Quality of Health Care in Ethiopia

Ethiopians have been longing for better health and modern medicine since Emperor Lebene Diengel in the 15th century. Unfortunately, quality has gone from bad to worse. Very little financial and informational resources are available. Today, in Ethiopia, any one can buy any pharmaceutical products, drugs, including antibiotics, steroids etc without any physician's written prescription from any pharmacy in the country. It only takes to know the name of the medicine and to have sufficient funds. This is indeed sad. It is no different from buying oranges and apples from the supermarket. The performance of the ministry of health, the medical association, pharmaceutical associations has been very poor. What is quite a paradox is that there are certain antibiotics that can not be prescribed by young doctors in the teaching-hospital based practice but the same medicine is available without any restriction for the public.

Patients are given little or no information on the drugs that they take. Pharmacists have no moral value to give a dangerous medicine to a lay person. Most people think taking a huge dose of antibiotic will cure fast the infection, like a notion of radical surgery " neklo yawotawal". It is a general view among health care providers that neither the patients nor the society is able to handle the medical information exchange. It is an unfortunate view, neglected by the ministry of health for years. And it is wrong, not to mention deaths from drug complications, resistance developments and the like that our people continue to suffer.

The Ethiopian public deserves optimal quality of care within our available means. This is not even a question of means but a question of doing the right thing right. It is a management issue and a failure. Ethiopia is not poor. It has best minerals, it is the home of coffee, anything can grow here, it is the cradle of civilization, it is the home of the Nile, and a lot more ... Our challenges are poor managements.

We have three thousand years of experience in bureaucratic maneuvers. During the time of the Derg, the Ethiopian people studied communism in groups, in small circles, lectures at colleges, universities and at political workshops mandated by the government, including the life history of Lenin and Marx. This is not to mention the lives lost. What a shame ! Today, while thousands of Ethiopians are dying every day from HIV/AIDs, very little education is given to Ethiopian people. This is a shame! There is no sex education. Most young people don't know sexually transmited diseases. Most women have no idea how to look for breast cancer.

Today in Ethiopia we don't have HIV clinics. We can not confirm the HIV infection as we don't have the technologocal means, we could if we worked hard; we don't have doctors formally trained in HIV medicine. It is again a shame. The country does not have policies of handling HIV/AIDs or guidelines given to all hospitals by the ministry of health. It is a disaster. Doctors and the health care network have to protect and respect what is best for patients. The response from the diaspora has been just lip service.There are many who are successfully situated outside Ethiopia and are the products of the Ethiopian health institutions, one would argue to see more enthusiasm and support from every one who has benefited from that country.

People talk about the brain drain being the issue. To my mind, leaving the country phyically is no big deal as long as people give back and become ambassadors of hope for others. Failure to give back is the real brain drain. To give back must be a responsibility that every Ethiopian should carry on his/her shoulder. And we all should bear responsibility to do what we can afford within our means. Respect for patients reflects the belief that every patient has the right and authority to make an informed decision about his or her medical care based on his/her own values or beliefs. In order for health care providers to give good quality of care, a mechanism needs to be adopted. An excellent quality of care means "doing the right thing right". To do the right thing requires the decision to be made and to make the right decision requires skills and judgement. The best interest of the patient has always been the best quality of medical care. Enhanced communication among health care providers, health care agencies etc and patients involvement in their own care and the ability of patients to take charge in the decision process must be fostered and incorporated as an integral component of medical practice in Ethiopia. There is a great need to develop guidelines and regulations and it has to be authorized by licensing physicians how /when and who to use a medicine. By the same token it is a shame that antiretroviral medications are not even today legal in Ethiopia, although the legalization process started about two years ago. It has never been practical.

Today, medical care in Ethiopia has lost its ethical and moral fabrics. Failure to address these challenges will be catastrophic. Our future is dependent on our quality of health care. A succesful nation is a product of a healthy society. Our development will depend on our care that we provide today to our citizens.