HEALTH EDUCATION PROGRAM

St Mary of Zion Ethiopian Orthodox Tewahdo Church
Travelers Health
by Dr Getachew Feleke
July 2019
Introduction
Millions of people travel globally every day. Travel from resource rich to resource limited countries can be associated with travel related illnesses. Most at risk are those who travel to their country of birth as they are more likely to socialize, stay with family and share food and drinks. These diaspora don’t necessarily feel they are at risk and are less likely to take precautions.
Risk of travel associated illnesses is related to where one is going, the length of stay, the time (month) of travel, activities during travel and the underlying health status of the traveler.
Travel associated illnesses can be prevented or reduced if appropriate precautions are taken. The goal of this presentation is to increase awareness of common travel related illnesses. Travel to Ethiopia is the focus of the presentation, but the information may be relevant to other destinations too.
Tips to all travelers
In long distance flights, getting up, walking or stretching every couple of hours to avoid blood clots is advised. Prolonged sitting may result in blood clot (deep venous thrombosis: DVT) which is a serious health hazard.
Travelers taking medication must carry enough supply of the medicines for the duration of the trip.
Mapping out available health service at the destination is advised. .Travelers may also consider buying travel insurance.
Getting pre-travel advice and immunization from an experienced clinician is advisable
Common travel associated illnesses
-Diarrhea
-Fever/chills: many infectious causes
-Respiratory infections
-Other (bites, traffic accident, sexually transmitted infections, skin rash)
Causes of travel associated illnesses
-Contaminated Food and water: Poor sanitary conditions lead to contamination of the food and water with human excreta (feces). Human excreta contain germs .Eating and drinking germ contaminated food and drinks cause illnesses such as traveler's diarrhea, hepatitis, typhoid, amoeba and cholera
- Ingesting raw foods such as eggs, milk and salad may lead to traveler’s diarrhea.
-Not washing hands and using contaminated utensils are risk factors for upset stomach/diarrhea
Poor sanitary conditions and poor hygiene can result from lack of knowledge, lack of clean water, crowding, lack of bathrooms/latrines (open defecation), or other environmental and cultural factors
Vector (Mosquito) bites: Infectious diseases such as malaria, yellow fever and dengue fever are transmitted by mosquitoes.
Malaria, a most serious infection that affects millions of people is transmitted by the bite of an infected female anopheles mosquito. Yellow fever and Dengue is transmitted by a different mosquito.
Contact with contaminated hands, utensils, environment: Infectious diseases can be transmitted from person to person through contact. Unclean hands, utensils, environment, etc play an important role in this regard. Diarrhea, vomiting, influenza are examples.
Airborne (Breathing contaminated air): Infectious agents(germs) maybe floating in the air we breathe. For the most part, these bugs come from infected persons nearby who cough and sneeze without covering mouth and nose; Measles and tuberculosis are spread this way.
The germ causing meningitis is spread similarly but requires close person to person contact
Blood/body fluids exposure: Serious infections such as HIV, Hepatitis B. and hepatitis C are acquired from blood or body fluids of an infected person. This occurs via contaminated needles, sharps (blades, surgical instrument), unprotected sexual contact and rarely transfusion. It is important to note that these infections are not transmitted through hugs, handshakes, eating together, etc.
Bites; scratches; cuts, puncture wounds Rabies is a deadly disease that results from the bite or scratch of a rabid animal, mainly dogs. Bats and raccoons are important carriers in the US
Accidents that result in open wound can predispose to tetanus, a serious preventable infection
Traffic accidents can present serious health risks to travelers
Prevention of travel associated illnesses.
Many travel associated diseases are preventable! Preventive measures include:
1) Vaccination: vaccines are available against: Hepatitis A. Hepatitis B, Yellow fever, Influenza,
Rabies, Typhoid fever, meningococcal meningitis and cholera. Pre-travel consultation regarding vaccination is advised
It is important to be up to date with routine childhood and adult vaccines. (Measles, mumps, rubella, polio, tetanus, diphtheria, pertussis, hepatitis B, influenza.)
2) Mosquito avoidance: These important measures include
-Staying indoors at dusk and dawn. Malaria transmitting Mosquitoes bite early evening (dusk) and early morning (dawn).
-Cover as much of the exposed skin as possible,
-apply insect repellents to exposed skin
-use bed nets preferably impregnated with insecticide
3) Chemoprophylaxis (Using drugs to prevent infections) .
-This mostly applies to malaria. There are effective drugs that can protect from malaria.
-Taking the pills start before the travel date and continued during and for few days after travel.
General behavioral precautions
-Wash hands after using the toilet and before eating or use hand sanitizer.
-Eat well cooked food while hot. Avoid cold foods. Food can be contaminated after it is cooked.
-Drink boiled water, bottled water or chemically treated water
-Fruits that you can peel are safe. Rinsing/ washing fruits, salads with water may not be safe as the water may be contaminated
-Avoid ice from tap water
-Avoid crowded places
-Avoid contact with animals
-Avoid unprotected sexual contact, unsafe body piercing, tattoos
-If dog bite occurs, wash wound with clean water immediately
What can be done if one gets sick while travelling?
Travelers’ diarrhea. This is the most common condition a traveler encounters. Travelers’ diarrhea may be mild, moderate or severe. Fluid replacement is important.
Mild diarrhea: Usually self-limited. It can be self-managed with fluids and anti-diarrheal drugs such as Bismuth sub salicylate or loperamide (lomotil).
Moderate to severe diarrhea is best managed by health care provider. Self-treatment with antidiarrheal drugs is acceptable. If there is no improvement in 2 to 3 days, a clinic visit is warranted,
Some travelers carry antibiotics ( ciprofloxacin ; azithromycin). In situations where no medical care is available, taking antibiotics as a temporary measure may be acceptable.
Fever: this may be caused by infectious diseases, that Include malaria typhoid and meningitis. Fever lasting over 24-48 hours must be taken seriously, and must be evaluated by a healthcare provider.
Being vaccinated or being on preventive drugs may not be fully protective. Serious infection such as malaria, typhoid, and meningitis can be deadly unless treatment is started early.
Fever in the returning traveler:
Fever may be caused by many infectious diseases, Including malaria typhoid and meningitis. Fever lasting over 24-48 hours must be taken seriously, and must be evaluated by a healthcare provider.
It is important to remember that being vaccinated or being on preventive drugs may not be fully protective.
Fever in the returning traveler could be a sign of a serious infection. Malaria and typhoid are two infections that can present in a returning traveler. If these infections are not treated early they can be deadly. The returning traveler who has fever must seek medical treatment immediately.
It is important to inform the doctor all the travel details (itinerary) including vaccinations and medications taken. It is preferable to consult with a doctor experienced in travel medicine.
Summary
Travel associated illnesses are common. Diaspora visiting friends and relatives are most affected. Traveler's diarrhea, hepatitis, typhoid and malaria make up the majority of travel related illnesses.
These infections can be prevented with pre-travel immunization (hepatitis A; hepatitis B; Typhoid) or taking preventive drugs (malaria).
Behavioral precautions are important in avoiding travel associated illnesses.
-Eating well cooked food while hot, avoiding raw foods and drinking boiled or bottled water.
-avoiding mosquito bites (staying indoors, covering skin, using insect repellent and bed nets.
Mild to moderate traveler's diarrhea can be self-managed by taking fluids and anti-diarrhea drugs
Fever can be a sign of serious infection .Consulting a health care provider is advisable.
Fever in the returning traveler must be taken seriously and warrants seeking medical help.
Selected vaccines for travelers
Hepatitis A –Transmission is via the fecal-oral route (by contaminated food or water)
--The vaccine is protective; two doses are required given 6 month apart
-- Vaccination is recommended for individuals who are not already immune
-- The vaccine may be taken any time before travel.
Hepatitis B: Transmission is via blood and body fluid exposure.
-The vaccine is protective; three doses are required at 0, 1 and 6 months
-Vaccination is recommended for individuals who are not immune
-Hepatitis B vaccine is currently included in as one of the routinely given childhood vaccines
Meningitis: -Transmission is from person to person (close contact)
-The vaccine is single dose.
-Vaccination is recommended for travel during the dry season (December to June)
-The vaccine is best given 10 days or earlier before travel.
-Booster doses are required in 3-5 years.
Typhoid Fever: Transmission is via contaminated food and or water
-The vaccine is moderately protective
-Vaccination recommended especially for those travelling rural areas,
-These vaccine comes in an oral and injection form. The oral vaccine comes in 4 doses
The injection form is a single dose. Protection may last for 3 to 5 years.
Rabies: -Transmission is by bite or scratch of a rabid animal primarily dogs
-The vaccine is protective.it is not routinely available.
- The vaccine is recommended for travelers at risk of coming in contact with animals
-If a bite/scratch occurs immediate medical attention is warranted
Yellow fever:-Transmission is via a mosquito bite
-The vaccine is protective. It is a one-time injection with lifelong protection.
-Vaccination is recommended if travelling to endemic countries.
-Yellow fever vaccination is a requirement to enter some countries
Tetanus: The tetanus causing spore (germ) is commonly found in the soil.
-wound (cut, lacerations) contaminated with soil may cause tetanus.
-The vaccine is protective .It comes as a combined vaccine against tetanus, diphtheria, pertussis (Whooping cough); it is one of the routinely given childhood vaccines
-Repeat vaccination (booster) every 10 years is recommended.
Travelers Health
by Dr Getachew Feleke
July 2019
Introduction
Millions of people travel globally every day. Travel from resource rich to resource limited countries can be associated with travel related illnesses. Most at risk are those who travel to their country of birth as they are more likely to socialize, stay with family and share food and drinks. These diaspora don’t necessarily feel they are at risk and are less likely to take precautions.
Risk of travel associated illnesses is related to where one is going, the length of stay, the time (month) of travel, activities during travel and the underlying health status of the traveler.
Travel associated illnesses can be prevented or reduced if appropriate precautions are taken. The goal of this presentation is to increase awareness of common travel related illnesses. Travel to Ethiopia is the focus of the presentation, but the information may be relevant to other destinations too.
Tips to all travelers
In long distance flights, getting up, walking or stretching every couple of hours to avoid blood clots is advised. Prolonged sitting may result in blood clot (deep venous thrombosis: DVT) which is a serious health hazard.
Travelers taking medication must carry enough supply of the medicines for the duration of the trip.
Mapping out available health service at the destination is advised. .Travelers may also consider buying travel insurance.
Getting pre-travel advice and immunization from an experienced clinician is advisable
Common travel associated illnesses
-Diarrhea
-Fever/chills: many infectious causes
-Respiratory infections
-Other (bites, traffic accident, sexually transmitted infections, skin rash)
Causes of travel associated illnesses
-Contaminated Food and water: Poor sanitary conditions lead to contamination of the food and water with human excreta (feces). Human excreta contain germs .Eating and drinking germ contaminated food and drinks cause illnesses such as traveler's diarrhea, hepatitis, typhoid, amoeba and cholera
- Ingesting raw foods such as eggs, milk and salad may lead to traveler’s diarrhea.
-Not washing hands and using contaminated utensils are risk factors for upset stomach/diarrhea
Poor sanitary conditions and poor hygiene can result from lack of knowledge, lack of clean water, crowding, lack of bathrooms/latrines (open defecation), or other environmental and cultural factors
Vector (Mosquito) bites: Infectious diseases such as malaria, yellow fever and dengue fever are transmitted by mosquitoes.
Malaria, a most serious infection that affects millions of people is transmitted by the bite of an infected female anopheles mosquito. Yellow fever and Dengue is transmitted by a different mosquito.
Contact with contaminated hands, utensils, environment: Infectious diseases can be transmitted from person to person through contact. Unclean hands, utensils, environment, etc play an important role in this regard. Diarrhea, vomiting, influenza are examples.
Airborne (Breathing contaminated air): Infectious agents(germs) maybe floating in the air we breathe. For the most part, these bugs come from infected persons nearby who cough and sneeze without covering mouth and nose; Measles and tuberculosis are spread this way.
The germ causing meningitis is spread similarly but requires close person to person contact
Blood/body fluids exposure: Serious infections such as HIV, Hepatitis B. and hepatitis C are acquired from blood or body fluids of an infected person. This occurs via contaminated needles, sharps (blades, surgical instrument), unprotected sexual contact and rarely transfusion. It is important to note that these infections are not transmitted through hugs, handshakes, eating together, etc.
Bites; scratches; cuts, puncture wounds Rabies is a deadly disease that results from the bite or scratch of a rabid animal, mainly dogs. Bats and raccoons are important carriers in the US
Accidents that result in open wound can predispose to tetanus, a serious preventable infection
Traffic accidents can present serious health risks to travelers
Prevention of travel associated illnesses.
Many travel associated diseases are preventable! Preventive measures include:
1) Vaccination: vaccines are available against: Hepatitis A. Hepatitis B, Yellow fever, Influenza,
Rabies, Typhoid fever, meningococcal meningitis and cholera. Pre-travel consultation regarding vaccination is advised
It is important to be up to date with routine childhood and adult vaccines. (Measles, mumps, rubella, polio, tetanus, diphtheria, pertussis, hepatitis B, influenza.)
