Kolla Diba Health Centre Development Project / Prevention of HIV transmission from Mother to Child
Two percent of Ethiopian women attending for antenatal (ANC) tested positive for HIV in 2012. Over 90% of paediatric HIV infections are caused by vertical transmission from mother to child. In 2014 13% of people living in Ethiopia were children. It is an Ethiopian Government policy to reduce and eventually eliminate mother to child transmission (MTCT) by 2020. This was a collaboration project between Dembia Woreda and Health Action Leicester for Ethiopia (HALE) to extend ANC in the remote areas of Dembia and the objective of reducing/eliminating MTCT of HIV. This study also investigated other health problems which impacted on maternal and infant mortality and morbidity. All women were encouraged to attend health centres for ANC, but providing care to women in remote areas of Ethiopia is logistically difficult. Some women live more than a day’s walk from their nearest health centre. The HIV Testing Service Co-ordinator managed this project at 9 health centres (Robit, Sankisa, Aberjeha, Aymba, Kolladiba, Chuahit, Gurumba, Girargie and Abaweram). Additional staff included the Head of Health Centres, Midwives, Health Extension Workers and Laboratory Technicians. HALE supplemented the consumables provided by the Dembia Woreda Health Centres.
Recommendations – (i) Improve attendance at ANCs (2) Introduce educational talks in the rural villages of HIV transmission (3) Women known to be HIV positive must be immediately treated with ART and counselled about risks of transmission before becoming pregnant (4) Plan to continue monitoring the infants within families living with HIV
The Leicester Gondar Orthopaedic Partnership has progressed over the last twelve months, but more slowly than expected. The container with all the equipment was shipped from the UK to Gondar arriving in April 2019. Unfortunately due to contractural disputes between the Hospital and the construction company the building work came to a halt for several months. However work resumed and is now in the final stages of completion. Official opening of the Operating Theatre with installation of the equipment is scheduled for January 21st 2020. Over the last twelve months the Partnership has supported one training visit by members of the Gondar Clinical team to Leicester and two visits from Leicester to Gondar.
Women’s Pelvic Floor Disorders
This project is a partnership between Dr Zelalem Mengistu in Gondar, Prof Douglas Tincello in Leicester in collaboration with Dr Chris Williams (Leicester) and Dr Emma Pitchforth (University of Exeter). The group is developing a strategy of implementation of conservative treatments for urinary incontinence and genital prolapse (a funding bid to the Medical Research Council in 2019 was not funded), and the group has current funding from the Wellcome Trust for a Priority Setting Partnership (PSP).
PSPs are collaborative exercises which bring together patients, carers and healthcare professionals to identify treatment uncertainties for a given condition. The concept was developed by the James Lind Alliance and has been very successful in the developed world. This PSP will be the first such partnership conducted in a Low or Middle Income country and is seeking to identify treatment uncertainties for urine incontinence and genital prolapse which can be presented to national and international funding bodies, and also direct our group’s future research work. In December 2019 we held our first steering committee and should begin collecting data in March or April.
Mental Health Projects
Two staff from Leicester visited Gondar in 2017 to discuss with our partners the next steps for our partnership. A needs analysis established that the main impediment to the expansion of the community service was lack of appropriate transport. Our partners informed us that the best way to secure a vehicle for the service was for our charity to buy a car and transport it to Ethiopia. An appropriate car was sourced and transported to Djibouti with the agreement with our partners that they would take over the management of the vehicle from there on and supply the running costs and maintenance. In March 2019 the car was still in Djibouti but progress to complete the process for final transport to Gondar.
In October 2018 a further visit to Gondar from Leicester staff was used to discuss with our partners how the car would be used, to provide an emergency medical bag and to review what was needed to enhance the ward environment.
Play Project – Childrens Ward, Gondar Hospital
This is a collaboration between the Children’s Play Service, Leicester Children’s Hospital and the Paediatric Department, Gondar University Hospital. Project members did a preliminary visit in November 2018, but no further visits since then, and no further action in 2019. The reason is that the Paediatricians do not want to start the Play Project until the childrens wards have moved into the new hospital which is being built. This should have happened earlier this year, but there have been delays. The plan is that once the move has been made, Louise Ballard, Senior Play Specialist, plus another Play Specialist will visit Gondar to train up nursing staff to become Play Leaders. We are in contact by email with the Paediatricians, who will notify us when they are ready for the training visit to take place.