Ethiopia's nail eater highlights malaise

The shocking contents of the Ethiopian man's stomach

By Nita Bhalla in Addis Ababa

A 40-year-old Ethiopian man is recovering in hospital after surgeons in Addis Ababa removed 222 metallic objects from his stomach.

He was never fussy about food. He ate whatever we put in front of him

Patient's relatives

Gazehegn Debebe was admitted to Tibebu General Hospital last week after complaining of continuous vomiting.

After intensive investigation, doctors opened his stomach to find an assortment of 15 cm nails, door keys, hair pins, coins and even watch batteries.

Doctors at the hospital say it's incredible that Gazahegn's stomach could contain all these objects.

"He had over 750 grams of metal inside his stomach. He must have been eating these objects for at least two years, as the wall of his stomach had thickened to accommodate all the inedible objects," said Dr Samuel.

The x-ray revealed the entent of the problem

Some of the nails found were 15 cm in length and doctors say that they are shocked that the patient could have swallowed these without perforating his gut.

His brother and sister said that they had no idea that Gazahegn was eating metal.

"He was never fussy about food. He ate whatever we put in front of him, but we had no idea that he was eating metal," they told doctors at the clinic.

It is unclear why Gazehegn was eating nails and other objects, but his family say he has a history of mental illness.

Mental illness

Like many countries, Ethiopia faces serious challenges in how to treat the mentally sick.

Mental health provision

More than 3m with mental disorders

10 qualified psychiatrists

One hospital

365 hospital beds

176 psychiatric nurses in regional centres

Almost 6% of the 63 million population are believed to suffer from mental disorders, but facilities as well as skilled manpower is scarce.

There is only one institution for the mentally sick in the country.

Amanuel Mental Hospital caters for patients with disorders like schizophrenia, major depression and anxiety.

Dr Mohamed Hyder Ali, acting director of the Amanuel Mental Hospital, says the hospitals resources are severely strained.

"We have only 356 beds in the hospital and all are constantly occupied. Every day we have to turn sick people away as we have no where to treat them," he says.

According to Dr Hyder Ali, there are only 10 qualified psychiatrists in the country.

"There is no school available to train psychiatrists and so all 10 of us have had to go abroad for our training," he adds.

'Lucky' patients

However, with the help of the World Health Organisation (WHO), the Ministry of Health has trained 176 psychiatric nurses, who work throughout the country in 226 centres.

There are thousands that are not so lucky

Dr Hyder Ali

Dr Hyder Ali however says the patients at Amanuel are luckier than most.

"Most of our patients have the financial support to pay the hospital fees and treatment. They also have families to support them in aftercare. But there are thousands that are not so lucky," he says.

This is evident, even in Addis Ababa, where the destitute, some of whom are mentally sick, roam the streets. They have no families and cannot afford to pay for treatment at Amanuel.

But Dr Hyder Ali says the biggest challenge for the government is to deal with rehabilitation after treatment.

"The hospital can only start the process but aftercare is essential. We need counsellors and social workers to follow-up the treatment the patients are given. But most importantly, we need to at least initiate some kind of care in the community programme," says Dr Hyder Ali.