2) Mosquito avoidance: These important measures include
-Staying indoors at dusk and dawn. Malaria transmitting Mosquitoes bite early evening (dusk) and early morning (dawn).
-Cover as much of the exposed skin as possible,
-apply insect repellents to exposed skin
-use bed nets preferably impregnated with insecticide
3) Chemoprophylaxis (Using drugs to prevent infections) .
-This mostly applies to malaria. There are effective drugs that can protect from malaria.
-Taking the pills start before the travel date and continued during and for few days after travel.
General behavioral precautions
-Wash hands after using the toilet and before eating or use hand sanitizer.
-Eat well cooked food while hot. Avoid cold foods. Food can be contaminated after it is cooked.
-Drink boiled water, bottled water or chemically treated water
-Fruits that you can peel are safe. Rinsing/ washing fruits, salads with water may not be safe as the water may be contaminated
-Avoid ice from tap water
-Avoid crowded places
-Avoid contact with animals
-Avoid unprotected sexual contact, unsafe body piercing, tattoos
-If dog bite occurs, wash wound with clean water immediately
What can be done if one gets sick while travelling?
Travelers’ diarrhea. This is the most common condition a traveler encounters. Travelers’ diarrhea may be mild, moderate or severe. Fluid replacement is important.
Mild diarrhea: Usually self-limited. It can be self-managed with fluids and anti-diarrheal drugs such as Bismuth sub salicylate or loperamide (lomotil).
Moderate to severe diarrhea is best managed by health care provider. Self-treatment with antidiarrheal drugs is acceptable. If there is no improvement in 2 to 3 days, a clinic visit is warranted,
Some travelers carry antibiotics ( ciprofloxacin ; azithromycin). In situations where no medical care is available, taking antibiotics as a temporary measure may be acceptable.
Fever: this may be caused by infectious diseases, that Include malaria typhoid and meningitis. Fever lasting over 24-48 hours must be taken seriously, and must be evaluated by a healthcare provider.
Being vaccinated or being on preventive drugs may not be fully protective. Serious infection such as malaria, typhoid, and meningitis can be deadly unless treatment is started early.
Fever in the returning traveler:
Fever may be caused by many infectious diseases, Including malaria typhoid and meningitis. Fever lasting over 24-48 hours must be taken seriously, and must be evaluated by a healthcare provider.
It is important to remember that being vaccinated or being on preventive drugs may not be fully protective.
Fever in the returning traveler could be a sign of a serious infection. Malaria and typhoid are two infections that can present in a returning traveler. If these infections are not treated early they can be deadly. The returning traveler who has fever must seek medical treatment immediately.
It is important to inform the doctor all the travel details (itinerary) including vaccinations and medications taken. It is preferable to consult with a doctor experienced in travel medicine.
Summary
Travel associated illnesses are common. Diaspora visiting friends and relatives are most affected. Traveler's diarrhea, hepatitis, typhoid and malaria make up the majority of travel related illnesses.
These infections can be prevented with pre-travel immunization (hepatitis A; hepatitis B; Typhoid) or taking preventive drugs (malaria).
Behavioral precautions are important in avoiding travel associated illnesses.
-Eating well cooked food while hot, avoiding raw foods and drinking boiled or bottled water.
-avoiding mosquito bites (staying indoors, covering skin, using insect repellent and bed nets.
Mild to moderate traveler's diarrhea can be self-managed by taking fluids and anti-diarrhea drugs
Fever can be a sign of serious infection .Consulting a health care provider is advisable.
Fever in the returning traveler must be taken seriously and warrants seeking medical help.
Selected vaccines for travelers
Hepatitis A –Transmission is via the fecal-oral route (by contaminated food or water)
--The vaccine is protective; two doses are required given 6 month apart
-- Vaccination is recommended for individuals who are not already immune
-- The vaccine may be taken any time before travel.
Hepatitis B: Transmission is via blood and body fluid exposure.
-The vaccine is protective; three doses are required at 0, 1 and 6 months
-Vaccination is recommended for individuals who are not immune
-Hepatitis B vaccine is currently included in as one of the routinely given childhood vaccines
Meningitis: -Transmission is from person to person (close contact)
-The vaccine is single dose.
-Vaccination is recommended for travel during the dry season (December to June)
-The vaccine is best given 10 days or earlier before travel.
-Booster doses are required in 3-5 years.
Typhoid Fever: Transmission is via contaminated food and or water
-The vaccine is moderately protective
-Vaccination recommended especially for those travelling rural areas,
-These vaccine comes in an oral and injection form. The oral vaccine comes in 4 doses
The injection form is a single dose. Protection may last for 3 to 5 years.
Rabies: -Transmission is by bite or scratch of a rabid animal primarily dogs
-The vaccine is protective.it is not routinely available.
- The vaccine is recommended for travelers at risk of coming in contact with animals
-If a bite/scratch occurs immediate medical attention is warranted
Yellow fever:-Transmission is via a mosquito bite
-The vaccine is protective. It is a one-time injection with lifelong protection.
-Vaccination is recommended if travelling to endemic countries.
-Yellow fever vaccination is a requirement to enter some countries
Tetanus: The tetanus causing spore (germ) is commonly found in the soil.
-wound (cut, lacerations) contaminated with soil may cause tetanus.
-The vaccine is protective .It comes as a combined vaccine against tetanus, diphtheria, pertussis (Whooping cough); it is one of the routinely given childhood vaccines
-Repeat vaccination (booster) every 10 years is recommended.
Annual Meeting of HWMB Society will be held in New york on July 4, 2019
This year's honoree is Dr. Widad Kidane Mariam.
Dr. Widad Kidane Mariam was born in 1931 and belonged to a free-will Ethiopian émigré family in Palestine. She received her medical degree in 1959 and post-graduate health sciences concentration in maternal and child health from the American University of Beirut [AUB]. She died in 1989 after few years of voluntary community service during her retirement from the Division of Medical Services of the Ministry of Public, Ethiopia.
Dr. Widad was one of the youngest trail blazers associated with the meaningful equal opportunity for all Ethiopians regardless of their genders, ethnic and socio-economic backgrounds during her lifetime tenure as Director General of the Division of the National Medical Service in the Ministry of Public Health. Given her pioneering spirit in bridge building coupled with her persistent and persuasive lifetime goals, Dr. Widad has fulfilled her unique dream by marching back from her temporary exodus status in Palestine and Lebanon to live forever in her eternally promised Ethiopian ancestral land sixty years ago. Very few pioneers recognize that the newly founded status for the first Ethiopian female medical graduate was a calculated success story on how overcome the historical odds for a woman facing the gradual but sure upward mobility to topmost health policy making position in Ethiopia.
The capstone of her professional life was when she mobilized and spent her precious free time to serve as uncompensated member of advisory boards of several interdisciplinary grassroots charity and non-governmental organizations. Beside her demanding position in the Ministry of Public Health, she served as a volunteer to organize the first Ethiopian Family Planning Association and aim of which was to promote and support Maternal Health and Child Survival health care services. Her vision was to leverage her liaison roles to collaborate with the wives of the Rotary and Toastmaster Clubs of Ethiopia to plan organize private maternal and child health clinics for homeless pregnant and indigent women to improve the quality of life of residents of Addis Ababa Municipality with ultimate up scaling into national policy. As a Good Samaritan, she was able to collect and distribute free drugs not only from non-for-profit international humanitarian grants and donations but also fund raising from wives of foreign diplomats and grassroots societies. She used her influence to negotiate public assistance to nongovernmental organization to claim reimbursement for not for profit health care services as part of the allocated Ministry of Public Health’s budgets for humanitarian women’s health and child survival projects in addition to funded partnerships supported by the Swedish Save the Children Fund [RADARN], as well other international humanitarian technical assistance such as USAID.
In the final analysis, Dr. Widad has dedicated her time and energy as the most honorable pioneer advocate of equal opportunity, equity and justice throughout holistic human span of life. Hakim Workineh and Melaku Beyan society honors Dr Widad for her dedicated life time contributions to promote health in Ethiopia.
WHO IS WHO BIOGRAPHY OF THE FIRST ETHIOPIAN FEMALE IN MEDICINE AND PUBLIC HEALTH: WIDAD KIDANE MARIAM, MD, MHS
Dr. Widad Kidane Mariam was born in 1931 and belonged to common Ethiopian émigré family in Palestine. Indeed their free-will destiny was determined by the superior values given to secure better education for their offspring who grew up in exodus but with final dream that someday they shall contribute to Ethiopia as their first promised land. She was one of five children who invariably excelled in their professions whether in health, public services or private entrepreneurship. Dr. Wadad Kidane Mariam became a valedictorian of Ramallah Girls Elementary and Highs School in Palestine. Subsequently, she attended the first Beirut College for Women [BCW] where she received her baccalaureate degree and in 1959 she graduated from the School of Medicine of the American University of Beirut [AUB]. AUB was also known for producing the highest number of the first generation of Ethiopian physicians until 1960s. She also received postgraduate degree in maternal and child health at the American University of Beirut [AUB]. Dr. Widad seized the unique opportunity from where she was in exodus to excel and has never forgotten Ethiopia as her land of origin. By the same token, her older brother, Yohannes Kidane Mariam, a graduate of the American University of Beirut [AUB] has his maiden career in public service when he finally held the multiple portfolio as Minister and Private Secretary of Emperor Haile Sillassie until his untimely execution in captivity at the outset of the Socialist Revolution Regime in 1974.
Dr. Widad was a private medical practitioner before she was offered permanent public service position leading to her appointment as the “first female” National Director General of the Division of Medical Services in the Ministry of Health. During her tenure as Director General during her maiden public health career[ 1960s-1970s] she served as Ethiopian the first female member of the National Medical Board of Advisers in the Ministry of Public Health, as well as the Ethiopian Medical Association. Her new status empowered her to surround herself with key associates such as Dr. Arnt Myer-Lee of the Swedish International Development [SIDA] and Dr. Ahmed A. Moen, Associate Director of Medical Services who was among other associate manager and all of whom were US trained health care managers in charge of the Offices of National Health Planning and Statistics and accreditation and licensing non-governmental hospitals and rural clinics and Office of Nursing and Gondar Graduate Health Officers, Community Nursing and Environment Health and Laboratory Technicians. The diverse team managers graduated from various universities such as AUB, the University of Michigan School of Public Health , University California School of Public Health in Los Angeles, Saint Louis School Health Administration Program Graduate and Yale School of Public Health. Dr. Ahmed Moen was transferred from his first position as the Associate Administrator of the Malaria Eradication Program in order to merge the autonomous vertical communicable diseases projects supported by expatriate advisers seconded by WHO, USAID, SIDA AND British Overseas Development Agency [BODA] under Vice Minister of Health Affairs and Medical Service Division in the Ministry of Public Health effective in 1960.
The appointment of qualified Ethiopian leadership team has ushered unprecedented restructured of referral services and coordination of primary care, hospitals and vertical programs which occurred as run-up to the establishment of the first Medical School in Addis Ababa University in collaboration with the American University of Beirut that admitted 4 premedical students two study in AUB while the medical students are expected to complete the bridging curriculum that lead to continuity of transferring their medical degree prerequisites to newly established School of Medicine of Addis Ababa University during in the 1960s. Some of the home-grown holders of the accredited first degree in medicine from the Ethiopian Medical also pursued post-graduate medical specialty programs overseas and when returned they assumed leadership positions such as Chairpersons and Deans of Addis Ababa University School of Medicine, Gondar University an affiliated of Addis Ababa University and the first Medical Degree in Community Medicine in Jimma. [Kidane Mariam and Moen, Ahmed, PP 111-139, JEM and National Five-Year Public Health Plan of Action 1965-1970]
The Medical Service Division was actively engaged to supersede the expatriate health advisers, managers of vertical programs such as malaria control and smallpox eradiation that involved joint expatriate full-time advisers, as well as American, Japanese and Austrian Peace Corps Volunteers. The new Ethiopian leadership team initiated the formal integration of multiple technical assistance's such as the World Health Organization [WHO], Swedish Development Agency [SIDA] and US Agency for International Development [USAID]. The young and enthusiastic policy makers including and not limited to the equal opportunity given to male and female graduates of the Gondar College of Public Health Officers, Community Nurses, and Environmental Health Technicians including the first Ethiopian Red Cross Nursing School that graduated the highest number of hospital registered diploma nurses and certified Medical Assistants and Licensed Practical Nurses and Nurse Mangers. All of these integrative human resource development policy making culminated with writing and managing two consecutive Fifth Five-year Strategic Plan of Ethiopia in 1960s-1970s.
Dr. Widad as a Director General of the Medical, as well as her associates worked as centralized and decentralized teams in charge of the first development of urban and provincial hospitals and public health centers staffing patterns for more than more than one small and midsize umber of hospital beds, community health centers, maternal and child health primary care stations. The Ethiopian leadership initiated sustainable human resource development plan to provide access and referral services from primary up to secondary district and tertiary regional and provincial healthcare delivery services. The plan included collaborative memorandum of understanding to formally institute partnership with the First Addis Ababa University Medical School and also the Ethiopian Medical Association and Gondar College of Public Health that formerly under the Ministry of Public Health in the newly founded Addis Ababa University regional baccalaureate colleges and schools on one the one hand and the Medical Service Division and the Department of National Public Health Planning of the Ministry of Health. [Kidane Mariam and Moen, Ahmed, PP 111-139, JEM and Admasu, Mengesha and Moen, Ahmed A. PP 23-29. P2P Publication 2013].
Given the leadership status of being the first female Ethiopian Medical Service Director, Dr. Widad with assistance of her associates of public health and nursing graduates, she was successful style of management included her in the new role of advisers of the Minister of Health, Ato Ketema Abebe and aim of which was to supersede WHO and bilateral appointed expatriates not only in the Ministry of Public Health but also coordinate reorientation of human resources development in collaboration with Addis Ababa University Medical School to implement policy priority of rural medical and health service national staffing patterns. Given the leadership status of being the first female Ethiopian Medical Service Director, Dr. Widad with assistance of her associates of public health and nursing graduates, she was successful style of management included her in the new role of advisers of the Late Non-Medical Minister of Health, Ato Ketema Abebe and aim of which was to supersede WHO and bilateral appointed expatriates not only in the Ministry of Public Health but also coordinate reorientation of human resources development in collaboration with Addis Ababa University Medical School to implement policy priority of rural medical and health service national staffing patterns.
The Medical Services Division under the leadership of its new home-grown and international medical and public health graduates collaborated to restructure, update and design modified curriculum and admissions standards for prospective graduates of Gondar public health and future applicants of medical school at the Addis Ababa University. The transfer of the joint ownership of Gondar School of Public Health from the Ministry of Health resulted in continuation of the Bachelor of Science Degree in public health and medicine with privileges and rights given to all students enrolled in colleges and schools in Addis Ababa University systems then. In so doing, several of Gondar Public Health Officers who completed a minimum of 4 years of rural and national services were granted advanced credits for premedical courses and practicum that waived the conventional admission of medical students. In so doing, the first merged curriculum graduates received Medical Degree in 1968 and also became the first time Ethiopian Medical and Health Provincial Officers eligible to be the seed of the first home-grown Ethiopians with Medical degrees. A new policy of requirement of obligatory and equitable minimum two years of field service for all graduates of the medical schools and public health was officially proclaimed and placed under the watch of the first Medical Director of the Ministry of Public Health.
[Kidane Mariam and Moen, Ahmed, PP 111-137, JEM and National Five-Year Public Health Plan of Action 1965-1970, Admasu, Mengesha and Moen, Ahmed, P2P Publication PP 23-29]
The 1960s witnessed the unprecedented self-reliance and pioneering investment return. The precedents set new standards for effective agenda of nation building when expatriate medical advisers and mangers were superseded by home-grown medical and public health graduates in charge of central and district levels. A new approach to constructive engagement in policy-making that refrained from exclusive privilege to serve in urban areas instead of under serviced rural areas. By all measures of success no one should avoid the obligatory integrative experience coupled with a minimum of two years of rotation at all levels of medical and allied health rank and file positions in Ethiopia. The policy involved service contract signed by all fresh medical and allied health sciences degrees holders regardless of obtaining their degree origin from national or international colleges and universities. The pioneers have already sacrificed to institute self-reliance as mandated national priority to achieve the ultimate vision of securing a fair share of the little Ethiopians can give back and also help in curtailing excess that favor the privileges of the fortunate class and the purposed enunciated in the health tax for health centers building in Ethiopia. [Mehari, Enawgaw et. al: Triangular Partnership to Support Medical Education in Ethiopia. P2P Publication, 2013]
THE GOOD SAMARITAN LEADERSHIP MODEL
In the final analysis, as a civil servant, Dr. Widad mobilized and spent her free time to work as uncompensated member of advisory boards of several interdisciplinary grassroots non-governmental organizations. She became an uncompensated volunteer to organize the first Ethiopian Family Planning Association and aim of which was to promote and support Maternal Health and Child Survival health care services. As one of her vision was to collaborate with the wives of the Rotary and Toastmaster Clubs of Ethiopia to plan organize private maternal and child health clinics for homeless pregnant and indigent women to improve the quality of life of residents of Addis Ababa Municipality. With ultimate upscaling into national policy. As a good Samaritan, she was able to collect and distribute free drugs not only from non-for-profit international humanitarian grants and donations from wives of foreign diplomats and grassroots societies. She used her influence to negotiate reallocation of public assistance to nongovernmental organization to claim reimbursement from the annual Ministry of Public Health’s budgets for women’s health and child survival projects as a partners of the Swedish Save the Children Fund [RADARN], as well other international humanitarian technical assistance such as USAID.
All of these Samaritan up-bringing fostered her pioneering spirit to turn back the clock to her favorite social experiment that allowed humanitarian assistance to bond with a group of women and children care givers and thereby focusing on the new phenomena of homeless and broken families in need of voluntary leadership to operate free-clinics for women and children. This could not have occurred without the partnership of the Ministry of Public Medical and Health Services Division and Addis Ababa Municipality Health Division. When Dr. Widad Kidane Mariam retired from the Ministry of Public Health and partly because of the mass attrition of qualified civil servants, she resorted to her basic humanitarian instinct of pioneers to engage in real health profession-based constructive leadership to practice ob-gyn in not-for-profit organization as an uncompensated volunteer to promote family health planning organizations and access for all as evidence-based lifetime achievement of her 30 years of public health service when she died in 1989.
What Dr. Widad achieved is complemented by her siblings and parents. Her oldest sister, the late Helen Kidane Mariam was employed in an executive position at the Economic Commission of Africa, Addis Ababa. Her father Kidane Mariam Wolde Mariam and mother Bekeletch Workneh, produced three college graduate Tekle Mariam, George and Diana. However, she was survived by her younger brother, George who graduated with MA from Eratmus University in Rotterdam, Netherland and retired there, as well as her younger sister Diana Kidane Mariam, BA, who graduated from Sweet Briar Women College, Briar, Virginia and Mt. Saint Mary University, Los Angeles, CA and finally her adopted daughter, Herut Kidane Mariam is an entrepreneur in the arts and works in Amsterdam, Netherlands.
References:
Dr. Widad Kidane Mariam was born in 1931 and belonged to a free-will Ethiopian émigré family in Palestine. She received her medical degree in 1959 and post-graduate health sciences concentration in maternal and child health from the American University of Beirut [AUB]. She died in 1989 after few years of voluntary community service during her retirement from the Division of Medical Services of the Ministry of Public, Ethiopia.
Dr. Widad was one of the youngest trail blazers associated with the meaningful equal opportunity for all Ethiopians regardless of their genders, ethnic and socio-economic backgrounds during her lifetime tenure as Director General of the Division of the National Medical Service in the Ministry of Public Health. Given her pioneering spirit in bridge building coupled with her persistent and persuasive lifetime goals, Dr. Widad has fulfilled her unique dream by marching back from her temporary exodus status in Palestine and Lebanon to live forever in her eternally promised Ethiopian ancestral land sixty years ago. Very few pioneers recognize that the newly founded status for the first Ethiopian female medical graduate was a calculated success story on how overcome the historical odds for a woman facing the gradual but sure upward mobility to topmost health policy making position in Ethiopia.
The capstone of her professional life was when she mobilized and spent her precious free time to serve as uncompensated member of advisory boards of several interdisciplinary grassroots charity and non-governmental organizations. Beside her demanding position in the Ministry of Public Health, she served as a volunteer to organize the first Ethiopian Family Planning Association and aim of which was to promote and support Maternal Health and Child Survival health care services. Her vision was to leverage her liaison roles to collaborate with the wives of the Rotary and Toastmaster Clubs of Ethiopia to plan organize private maternal and child health clinics for homeless pregnant and indigent women to improve the quality of life of residents of Addis Ababa Municipality with ultimate up scaling into national policy. As a Good Samaritan, she was able to collect and distribute free drugs not only from non-for-profit international humanitarian grants and donations but also fund raising from wives of foreign diplomats and grassroots societies. She used her influence to negotiate public assistance to nongovernmental organization to claim reimbursement for not for profit health care services as part of the allocated Ministry of Public Health’s budgets for humanitarian women’s health and child survival projects in addition to funded partnerships supported by the Swedish Save the Children Fund [RADARN], as well other international humanitarian technical assistance such as USAID.
In the final analysis, Dr. Widad has dedicated her time and energy as the most honorable pioneer advocate of equal opportunity, equity and justice throughout holistic human span of life. Hakim Workineh and Melaku Beyan society honors Dr Widad for her dedicated life time contributions to promote health in Ethiopia.
WHO IS WHO BIOGRAPHY OF THE FIRST ETHIOPIAN FEMALE IN MEDICINE AND PUBLIC HEALTH: WIDAD KIDANE MARIAM, MD, MHS
Dr. Widad Kidane Mariam was born in 1931 and belonged to common Ethiopian émigré family in Palestine. Indeed their free-will destiny was determined by the superior values given to secure better education for their offspring who grew up in exodus but with final dream that someday they shall contribute to Ethiopia as their first promised land. She was one of five children who invariably excelled in their professions whether in health, public services or private entrepreneurship. Dr. Wadad Kidane Mariam became a valedictorian of Ramallah Girls Elementary and Highs School in Palestine. Subsequently, she attended the first Beirut College for Women [BCW] where she received her baccalaureate degree and in 1959 she graduated from the School of Medicine of the American University of Beirut [AUB]. AUB was also known for producing the highest number of the first generation of Ethiopian physicians until 1960s. She also received postgraduate degree in maternal and child health at the American University of Beirut [AUB]. Dr. Widad seized the unique opportunity from where she was in exodus to excel and has never forgotten Ethiopia as her land of origin. By the same token, her older brother, Yohannes Kidane Mariam, a graduate of the American University of Beirut [AUB] has his maiden career in public service when he finally held the multiple portfolio as Minister and Private Secretary of Emperor Haile Sillassie until his untimely execution in captivity at the outset of the Socialist Revolution Regime in 1974.
Dr. Widad was a private medical practitioner before she was offered permanent public service position leading to her appointment as the “first female” National Director General of the Division of Medical Services in the Ministry of Health. During her tenure as Director General during her maiden public health career[ 1960s-1970s] she served as Ethiopian the first female member of the National Medical Board of Advisers in the Ministry of Public Health, as well as the Ethiopian Medical Association. Her new status empowered her to surround herself with key associates such as Dr. Arnt Myer-Lee of the Swedish International Development [SIDA] and Dr. Ahmed A. Moen, Associate Director of Medical Services who was among other associate manager and all of whom were US trained health care managers in charge of the Offices of National Health Planning and Statistics and accreditation and licensing non-governmental hospitals and rural clinics and Office of Nursing and Gondar Graduate Health Officers, Community Nursing and Environment Health and Laboratory Technicians. The diverse team managers graduated from various universities such as AUB, the University of Michigan School of Public Health , University California School of Public Health in Los Angeles, Saint Louis School Health Administration Program Graduate and Yale School of Public Health. Dr. Ahmed Moen was transferred from his first position as the Associate Administrator of the Malaria Eradication Program in order to merge the autonomous vertical communicable diseases projects supported by expatriate advisers seconded by WHO, USAID, SIDA AND British Overseas Development Agency [BODA] under Vice Minister of Health Affairs and Medical Service Division in the Ministry of Public Health effective in 1960.
The appointment of qualified Ethiopian leadership team has ushered unprecedented restructured of referral services and coordination of primary care, hospitals and vertical programs which occurred as run-up to the establishment of the first Medical School in Addis Ababa University in collaboration with the American University of Beirut that admitted 4 premedical students two study in AUB while the medical students are expected to complete the bridging curriculum that lead to continuity of transferring their medical degree prerequisites to newly established School of Medicine of Addis Ababa University during in the 1960s. Some of the home-grown holders of the accredited first degree in medicine from the Ethiopian Medical also pursued post-graduate medical specialty programs overseas and when returned they assumed leadership positions such as Chairpersons and Deans of Addis Ababa University School of Medicine, Gondar University an affiliated of Addis Ababa University and the first Medical Degree in Community Medicine in Jimma. [Kidane Mariam and Moen, Ahmed, PP 111-139, JEM and National Five-Year Public Health Plan of Action 1965-1970]
The Medical Service Division was actively engaged to supersede the expatriate health advisers, managers of vertical programs such as malaria control and smallpox eradiation that involved joint expatriate full-time advisers, as well as American, Japanese and Austrian Peace Corps Volunteers. The new Ethiopian leadership team initiated the formal integration of multiple technical assistance's such as the World Health Organization [WHO], Swedish Development Agency [SIDA] and US Agency for International Development [USAID]. The young and enthusiastic policy makers including and not limited to the equal opportunity given to male and female graduates of the Gondar College of Public Health Officers, Community Nurses, and Environmental Health Technicians including the first Ethiopian Red Cross Nursing School that graduated the highest number of hospital registered diploma nurses and certified Medical Assistants and Licensed Practical Nurses and Nurse Mangers. All of these integrative human resource development policy making culminated with writing and managing two consecutive Fifth Five-year Strategic Plan of Ethiopia in 1960s-1970s.
