VISIT TO AIRA HOSPITAL 2015
Entrance to Aira Hospital
Road to the Hospital
Nurses with Matron Ruth
In October 2015, Karen Walhof and Rachel Stein from Lutheran Church of the Good Shepherd, Minneapolis, MN; Girma Daka, a U.S. citizen of Ethiopian heritage who works as a civil engineer in St. Paul, Minnesota; and Ronald Ommen from Global Health Administration Partners (GHAP) traveled to Aira, Ethiopia, to visit the hospital, clinics, schools and seminary. This was not the first trip to Aira for Karen, Girma or Ron, but it was the first for Rachel and we were all eager to see her reaction as a first time visitor and a nurse to the hospital and area. Rachel did not disappoint: she engaged the people she met, was appropriately inquisitive, and absolutely unafraid to try anything new.
We would like to thank the many people who made our trip both meaningful and informative. While I will talk about many of them in this article, it should be known that, whether in Addis Ababa or Aira, we were treated with real courtesy and openness.
The primary purpose of this article is to discuss the hospital and health care. Aira Hospital is the only remaining Ethiopian Evangelical Church Mekane Yesus (EECMY) church-owned hospital in Ethiopia. Located in West Ethiopia, it has a catchment area of over a quarter million, mostly poor, people. It is a very successful hospital in terms of patient volumes with over 52,000 outpatient visits, 11,000 admissions, and 3,000 surgeries per year. While having beds for 100 patients, it is not unusual for the hospital to run up to 140 patients on a given day. It has long been known for its work on cleft palette, vaginal fistula, vaginal prolapse and eye surgeries. These surgeries receive outside funding from various charities or the government provides a large portion of the revenue for the hospital. It is interesting to note that while the increasing volumes at the hospital are a testimony to their expertise, these volumes are also a threat in that the revenues from the government are fixed, the patients are often quite poor, and the outside charities that pay for certain procedures don't cover all the costs by themselves. In addition, the support monies from Europe and the U.S. are being targeted for projects that will become self-sustaining with what appears to be a steady reduction in monies to fund services where there is no ability or attempt to create at least partial sustainability.
It is necessary to mention the dedicated physicians who serve the patients here and to especially mention the Medical Director, Dr. Tariku Kenea, who is dedicated to the EECMY, the hospital and the patients he serves. He is a well-known surgeon in the country and receives patients from other area physicians mostly for orthopedic procedures as well as other, more complicated surgeries. Dr. Tariku wants to recruit other medical specialists such as Internal Medicine, OB-GYN and Family Practice; to bring a Family Practice Residency Program to Aira; to add to the visiting physicians from other countries who come to serve in Aira; and to make the hospital into a regional center for West Ethiopia.
Touring the hospital is a trip through a complex maze of diagnoses ranging from obstetrics to gynecology to adult surgery and medicine to pediatric surgery and medicine. We observed two elderly women with broken hips, and instead of giving up on them because of age, Dr. Tariku's plan is to get them home with some mobility. We also saw a pediatric patient who was in a medical unit due to gum disease so severe that the infection could not be taken care of on an outpatient basis.
Of particular interest to us were the growing number of patients involved in highway trauma since new roads have been built in the area. There has also been increase in what the physicians refer to as "Western diseases" – that is, cardiovascular issues, diabetes and cancers that are a result of changing diets and activities. Of particular note was a comment made by a pediatrician from Illinois who visits the hospital for two weeks every year and has a long history in Aira. The comment was a response to Rachel's question concerning the infant death rate in Ethiopia. He stated, "Ten years ago, the death rate for children five and younger was over 130 per thousand and last year it was in the low 40s." Yes, still a high death rate, but the reduction speaks for the health professionals' work in Ethiopia.
I want to recognize one of the health workers we met and observed: the Matron (director of nursing) is Ruth. Quiet and efficient, she leads by her experience and ability to work well with the other nurses and hospital staff around her. While there had been a lot of turnover in leadership positions from my 2012 visit, Ruth was still there and still doing an outstanding job.
In 2012, Cindy Wilke, director of GHAP, and Ron Ommen provided consultation to the hospital and clinics. Our recommendations dealt in large part with how the hospital could improve its range of services and also discussed a more robust human resource function at the hospital. It continues to be our goal to encourage the EECMY in how to best support this hospital, given their limited resources. From our discussions with the EECMY president, Dr. Wakseyoum Idossa, it is clear that the needed support will be there.