Download Health Education Project - Gambella Medical Team Connection

By
Omot Olok Dang,
MPH
Executive and director of the Gambella Medical
Team Connection (GmTc)
July-December, 2015
Volunteer site location: Gambella Region of Ethiopia
Ethiopia
Gambella
Vision and Mission Statement
 Vision
 To promote health education, Prevention, treatment, and address public health
issues in the rural communities.
 Mission
 To improve quality health care for those who are in need of medical assistant.
 Train health workers to update their skills, keep a record of the data, and graph
 Empower rural community and public health awareness
 Provides sanitation and hygiene education to decrease the level of food and water
borne illness.
Objectives
 Worked with Gambella people Regional Health Bureau and rural communities
 Teaches health workers about ongoing treatment, prevention of the Malaria,
HIV/AIDS, and Guinea Worm.
 Worked with interdisciplinary team and conducted malnutrition assessment,
investigate Guinea Worm case, collected data and analysis.
 Worked with preceptor on Health Education Project related to public health.
 Participated in local clinic, hospital, and work with the board to address public
health needs in case of outbreak, and emergency situation.
 Established relationship with indigenous people and give villagers ownership of
their local health educational programs
Project focused on:
Education
Treatment
Prevention
This project raised public health awareness in the Gambella Region’s area through education, primary, and
secondary preventive care for vulnerable people who are living in the rural community. The indigenous people
of Gambella region have medical languages barrier, developed health issues, and experienced uncertainly
outbreak diseases.
Purpose
The main purpose of this project in Gambella Region is to learn and observe public health system,
followed up ongoing treatment, and prevention. To improve quality health care through education for
those who are vulnerable and suffering from infectious disease, such as Guinea Worm, HIV/AIDS,
Malaria, and malnutrition.
Guinea
Worm
HIV/AI
DS
Main
purpose
Malnutritio
n
Malaria
Guinea Worm Assessment (dracunculiasis)
Guinea Worm has been one of the greatest infectious disease affected people in the Gambella Region
of Ethiopia, particularly Abobo and Gog districts. The Global eradication campaign indicated that
Dracunculiasis was the first parasite disease set for eradication but for some reason it failed to
achieved its goals due to development of new cases in Animals.
Animal cases in Guinea Worm disease
Guinea Worm (Dracunculiasis) disease was infected Dog in the village of Atheti, Gog district of
Gambella Region of Ethiopia unlike it well known that the disease was infected only human. But these
days, four cases were found on animals and public health professional were invited to investigate the
case of Guinea Worm how it transmit to animals.
Guinea Worm infected dog bandage on
lift the leg.
HIV/AIDS
 My first choice at the Gambella Hospital was to work with HIV/AIDS patients because
Gambella Region was one of the top nine Regions in Ethiopia devastated by HIV/AIDS virus
due to lack of knowledge about the disease how it transmitted, prevented, and lack of uses
different method during sexual intercourse.
 Project was focusing on patients who were taking antiretroviral medicine and those who
missed their appointments for the last 6 months would be sent to laboratory to check their CD4
count.
 According to World Health Organization (WHO) when person diagnosed with HIV virus and
CD4 count is < 350 he/she will start taking antiretroviral therapy medication.
 The CD4 T lymphocytes; a subpopulation of the lymphocytes also known as T helper cells, are
coordinators of the body's immune response, e.g., providing help to B cells in the production of
antibody, as well as in augmenting cellular immune response to antigens (WHO, 2007).
 The CD4 count test is mandatory by the Regional State health system and those who are
diagnosed with HIV/AIDS need to check every 6 months.
 Electric power was the most common problem here in Gambella, sometimes patient had to go
home and come back the next day for CD4 blood test due to electric power blockage.
Pattern of commonly detected HIV-specific immune responses and plasma viral RNA
level World Health Organization (WHO, 2007). is shown in Fig. 14
Figure 1.4: Immunological and virological events in natural course of HIV infection
Phase
Acute
Asymptomatic phase
AIDS
HIV CTL
Seroconversion
HIV-antibodies
CD4+ T cell count
Plasma viral load
0 1 3 6
Months
Time post infection
1
2
Years
CD4+ T cell count
HIV CTL
3
4
5
6
7
8
9 10 11
HIV-antibodies
Plasma viral load
Child Malnutrition Assessment
Interdisciplinary team conducted child malnutrition assessment in Makuey and Wantoha
districts of Gambella Region of Ethiopia
Interdisciplinary Team
Group of Interdisciplinary team from Federal health ministry of Ethiopia and Gambella
Regional Health Bureau conducted child malnutrition assessment in two districts of
Gambella Region of Ethiopia. See the pictures below
Malnutrition Assessment
 Availability of health care workers and surveillance Trained by interdisciplinary
team at Makuey and Wantoha Districts of Gambella of Ethiopia.