Dr. Widad as a Director General of the Medical, as well as her associates worked as centralized and decentralized teams in charge of the first development of urban and provincial hospitals and public health centers staffing patterns for more than more than one small and midsize umber of hospital beds, community health centers, maternal and child health primary care stations. The Ethiopian leadership initiated sustainable human resource development plan to provide access and referral services from primary up to secondary district and tertiary regional and provincial healthcare delivery services. The plan included collaborative memorandum of understanding to formally institute partnership with the First Addis Ababa University Medical School and also the Ethiopian Medical Association and Gondar College of Public Health that formerly under the Ministry of Public Health in the newly founded Addis Ababa University regional baccalaureate colleges and schools on one the one hand and the Medical Service Division and the Department of National Public Health Planning of the Ministry of Health. [Kidane Mariam and Moen, Ahmed, PP 111-139, JEM and Admasu, Mengesha and Moen, Ahmed A. PP 23-29. P2P Publication 2013].
Given the leadership status of being the first female Ethiopian Medical Service Director, Dr. Widad with assistance of her associates of public health and nursing graduates, she was successful style of management included her in the new role of advisers of the Minister of Health, Ato Ketema Abebe and aim of which was to supersede WHO and bilateral appointed expatriates not only in the Ministry of Public Health but also coordinate reorientation of human resources development in collaboration with Addis Ababa University Medical School to implement policy priority of rural medical and health service national staffing patterns. Given the leadership status of being the first female Ethiopian Medical Service Director, Dr. Widad with assistance of her associates of public health and nursing graduates, she was successful style of management included her in the new role of advisers of the Late Non-Medical Minister of Health, Ato Ketema Abebe and aim of which was to supersede WHO and bilateral appointed expatriates not only in the Ministry of Public Health but also coordinate reorientation of human resources development in collaboration with Addis Ababa University Medical School to implement policy priority of rural medical and health service national staffing patterns.
The Medical Services Division under the leadership of its new home-grown and international medical and public health graduates collaborated to restructure, update and design modified curriculum and admissions standards for prospective graduates of Gondar public health and future applicants of medical school at the Addis Ababa University. The transfer of the joint ownership of Gondar School of Public Health from the Ministry of Health resulted in continuation of the Bachelor of Science Degree in public health and medicine with privileges and rights given to all students enrolled in colleges and schools in Addis Ababa University systems then. In so doing, several of Gondar Public Health Officers who completed a minimum of 4 years of rural and national services were granted advanced credits for premedical courses and practicum that waived the conventional admission of medical students. In so doing, the first merged curriculum graduates received Medical Degree in 1968 and also became the first time Ethiopian Medical and Health Provincial Officers eligible to be the seed of the first home-grown Ethiopians with Medical degrees. A new policy of requirement of obligatory and equitable minimum two years of field service for all graduates of the medical schools and public health was officially proclaimed and placed under the watch of the first Medical Director of the Ministry of Public Health.
[Kidane Mariam and Moen, Ahmed, PP 111-137, JEM and National Five-Year Public Health Plan of Action 1965-1970, Admasu, Mengesha and Moen, Ahmed, P2P Publication PP 23-29]
The 1960s witnessed the unprecedented self-reliance and pioneering investment return. The precedents set new standards for effective agenda of nation building when expatriate medical advisers and mangers were superseded by home-grown medical and public health graduates in charge of central and district levels. A new approach to constructive engagement in policy-making that refrained from exclusive privilege to serve in urban areas instead of under serviced rural areas. By all measures of success no one should avoid the obligatory integrative experience coupled with a minimum of two years of rotation at all levels of medical and allied health rank and file positions in Ethiopia. The policy involved service contract signed by all fresh medical and allied health sciences degrees holders regardless of obtaining their degree origin from national or international colleges and universities. The pioneers have already sacrificed to institute self-reliance as mandated national priority to achieve the ultimate vision of securing a fair share of the little Ethiopians can give back and also help in curtailing excess that favor the privileges of the fortunate class and the purposed enunciated in the health tax for health centers building in Ethiopia. [Mehari, Enawgaw et. al: Triangular Partnership to Support Medical Education in Ethiopia. P2P Publication, 2013]
THE GOOD SAMARITAN LEADERSHIP MODEL
In the final analysis, as a civil servant, Dr. Widad mobilized and spent her free time to work as uncompensated member of advisory boards of several interdisciplinary grassroots non-governmental organizations. She became an uncompensated volunteer to organize the first Ethiopian Family Planning Association and aim of which was to promote and support Maternal Health and Child Survival health care services. As one of her vision was to collaborate with the wives of the Rotary and Toastmaster Clubs of Ethiopia to plan organize private maternal and child health clinics for homeless pregnant and indigent women to improve the quality of life of residents of Addis Ababa Municipality. With ultimate upscaling into national policy. As a good Samaritan, she was able to collect and distribute free drugs not only from non-for-profit international humanitarian grants and donations from wives of foreign diplomats and grassroots societies. She used her influence to negotiate reallocation of public assistance to nongovernmental organization to claim reimbursement from the annual Ministry of Public Health’s budgets for women’s health and child survival projects as a partners of the Swedish Save the Children Fund [RADARN], as well other international humanitarian technical assistance such as USAID.
All of these Samaritan up-bringing fostered her pioneering spirit to turn back the clock to her favorite social experiment that allowed humanitarian assistance to bond with a group of women and children care givers and thereby focusing on the new phenomena of homeless and broken families in need of voluntary leadership to operate free-clinics for women and children. This could not have occurred without the partnership of the Ministry of Public Medical and Health Services Division and Addis Ababa Municipality Health Division. When Dr. Widad Kidane Mariam retired from the Ministry of Public Health and partly because of the mass attrition of qualified civil servants, she resorted to her basic humanitarian instinct of pioneers to engage in real health profession-based constructive leadership to practice ob-gyn in not-for-profit organization as an uncompensated volunteer to promote family health planning organizations and access for all as evidence-based lifetime achievement of her 30 years of public health service when she died in 1989.
What Dr. Widad achieved is complemented by her siblings and parents. Her oldest sister, the late Helen Kidane Mariam was employed in an executive position at the Economic Commission of Africa, Addis Ababa. Her father Kidane Mariam Wolde Mariam and mother Bekeletch Workneh, produced three college graduate Tekle Mariam, George and Diana. However, she was survived by her younger brother, George who graduated with MA from Eratmus University in Rotterdam, Netherland and retired there, as well as her younger sister Diana Kidane Mariam, BA, who graduated from Sweet Briar Women College, Briar, Virginia and Mt. Saint Mary University, Los Angeles, CA and finally her adopted daughter, Herut Kidane Mariam is an entrepreneur in the arts and works in Amsterdam, Netherlands.
References:
- Kidane-Mariam, Widad and Ahmed Moen. “Government Health Services in Ethiopia and the Role of Medical Graduates in it. Ethiopian Medical Journal, 10, PP 111-139,1972 .
