Breathing life into the medical sector

28 Aug 2017

 

Today’s guest is Dr. Wondwossen Eshetu. He was born and raised in the heart of Addis Ababa. After completing primary and secondary education at Nativity Boys School, he joined the Gondar Medical School, which was under the umbrella of the Addis Ababa University at that point in time. Having studied there for six years, he was deployed in the Military Hospital.

Dr. Wondwossen is a Medical Doctor with Clinical Tropical specialty and Public Health (MD, MSc, DTM &H). He worked for the last thirty years as clinical physician, Public health expert with a caliber of Country Director in different parts of the world mainly in Ethiopia, Djibouti, Uganda, Jordan and United Kingdom. Currently, he is a Country Director of Women and Health Alliance International in Ethiopia which is a French Medical, non-political, non sectarian, Humanitarian medical organization.

Dr. Wondwossen has been working in health care management, monitoring and evaluation of programs, in financial management, in project proposal developing and negotiation, in curriculum development, in harmonization and revision, in giving training on the job tutoring and in lecturing both clinical and public health disciplines. He also deliver courses in medical Ethics and professionalism- giving lecture for medical students, graduating Doctors and Health care professionals in different setup and the like.

He has gained substantial experience and knowledge in leadership, program development, implementation and monitoring and evaluation of programs. His experience in coordinating and leading projects coupled with his tenacity and ability to deliver has allowed him the foothold to display outstanding results in his assignments. Hence, he strives to further develop, capitalize and utilize his clinical as well as public health expert. He is diligent and flexible enough to chime in with situations current trends dictate. He has the ambition for continuous learning and working with a team spirit.

The Ethiopian Herald had a short stay with Dr. Wondwossen with the purpose of familiarizing his personal and professional life with our esteemed readers: Excerpts:

What inspired you to study medicine?

When I was a grade nine and ten student, I was dreaming of becoming an engineer. But when I went to grade eleven and twelve, I grew to be a super student in biology subject. Our biology teacher was always surprised by my performance. He was constantly showering me with pieces of advice to study medicine. He was the one who patted me on the back to tackle the daunting task of studying medicine. Propelled by the incentive I turned out to be an outshining student in each subject. He proved the source of my inspiration to mold a medical doctor out of me. I as well openly discussed with my dad and mom about my interest seeing that they were well-educated persons and well exposed to the western world. Moreover, there was no a medical professional in our family as most of my siblings got involved themselves in other professions.

By the same token, a friend of my brother who was just a neighbor around told me to have three things at the back of my mind if I would like to be a medical doctor. He said, “You are going to be the person between God and human beings advocating in between the two. You have to be a dedicated and very committed person for the profession and the people at large. You must have devotion for the profession. You have to be compassionate to the sick. As a professional in the same field, I am very much into it. You should as well selflessly help the ailing. Besides, you do not have to be finance oriented.” Therefore, my first, second and third choice grew up to be medicine. In due season, I just ended up being a medical doctor.

How did you return home?

One fine day, a certain lady from the United States of America wanted to construct oncology hospital in Debre Birhan and asked me to give a presentation. Hence, I gave the presentation in the presence of his Excellency Dr. Tedros Adhanom, Ministers and ambassadors and Doctor Bogale, from the Black Lion Hospital. During breaks, we just started talking with Dr. Tewodros. I found him to be an inspirational person. After that we arranged to meet and had a long discussion in a certain restaurant concerning my coming back and serving my country. I did really owe him big time.

I was entertaining a haunting feeling of me not working good enough for own country. I always asked myself when I would give back much to the community who gave me much— made me a doctor. In due course, when my first born daughter finished doing her masters, I came to a decision to return back and give my part for my country. At the end of the day, I applied for American International Health Alliance and grew to be Program Adviser for Medical Education team in the Ministry of Health, Ethiopia. That was how I returned home.

What was program advising in Ministry of Health, Ethiopia like?

The number of Medical schools was very few before effective strategies were chalked out. At this point in time, there are a number of medical schools at every corner of the country. The first thing that we were supposed to do was to check the quality of the medical education as well as its infrastructures. Within the shortest time possible, we found out a huge gap. I convinced myself to come up with a solution rather than lamenting chasms. Therefore, I met with Dr Wendemagenge, Director of HRH (my immediate boss) very intelligent and human person. He hinted on ways forward.

Hence, I set in motion working hand in glove with Ms Ekram Redwan, Team coordinator who is a young professional with dedication and bright future. She is an asset for FMoH .I also clicked with Mr_Dereje, who is a staff of Medical education team with profound knowledge of the system. He taught me much about the health system in Ethiopia. They are friendly, with beautiful personality. To start with, among the missing staff in the universities skill labs were the bigger problems. There were no enough books, classrooms, computers and other necessary gadgets. That was the responsibility of the Ministry of Education.

Then, we began hunting for what were missing in a little while. We had to prevail on the Ministry of Education as that was not our remit. In the meantime, there was a shortage of seniors who could teach the undergraduate students. We had to talk with the inspirational-young State Minster, Dr. Amir Aman. We talked like friends regarding the quality, the qualification, the management, the administration, the curriculum issues, among other major problems. We made up our mind to work on the problems at any price. The curriculum had to be really recasted. Along with my team, we reshaped that curriculum as per my own perspective. We produced two curriculums for the nation. It is internationally accepted new model of competency based, integrated modular curriculum.

At the outset, our focus was on infrastructural development and later we concentrated on medical education revolving around the scopes, the skills and other related aspects that students are expected to have. We were getting ourselves engaged in supportive supervision in a little while.

What was the next move?

The memorandum of understanding between a given university and Ministry of Education was difficult to solve at that point. For example, all lecturers were under the Ministry of Education whereas the hospitals were under the Regional Health Bureaus. Hence, in order to go from a certain university of the country to a certain hospital, they had to have memorandum of understanding. Moreover, the state health bureaus and the university had to be involved. It really was a difficult problem to solve. To and fro, our team was shuttling from universities to the state bureaus like a headless chicken. After we had passed through many twists and turns, we solved the problem shortly. We really passed through tick and thin. