A Ray of Hope for a Better-Prepared Ethiopia

I have called Ethiopia home for the past five years – it is a country that is very close to my heart. I was moved to humanitarian work by images of the famine when I was in college and subsequently adopted my daughter from here. As we face our worst drought in 50 years, I am worried. But I am also heartened by the change taking place around me and by the knowledge that I work closely with some of the most passionate and innovative people I have ever met. On any given day, I bounce between fearful reminders of the country’s struggles and bright hope for its future.

Today’s Ethiopia is not the same country that faced the horrible famine of the 1980’s. Over the past decade, Ethiopia has seen astonishing economic growth of around 10% per year. Furthermore, the country has been investing in solutions to maximize its food security, including amassing food stocks and putting early warning systems into place. They are building systems to try and prevent the mass malnutrition caused by previous droughts.

I have been working as an advisor within one of these systems: Ethiopia’s Field Epidemiology Training Program (FETP). FETPs train disease detectives through hands-on experience in the field. FETP residents and graduates have the skills to collect and analyze public health data and – most importantly – to turn it into action. These disease detectives are our boots on the ground when health threats strike. In Ethiopia, they are making a very real difference.

An innovative approach

Ethiopia is one of many countries around the world to invest in an FETP, a decision that is paying off now, as crisis looms. The Ethiopian Ministry of Health has vigorously embraced the FETP model, taking a single program with 18 residents in Addis Ababa and replicating it in seven other universities all across the country. CDC is assisting with shaping this expansion into a full FETP pyramid model, which involves three levels of training – frontline, intermediate, and advanced – ranging from six months to two years.

Ethiopia now has 180 first- and second-year trainees in the field. The sheer number of residents and trainees is allowing them to address problems of malnutrition in ways they never could before.

Taking action to make a difference

All 180 trainees are currently deployed throughout the country to “hot spots” – communities with the highest levels of malnutrition. These communities have been identified through a surveillance system that has been developed with FETP over the past six years. It’s a unique situation – you might find a community that’s had crop failure for a year and a half near a community that’s fine.

Trainees are doing active surveillance for cases of malnutrition and trying to overcome challenges. Not all families bring their children in or know where to bring their children in; they don’t know that help is available. Much outpatient feeding is done through health centers, and inpatient centers are being developed for the most severely malnourished. To help find information about where help is needed most, trainees are collecting and analyzing the data from every health facility to see if the number of malnourished people is going up or down, or if people are moving from being severely to moderately malnourished – or in the other direction.

International partners are bringing in large supplies of food, and specific supplements are being provided. Trainees are matching their data to logistics to get this food where it is most urgently needed. They are constantly re-evaluating the situation and making adjustments using an evaluation tool that looks at seven pillars of response: surveillance, case management, supplies and logistics, coordination, human resources, communication, and social mobilization.

Changing the landscape

The trainees feel like they’re changing Ethiopia. For the first time, Ethiopia is developing the expertise to identify and respond to public health emergencies. This makes the residents and trainees feel proud.

When I came to Ethiopia, my main goal as FETP Resident Advisor was to grow the program. And grow, it has. Ethiopia has come a long way in the past decade, becoming more interconnected with the global health community. FETP has been integral to this process. We’re not just training people; we’re watching whole systems evolve.

The most critical time is yet to come as harvest approaches and existing supplies get depleted. The country is mustering all its resources and has reached out for help from the international community. It’s too early to know if any amount of intervention can overcome nature’s wrath and avoid a humanitarian catastrophe – the next few months will tell. But we do know that, thanks to forward-thinking policies and investments, hope for Ethiopia remains stronger than ever.