Page last updated at 10:35 GMT, Saturday, 23 April 2011 11:35 UK

Nurses give ailing Ethiopian healthcare shot in arm

By Claudia Hammond
BBC, Ethiopia

The majority of Ethiopia's population lives in rural areas and when they are ill many do not seek medical advice. But a new government programme hopes to change this at a local level.

Eynalem Taye (L) and a colleague (R)
Eynalem Taye (L) wants to take her training further and become a doctor

Eynalem Taye is 23 years old, but her tiny frame makes her look like a teenager.

She sits confidently in the single-storey building she shares with another young woman health worker. She does not wear a uniform, save for a bright blue watch marked with a tiny Ethiopian flag and the words "Health Extension Worker", which denote that she is now qualified.

To get to this remote health-post I drove out into the countryside, past rows of billy cans filled with water, suspended in wickerwork bags ready to sell to passing truck drivers.

Hundreds of tropical plants were lined up in plastic bags in what appeared to be miles and miles of garden centres next to each other along the roadside.

High-school students streamed past in school uniforms in a shade of mauve exactly matching the blossom on the jacaranda trees.

Not daunted

Further out into the countryside the land is flat and dry and on the right, set back from the road, is a building all on its own - Eynalem's health-post.

So many women [Eynalem] had known had died during pregnancy or childbirth that she was determined to find a way to stop these deaths from happening

Eynalem is not a doctor, nor a nurse and she has had just had one year's training as a health extension worker.

The emphasis, she tells me, is on prevention. She gives tests for HIV/Aids and tuberculosis, and treats malaria as well as offering antenatal care.

For more complex ailments she can refer patients on to a larger clinic, still without any doctors, but where some surgery can be done.

Every inch of wall space here is covered with posters charting the successes of Eynalem and her colleague.

She is clearly very proud of her health-post and apologises for the piles of supplies which have just been delivered.

Health post where Eynalem works
Health posts have provided better access to medical care in rural areas

She adds casually that she and her colleague also deliver all the babies. This was why she wanted to train for this job, she says.

So many women she knew had died during pregnancy or childbirth that she was determined to find a way to prevent these deaths.

It seems like a lot of responsibility for one so young, I thought, but she was not daunted and wants to undertake further study to become a doctor.

The authorities here chose Eynalem and her female colleague for the jobs here because they think women are more likely to remain in these communities for longer.

This is part of an ambitious plan by the Ethiopian government to get healthcare out into every rural area, where 85% of the population live.

Thirty-two thousand women have been trained so far.

It is difficult to get qualified doctors to work out here - and hundreds leave the country every year to go and work abroad.

Those who remain are often not keen on moving to the countryside when they could be living in a city with a 24-hour electricity supply and other facilities.

Food poisoning

I go to meet five students at the oldest medical school in the capital, Addis Ababa.

They all seem very committed and put up with sitting on the floor in overcrowded lecture theatres to complete their studies.

(File photo 2005) A Doctor treats a patient in Addis Ababa
The government hopes more doctors will remain in Ethiopia

But four out of the five tell me that once their training is finished they plan to leave as soon as possible. They insist it is not just about the money.

They have been learning how to save lives, but say that in hospitals without drips or basic antibiotics these skills are not worth much.

They are training in order to save people and instead they know they might have to watch them die.

The dean of the medical school tells me about a new rule which compels them to work for two years in the countryside or four years in the capital before they can receive their medical certificates and can leave the country.

The government's other plan is to encourage more and more people to become doctors so that if some leave there will still be lots of others to tend to the people of Ethiopia.

Just as the dean's answering my last question I start to feel sick. Realising I must have food poisoning, I drop the microphone and flee his office.

After taking some basic antibiotics that I have brought from the UK it is not long before I have recovered.

But looking at the name on the label I realise these are the same basic drugs the medical students were complaining that they could not get - part of the reason they want to go and work elsewhere.

Back at the health-post, I learn Eynalem is something of a star as she has now persuaded 514 local families to sign up with her.

This is no mean achievement as she has had to win the trust of people who, up to now, have had little experience of professional healthcare.

She says she is determined to save lives. The most satisfying part of her work, she tells me, is safely delivering a tiny baby and knowing the mother is still alive too. "I really love my job, " she says, with a smile.

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