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Isolated and Malnourished: Treating Patients in Rural Afar, Ethiopia | Doctors Without Borders

Ethiopia 2013 © Faith Schwieker-Miyandazi/MSF

An MSF staff member examines a young patient in Afar.

When Zahari Nur’s grandmother brought her to the outpatient post where Doctors Without Borders/Médecins Sans Frontières (MSF) teams were conducting outreach activities in Digdiga—one of the 12 Kebeles (provincial administrative units) that MSF is covering in its nutritional intervention in Afar—everybody thought she had just a few days to live.

“I had given up hope on my grandchild,” says Eisa Wasaitu, Zahari’s grandmother. “I thought she was going to die like the three others before her.”

The one-year-old was suffering from severe acute malnutrition when she arrived at the MSF outreach post. Her mother is also ailing and suffers from psychosis. She is in no condition to take care of Zahari and her older brother, leaving the grandmother as their sole guardian.

MSF began working in the inimitable lands of Afar in April 2013 in response to a nutritional emergency. Afar is vast, and Teru—the area that MSF covers—is one of its most remote and most neglected regions. Subject to huge sandstorms and extreme temperatures in the dry season and violent rainstorms that flood rivers and render roads impassible during the rainy season, Teru is an extremely difficult context in which to work.

The Afari are a pastoral nomadic people who move from place to place in search of water and pasture for their animals. Living this way makes it difficult to adhere to treatment regimens, meaning that many people default before completing the program. It also makes it difficult for MSF teams to follow up with people who default.

MSF’s intervention covered 12 Kebeles whose inhabitants are completely cut off from health care. The decision to intervene was reached after an assessment revealed an alarming rate of severe acute malnutrition in the region—26.6 percent of an estimated catchment population of 87,374 people suffer from the condition.

“Most of the cases that we admit in the stabilization center are severe acute malnutrition with complications,” says Frank Katambula, MSF medical team leader in Afar. What’s more, he adds, “most of these are combined with either pneumonia or TB.”

Despite the difficulties associated with providing care in Teru, most cases have now stabilized and children under the age of five continue to receive therapeutic food. Overall, a total of 726 malnourished children were admitted to the therapeutic feeding program (including 134 children in the stabilization center) and 1,154 moderately acute malnourished patients (including 416 pregnant and lactating women) benefitted from the program.

“In total we have 78.2 percent cured cases and a defaulter rate of 4.5 percent, which to me is quite ‘good’ considering that access [to health care] in this area is not at all easy,” says Jean François Saint-Sauveur, MSF medical coordinator in Ethiopia.

After two months in the MSF program and admission into the stabilization center where she was also given specialized treatment for pneumonia, Zahari was improving. When we saw her a few weeks ago, her weight had increased from 3.2 kilograms [a little more than 7 pounds] to 4.9 kilograms [almost 11 pounds].

“When I see this child I feel very happy because the grandmother and the rest of the community thought she was going to die,” says Nabiyu Ayalew, MSF’s outreach nurse. “But we saved her life and she is still alive.” 

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Ethiopia: Health Risks Fail to Deter Ethiopians From Eating Raw Meat

Ethiopians continue to eat raw meat at family and festive occasions despite health risks that include exposure to tapeworms, salmonella and E-coli.

While most people are taught that eating raw meat is not good for you, the tradition persists in Ethiopia. Whenever there is something to celebrate -- like a wedding, or the end of one of the many fasting weeks for the large Orthodox community -- raw meat is eaten in large quantities.

The story goes that eating raw meat started during times of war. Fighters hiding in the mountains would have exposed themselves by making fire, and so ate their meat raw.

Temesgen Yilma is the owner of Yilma Restaurant, one of the most famous raw meat restaurants in Addis Ababa. He eats raw meat almost every day and claims that neither he nor his customers have gotten sick from eating it.

"Today we are the only butchery in the country having our own animal transport trucks and meat transport vehicle," noted Yilma. "And our meat is always inspected by the ministry of agriculture, it's free of any tape worm or any other thing. It's always inspected and its always healthy."

The meat is delivered late at night or early in the morning to one of the hundreds of raw meat establishments in the city. The delivery time is important, to ensure the freshness of the meat and thus to prevent customers from falling ill.

But despite these precautions, eating raw meat still poses the risk of several types of infections. Akaze Teame is the medical director at the American Medical Center. He said that eating raw meat is not recommended.