- Moen, Ahmed A. The Pioneers in Medical and Public Health Professions in Ethiopia: Narratives and Attributes of Leadership. Special Article published on P2P Forum [2012] and Reproduced by Wyeyete Medreck Magazine, Google.com in 2012.
- Ministry of Public Health, National Five Year Plan – 1965-1970.
- Mehari, Enwagaw, et.al, The Manual of Ethiopian Medical History. P2P Publication, Amazon 2013.
- Mehari, Enawgaw et. al. Triangular Partnership to Support Medical Education in Ethiopia: The Diaspora as a Bridge between Ethiopian Medical Schools & Foreign Institutions. P2P Pre-Publication Issue 2013.
- Admasu, Mengesha and Moen, Ahmed. A Module for Training Medical Students in Ethiopia. Transformation and Trends in 20th and 21 Century. PP 23-29. The Manual of History of Medicine. P2P Publication, 2013.
LAST YEARS HONOREE: EMPEROR MENeLIK ii
previous honorees: 1. Prof. Edemarian Tega and Dr. F. Lester
2. prof. Asrat wodleyes
3, Dr Fikre Workineh
4. Prof. Taye mekuria
5. Prof. Bayu Teklu
6 Dr . Paulos Quaana
7. Dr Hamlin
8. Dr .Solomon Haregewoin
9. Prof. Jemal Abdulkadir
10. Hakim workineh
11. Dr . Tekletsion
12. Prof. Nebiat Teferi
A Historical Outline of Ophthalmic Practice in Ethiopia
Not much is known of eye services in Ethiopia before the Italian occupation. After the liberation of Ethiopia from Italy, the school health services concentrating on trachoma diagnosis and treatment by copper sulphate scraping was under the care of the Italian, Dr Pace.
Ophthalmic services in Ethiopia solely depended on expatriate ophthalmologists until mid-1960's. Ophthalmologists from Cyprus, Sweden and Germany, in addition to rendering services to the public, had trained few nurses which were assisting them. Strong ties with president Tito of Yugoslavia resulted in the fact that there were some 400 nationals from Yugoslavia including Dr. Obradovic, who was at the time the prominent ophthalmologist in Ethiopia.
Dr. Paulos Quana'a, the first Ethiopian ophthalmologist from the American University of Beirut, Lebanon, arrived on the scene in 1964 and joined Dr. Zagora, an ophthalmologist from Israel at Menelik II hospital. This young energetic individual soon recognized the full responsibility ahead of him of enhancing the ophthalmic services in Ethiopia. While he was doing surgery in the mornings every day, he had also to take care of the hundreds of patients waiting for him at the out-patient department in the afternoon.
It was apparent for him at that juncture, that there has to be accelerated manpower development in the ophthalmic field to overcome the often quoted ratio at international forums of "one ophthalmologist for one million populations" in Sub Saharan countries including Ethiopia. As a result, he launched a three years postgraduate program in ophthalmology in 1980. Because he was the only staff involved in training as well as surgical and medical services at that time, he felt the surgical practical experience of residents was inadequate. Thus, the residency program was made to continue as a four year program.
The eye department uninterruptedly continued to recruit young medical doctors to join the residency program, despite constraints of staff and material. To strengthen the staff, he recruited subsequent graduates whose capability and interest to teach were inviting. He collaborated with international organizations like International Eye Foundations (IEF) to obtain journals, books as well as some equipment. In additional, he was inviting expatriate nationals to teach residents through the program of UNDP TOKTEN (UNDP Transfer of Knowledge through Expatriate Nationals). He played a core role to establish the "Ophthalmological Society of Ethiopia" creating a forum of the exchange of scientific clinical research among members.
The department that was started by him alone has continued in a strengthened manner and so far 118 ophthalmologists have graduated. Indeed, Dr. Paulos has tirelessly served the nation and is till strong enough to continue serving as an active consultant. All of us who the products of the department he started long ago are proud of his dedication and contributions to Ethiopia. The quality and quantity of services given in Ethiopia today have rotted from his idea initiated more than 30 years ago. We give tribute to him for our successes and wish him a healthy and prosperous life.
Abebe Bejiga, MD
Associate professor of ophthalmology
Addis Ababa University
Ophthalmic services in Ethiopia solely depended on expatriate ophthalmologists until mid-1960's. Ophthalmologists from Cyprus, Sweden and Germany, in addition to rendering services to the public, had trained few nurses which were assisting them. Strong ties with president Tito of Yugoslavia resulted in the fact that there were some 400 nationals from Yugoslavia including Dr. Obradovic, who was at the time the prominent ophthalmologist in Ethiopia.
Dr. Paulos Quana'a, the first Ethiopian ophthalmologist from the American University of Beirut, Lebanon, arrived on the scene in 1964 and joined Dr. Zagora, an ophthalmologist from Israel at Menelik II hospital. This young energetic individual soon recognized the full responsibility ahead of him of enhancing the ophthalmic services in Ethiopia. While he was doing surgery in the mornings every day, he had also to take care of the hundreds of patients waiting for him at the out-patient department in the afternoon.
It was apparent for him at that juncture, that there has to be accelerated manpower development in the ophthalmic field to overcome the often quoted ratio at international forums of "one ophthalmologist for one million populations" in Sub Saharan countries including Ethiopia. As a result, he launched a three years postgraduate program in ophthalmology in 1980. Because he was the only staff involved in training as well as surgical and medical services at that time, he felt the surgical practical experience of residents was inadequate. Thus, the residency program was made to continue as a four year program.
The eye department uninterruptedly continued to recruit young medical doctors to join the residency program, despite constraints of staff and material. To strengthen the staff, he recruited subsequent graduates whose capability and interest to teach were inviting. He collaborated with international organizations like International Eye Foundations (IEF) to obtain journals, books as well as some equipment. In additional, he was inviting expatriate nationals to teach residents through the program of UNDP TOKTEN (UNDP Transfer of Knowledge through Expatriate Nationals). He played a core role to establish the "Ophthalmological Society of Ethiopia" creating a forum of the exchange of scientific clinical research among members.
The department that was started by him alone has continued in a strengthened manner and so far 118 ophthalmologists have graduated. Indeed, Dr. Paulos has tirelessly served the nation and is till strong enough to continue serving as an active consultant. All of us who the products of the department he started long ago are proud of his dedication and contributions to Ethiopia. The quality and quantity of services given in Ethiopia today have rotted from his idea initiated more than 30 years ago. We give tribute to him for our successes and wish him a healthy and prosperous life.
Abebe Bejiga, MD
Associate professor of ophthalmology
Addis Ababa University