EthiopiaIntroduction to the Medical History of Ethiopia
 We have been familiar with a wide range of diseases and
medical complaints
 which they had long-established names
 Their ancient classical language, Ge’ez, and
 Indigenous tongues of the country
 Majority of which are unfortunately still mainly accessible
only in foreign collections
 Indicates that traditional Ethiopian healers also possessed a
wide variety of cures.
 Vegetable Kingdom like leaves, roots, flowers, and seeds or
fruit of locally grown plants
 Other traditional treatments like purging, bleeding and
cupping, steam baths and immersion in hot
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4. Conti….Conti….
 Around early 16th century Portuguese traveller,
Francesco Alvares, and in the subsequent records of
Spanish and Portuguese Jesuits.
 Extensive accounts of traditional medical cures were
later found in early 19th and 20th century European
scientific, botanical, and other literature.
 Polish ( stafan strelcyn) 
◦ Publish Geez text
◦ extend his study to botany
 Expanded in the early 20th century through the study of
traditional Ethiopian medical manuscripts, Marcel Cohen
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5. Is it important to us knowing history of medicineIs it important to us knowing history of medicine
 The history of medicine broadens our educational
horizon
 It helps us develop critical analytical approaches to
medical knowledge and practice beyond the rigidly
biomedical and statistical preoccupation of modern
medicine
 It helps us avoid developing a tunnel vision in studying
and applying the practice of the art and science of
medicine
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6. Indigenous Healing Practices in EthiopiaIndigenous Healing Practices in Ethiopia
 Indigenous Views on Causation of Diseases
◦ the result of mixed beliefs of Christian, Islamic, and
indigenous beliefs and practices
◦ all natural objects were pervaded by spirits that
were also personified and worshipped.
◦ The wraths of these spiritual entities were often
considered as causative agents of a whole range of
human misfortune
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7. Conti…Conti…
 Types of Indigenous Healers and Therapeutic Methods
◦ Herbalist
◦ The balazar
◦ The waggesha--empiric-therapeutic vocations date from
the 16th c
◦ Church-based healers (dabtara)
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8. The Evolution of Modern Medicine in EthiopiaThe Evolution of Modern Medicine in Ethiopia
 Since the early 16th century,
 Western doctors from different countries were coming to
Ethiopia as missionaries, sportsmen, scholars or diplomats
 The 1st
organized and hospital-based modern medical
practice for the public was started immediately after the
Battle of Adwa by a team of Russian physicians and nurses.
 .
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9. Conti…Conti…
 Modern medical services for the public can be classified
into four major phases:
 between the Battle of Adwa (1896) and 1901.
 between 1901 and the establishment of the
Ministry of Health (1948).
 between the establishment of the Ministry of
Health and the 1974 Revolution.
 begins in 1974 and continues till the present
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10. Conti…Conti…
 the first health service institution was established in Addis
Ababa following the Battle of Adwa
 it was named Russian Hospital. It had 20 beds --(Russian st)
 In 1906-07, Emperor Menelik II established 12 ministries for
the first time in Ethiopian history; yet MOH was not a
priority.
 The first Ethiopian health legislation, known as “Public
Health Proclamation of 1947”, was formulated and stated
that the government was in charge of the health of the
people.
 Laid a cornerstone in the establishment of (MOH) in 1948
 Blata Zewde Belayineh 1st
minster – cotton engineer
 No formulated national health policy and strategy till 1963
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11.  Hospitals established between Battle of Adwa to the second
Italian invasion
Name of Hospital year Status
Russian Hospital 1896 Closed 1906 when physicians left
Harer Ras Makonnen Hospital 1903 Sold to France and renamed
Menelik II Hospital 1906 Still operating as such
Diredawa Railway Hospital 1911 No data after establishment
Gulele Hospital 1922 Later, Pasteur Institute, now EHNRI
Bete Saida Hospital 1923 Currently Yekatit 12 Hospital
Zenebework Hospital 1930 Now Alert Hospital
Ras Desta Damtew 1932 Still operating as such
Zewuditu Hospital 1933 Still operating as such
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12. Conti…Conti…
 After the end of the war with Italy, Princess Tsahai Memorial
Hospital – named after the first Ethiopian nurse and also the
daughter of the emperor – was established in Addis Ababa.
 1935-1941, there were 13 government-owned hospitals at
the national level
 During the five-year Italian invasion, 19 hospitals were built
 Next 30 years – between 1966 and 1996 – much attention
was given to hospital expansion rather than construction.
 Portuguese “barber-surgeon” (Joao Bermudez)- King
Libne Dengel (1520-1535).
 A German missionary, Peter Heiling (1632-1667) Emperor
Fasilidas
 physicians came from different countries and gave service
mainly to the ruling class Emperor Menelik II
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13. Conti…Conti…
 The first Ethiopian physician, who
graduated with a medical doctorate
degree from Lahore University in
India (1882), was Dr. Workneh
Martin Hakim Workneh .