"You will also be at risk of non-communicable diseases such as stroke and heart disease because as you've witnessed, most people when they consume raw meat they actually like it white, with a lot of fat on it," Teame explained. "So that puts the person at a much increased risk for heart disease and stroke as well."

Whatever the health risks, for many Ethiopians raw meat remains one of the most popular dishes. And to prevent tapeworms, the most common and well-known consequence of eating raw meat, any meat lover can just walk to the pharmacy and buy pills without a prescription.

Health Risks Fail to Deter Ethiopians from Eating Raw Meat

Two million children for polio immunisation

Two million children for polio immunisationPublish Date: Sep 17, 2013

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newvision

By Francis Kagolo

About 2.1 million children below the age of five are to be immunised against polio in a new mass campaign in 36 ‘high risk’ districts. 

The ‘door-to-door’ immunisation campaign worth sh8.8b is funded by the Government, UNICEF and Rotary International.  

Following the outbreak of polio in neighboring Kenya, Ethiopia and Somalia, health experts last month warned that Uganda risked a similar outbreak if nothing was done to prevent it. 

The three-day campaign, scheduled to kick off on September 21, will run in the districts mainly along the Uganda border with Kenya and Somalia. 

They include Amudat, Bududa, Bugiri, Buikwe, Bukwo, Bulambuli, Bundibugyo, Busia, Buvuma, and Iganga.

Other districts include Isingiro, Jinja Kaabong, Kabale, Kabarole, Kamwenge, Kanungu, Kapchorwa, Kasese, Kisoro, Kotido, Kween, Kyegegwa, and Kyenjojo.

According to a statement from the ministry of health, Manafwa, Mayuge, Moroto, Nakapiripirit, Namayingo, Napak, Ntoroko, Ntungamo, Rubirizi, Rukungiri, Sironko, and Tororo districts will also benefit.

“The campaign is intended to reach out to every child especially those children likely to have missed out by the routine vaccination programs,” the director general of health   services, Jane Aceng, said in the statement on Tuesday.

She however, explained that the supplemental campaign will replace the routine immunisation.

She urged parents and guardians to take children for immunisation against all the nine immunisable diseases before their first birthday. The diseases include Measles, Diphtheria, Whooping Cough, Tuberculosis, Meningitis, Polio, Pneumonia, Hepatitis B and Tetanus.  

“Children who will not have received this supplemental dose during the campaign should go to the nearest health facility or outreach for their due routine Polio and other vaccines doses,” Aceng said. 

“The ministry appeals to communities in the affected districts to cooperate with the vaccinators and allow them to vaccinate their children under five years. The vaccines are safe and have been certified by the World Health Organization.”

Uganda is one of the countries with the highest number of un-immunised children, currently standing at about 153,616 and 258,580 under-immunised who are at risk of contracting vaccine-preventable diseases.

Polio alone is considered one of the most deadly vaccine-preventable diseases, accounting for an estimated 777,000 childhood deaths per year worldwide, with more than half of these occurring in Africa.

Uganda suffered a setback in immunisation coverage in 2006 when the Global Alliance for Vaccines (GAVI) suspended cash support to the country following the misappropriation of US$4.3m (about sh7.6b).

Immunisation coverage dropped from 83% in 2008 to 76% in 2009/10, according to health ministry statistics.

As the downward trend continued, the national immunisation coverage reached 52% in 2011, turning Uganda into the same category of countries like Somalia which have the lowest number of fully immunized children in the world.

GAVI this year reinstated its cash support for immunisation with US$20m (about sh51b). The Government Currently provides free vaccines in both public and private health facilities in addition to routine mass immunization programmes. 

160 years old Ethiopian discovered being the world's oldest living man

An Ethiopian reporter claims to have discovered the world's oldest living man.

Retired farmer Dhaqabo Ebba claims to have clear memories of Italy's 1895 invasion of the country. In an interview with regional Oromiya TV, he provided so much detail on the changes of power in his local area that reporter Mohammed Ademo has become convinced that Dhaqabo must be at least 160 - 46 years older than the oldest ever recorded man.

'When Italy invaded Ethiopia I had two wives, and my son was old enough to herd cattle,' he said at home near Dodola. He went on to recount his childhood eight-day horseback ride to Addis Ababa - a journey of a few hours today.

There is no way of verifying Mr Dhaqabo's age, but Mohammed Ademo notes that in an oral society like the Oromo, "every time an elder dies, a library is lost. Ebba is one such library from whom so much can still be preserved