Another early morning rainstorm. I packed my second suitcase to drop off at GSK House while I am up north. I called Yenene (another "GSK" approved taxi driver) and he was at the hotel within 5 min. He took me around to GSK House. Heard from Sarah that Dr Awash would be in the office today. I dropped off my suitcase and we headed to the office. Met Laura, Bridget and Hiwot on the road heading to coffee as power was out. We sat at a shop for coffee and chai near MVP office and chatted for a while until the music came on which indicated that power was restored to the area.
I met Dr Awash, head of MVP in Ethiopia, a distinguished doctor. We discussed the project and what I though it would be doing. Not to dissimilar to the brief of bringing some system and organisation to the 4 laboratories in the MVP cluster. I was particularly interested in his explanation of how the health system operates.
The health system in Tigray as in other provinces is a tiered system. Starting with a major teaching hospital in the capital in Mekele and a few other smaller hospitals to district hospital in the larger cities, district hopsitals in some towns, to Health Centers in large villages and finally health posts in villages serving about 5,000 people. th ehealth centers serve up to 5 villages or about 25,000 people. The Health Posts have maybe 2 Health Extension Workers who provide programme support and initial oversight of patients. The Health Centers have a number of trained health workers who provide effective diagnosis (where appropriate) and treatment and in the case of Millennmu Villages at Koraro, Rapid Diagnosis Tests (RDT). A positive test result is immediately treated where negative results in referal to a larger testing site.
At the core of Health Extension Program implementation is a sizeable cadre of new Health Extension Workers (HEWs), who are trained in a one-year programme to implement a Health Extension Package of 16 healthcare activities at the kebele (village) level. By 2010, 30,000 health extension workers (HEWs), almost all young women from the communities they serve, will be trained and distributed in pairs to live and work at the village-level throughout the country.
The HEP (Health Extension program) promotes four areas of care: Disease Prevention and Control, Family Health, Hygiene and Environmental Sanitation, and Health Education and Communication. HEWs spend 75 percent of their time visiting families in their homes and performing outreach activities in the community. They spend the remaining 25 percent of their time providing services at the health posts, including giving immunizations and injectable contraceptives, among other health and educational services.
I also met Alem, Sarahs boss who showed me some of his travel pictures and told me that his sister and her husband live in Melbourne.
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