Hotspot
Districts
# of healthcare public health
workers
workers, Nurse,
Surveillance
officer
and health
extension
Makuey
5
Nurse,
health extension
4 public health
workers trained
Wantoha
5
Nurse,
health extension
4 public health
workers trained
Cases of Child malnutrition Assessment in the last 6 months in Wantoha and Makuey
districts of Gambella, Ethiopia. See the graphic below
35
30
25
20
15
Wantoha District
10
Makuey District
5
0
Malaria
Malaria is a dangerous disease when treatment not provided early stage and taken seriously.
Working in the Gambella rural communities for the past months has given the best learning
experiences, especially working with malaria patients. I have seen many patients brought to the
hospital. The majority of them were children under the age of 10 years old who were unconscious
due to Malaria outbreak in the region. This outbreak devastated the entirely Gambella Region.
 Malaria is a tropical disease caused by a blood parasite called Plasmodium which
has four species of human Plasmodium:
 P. falciparum,
 P. malariae,
 P. ovale and
 P. vivax.
 In the Gambella Region, an average 60%-70% of malaria cases have been due to P.
falciparum, followed by P. vivax. Federal Democratic Republic of Ethiopia Ministry
of Health (2012),
Malaria
Ethiopia is among the few countries with unstable malaria transmission. Consequently, malaria epidemics are
serious public health emergencies
Mosquito life cycle
The mosquito life cycle has four distinct
developmental stages: egg, larva, pupa and adult
stages (National Malaria guidelines, Jan. 2012).
Blood sucker female mosquito feeding on human blood. Only female Mosquito bites
and can transmit the malaria.
Malaria is one of the worst viruses that affected many people in Africa, specifically Ethiopia. The biggest
problems is how to isolate the Mosquito and transmission.
Challenges
 Weak coordination at districts levels.
 Lack of commitment of health professionals.
 Lack of medical supplies
 Lack of data collection and analysis records
 Work loads and shortage of health care workers
 Lack of skills at rural community level.
 Waiting too long to see the health care profession
 Lack of transportation and access to rural community
 Limited number of health professionals at district level.
 Lack of technology.
 No network(Internet) access.
 No electric power
Recommendations
 Solar energy need to be provided to the health center in order to secure emergency
situation and access to internet.
 Number of health care workers should be increase to avoid patient dissatisfaction
and overwhelming.
 Roads should be construct well to get access to villages, allocated for the fuel and
per dim of driver.
 All district’s health center should keep communicating with Gambella Region health
bureau to support the program.
 Regional Health Bureau should update health workers skills and follow up on
training every six months.
 Bi-weekly meeting in districts level should be monitoring and report it to the
Regional health bureau.
Finding problems and solutions
 Child malnutrition was reported to the Regional Health Bureau and Ethiopian Health
and Nutrition Research Institute.
 Region Health Bureau borrowed fuels and per dim for driver from other program,
this problem was also reported to the Regional health bureau and Federal Health
Ministry of Ethiopia.
 For the internet use, health workers were using the payable broadband and the
problem was address to Regional Health Bureau.
 There were no functional coordinating committee/task force in some districts;
therefore, interdisciplinary team strengthening the coordination system at all district
level.
 Appropriate suggestions, comments, training, and assist was made by the
Interdisciplinary team during visited in districts.
 Supporting and strengthening Social mobilization and Out patient sites .
 Strengthening the surveillance system of the region throughout the districts.
References
Carter Center, One Copenhill 453 Freedom Parkway Atlanta, GA 30307 retrieved
fromhttp://www.cartercenter.org/health/guinea_worm/index.html
Federal Democratic Republic of Ethiopia Ministry of Health. (2012). National
malariaguidelines: third Edition; Addis Ababa, Ethiopia.
World Health Organization (WHO). (2007). Laboratory guidelines for enumerating
CD4 T lymphocytes in the context of HIV/AIDS. Regional Office for South-East Asia
New Delhi.