John Green Goes to Ethiopia

John Green recently went to Ethiopia with the Bill & Melinda Gates Foundation (and possibly with Save the Children too?). He just posted his first video about the experience, in which he visits Yekatit 12 Hospital (a hospital I visited earlier this year) in Addis Ababa, Ethiopia’s capital: It’s worth quickly shading in a few things:

  • The “jerry-rigged” CPAPs – basically devices that, in this context, keep babies’ airways open – require a source of oxygen to function; Yekatit 12 buys large oxygen canisters from a local supplier in Addis Ababa. Unfortunately, that local supplier is currently the only supplier of canister oxygen for the entire country. I visited the production site – which was recently privatized after years of being owned and operated by the government – and found it to be run by a nice, bright, passionate team. But oxygen compressors are difficult to maintain and, at some point the compressor will break down. When it does, hospitals like Yekatit 12 will be without their only source of oxygen canisters; hospitals hours away from Addis Ababa will be in an even worse position. Compressed oxygen is an absolutely critical medical supply; it’s needed for, among other things, anesthesia machines (shameless promotion: well, most of them, anyway). Without it, patients suffer. This is an extremely under-discussed problem with too few decent solutions for East Africans
  • Green highlights Kangaroo Mother Care, which is fantastic – it’s really, really great. The incubators in Yekatit 12? Not so much. They look old, were almost certainly donated secondhand, and require a constant source of electricity. While in Uganda, I wrote about an alternative: the Embrace BabyWrap, a bright blue bag with a warming pack that keeps a baby warm for hours
  • According to Green, there are seven neonatologists in Ethiopia, a country of something like 94 million people. Keep in mind, all seven neonatologists almost certainly live in one of the large population centers – probably Addis Ababa, maybe Bahir Dar or Jimmy or Hawassa – meaning that the neonatologist-to-nurse ratio is much lower in the rest of the enormous country
  • I need to mention the troubling political situation in Ethiopia, a country that imprisons journalists and bloggers on account of “destabilizing” the country
  • Finally, it’s worth being at least a little skeptical about Ethiopia’s child mortality statistics, for many reasons, two of which I’ll quickly touch on. First, these figures are really hard to collect, and they are, by their very nature, speculative and gameable. Just as importantly, check out the date his graph starts: 1994, just after the Derg (led by Mengistu Haile Mariam), a junta that put almost no effort into building the country’s health infrastructure, were ousted by a rebel group. Therefore, the mortality statistics are almost certainly “artificially” high compared to peer countries: a relatively small investment is likely to yield a relatively high ROI. This isn’t to say that Green is wrong when he says that the Ethiopian government has put a lot of effort into improving its health system; when I met with leaders of the MoH, hospital administrators, and regional health directors, it was obvious each had a passion for the job, and the country has extremely ambitious plans and goals. As always, it’s worth viewing data with a skeptic’s eye

  1 comment for “John Green Goes to Ethiopia

  1. David
    July 30, 2014 at 7:16 am

    The situation in Ethiopia is pathetic, as reflected by one of the lowest life expectancy stat in the world, 47. Despite government effort or propaganda, it is hard to get an affordable doctor or a bed in Ethiopia. It is simply pathetic and sorry state.

    Thanks to Bill and Gate foundation for trying, but the solution is to work on getting a better transparent regime that really cares for the people.

    The current cadre is a bunch of thieves that is merely interested in self-preservation, not advancing Ethiopia health or welfare.

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