 Dr. Charles Martin invited by
Menelik II  welcomed the
invitation installed a tent at the
center of the city and started to
treat patients free of charge
 He became Emperor Menelik’s
personal physician, director and
clinician at Menelik II Hospital.
Dr. Workneh Eshete
became the first Ethiopian
doctor to obtain a modern
medical education in 1882.
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14. Conti…Conti… Dr. Melaku Beyan was the second
Ethiopian medical doctor,
 Graduated from Howard University in
the U.S.
 During the Italian invasion, he was the
chief medical officer of the Ethiopian
army
 he was sent to the Ogaden with the
Ethiopian Red Cross to tend to the
wounded soldiers.
 In late November 1935, Emperor Haile
Selassie was about to leave Addis Ababa
for the northern front
Dr. Melaku Beyan
became the first
Ethiopian doctor to
complete his education in
the United states
in 1935
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15. Conti…Conti…
 Members of the Imperial Council met in Addis Ababa and it
was proposed that the Emperor depart immediately to
appeal to the League of Nations for justice.
 There were oppositions to the Emperor’s departure.
 Dr.Melaku agreed with those who opposed the departure
of the Emperor. He said,
“I came to a definite conclusion that our hope lay in what we
Ethiopians at home could do and what our people, the black
people of the world, would do to help us save our
independence”.
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16. Conti….Conti….
 Dr. Widad Kidane-Mariam was born to an Ethiopian emigre
family in Palestine during the Italian Occupation
 The “first female” medical practitioner and physician
administrator
 Dr. Asrat Woldeyes was also born and raised in Ethiopia
during the Italian Occupation and graduated many decades
later in the 1950s to follow in the footsteps of Dr.
Workneh Eshete
 All these Ethiopian pioneers were “firsts” – dreamers who
served their people in different capacities.
 They were nation builders who gave everything they had to
make a better place.
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17. Dr Akelilu Lemma 1928-1989ECDr Akelilu Lemma 1928-1989EC
 AAU- 1st
degree science
 Wisconsion Univeristy -2nd
degree
 While he was doing his doctoral degree he was already
interested on biliiharzia
 1964 – dead snail
 1966 present his finding to a science form
 In the meantime he started a parasitological program at
medical college
 Has won many awards
 The Haile sellassie I Gold medal
 1989 Right livelihood award
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18. Conti…Conti…
 MOH was established, 110 Ethiopian and expatriate medical
doctors were working in 46 hospitals, mainly in the capital.
 Growth in the number of medical professionals was slow until
1980;
 at which time the number of physicians began to double every
five-years up to 1989.
 In the history of the public sector serving medical doctors
(MOH), the highest number of new physicians recorded was in
1989 and 1990 (1,658 and 1,596 medical doctors, respectively).
 Contrary to a sharp increase in the number of physicians of all
types in the public sector from 1980-1990, there was a sharp
decline between 1990 and 2006.
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19. Medical doctors’ annual gain versus annual loss in public sector,
Ministry of Health (1987-2006)
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20. Conti…Conti…
 In an effort to maximize medical doctors’ retention in the
public sector in 2006, stake holders recommended short-and
long-term solutions. These solutions were offered so that
retention becomes a strategy and producing new doctors
becomes a program.
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21. An Overview of Health-Delivery ServiceAn Overview of Health-Delivery Service
 The Structures and Functions of Health-Delivery Services:
Historic Perspective
 From 1941 to 1947, public health services were administered by
the Department of Health in the Ministry of Interior.
 The primary responsibility of the Department of Health was to
support and sustain the basic hospitals and clinic systems left in
the aftermath of liberation from the Italian occupation in 1941.
 Proclamation No. 91 of 1947 directed the decentralization
of public health services down to the provincial and/or
regional levels.
 Proclamation No. 100 of 1948 of the Registration of the
Medical Practitioners
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22. Conti…Conti…
 Health Reforms and Policies of the Ministry of Health –
2010/11-2015
 The recently health sector has introduced a three tier
health care delivery system:
 Level One is a Woreda/District health system comprised
of a primary hospital (to cover 60,000-100,000 people)
 Level Two is a general hospital covering a population of 1-
1.5 million people
 Level Three is a specialized hospital covering a population
of 3.5-5 million people
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23. Conti…Conti…
 Medical and Health Sciences Education and Human
Resources – University of Gondar (1954- Response to
malaria)
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24. History of Epidemics in EthiopiaHistory of Epidemics in Ethiopia
 Past documented historical examples of epidemics in Ethiopia
included: Malaria, Meningitis, Typhus, Typhoid, Relapsing
Fever, Influenza, Cholera and many sexually transmitted
infections, including HIV, Gonorrhea, Syphilis and Chlamydia.
 Food-borne infections of different etiologies,
 many insect-transmitted diseases
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25. ReferenceReference
 The manual of Ethiopian medical history , Enawgaw Mehari, M
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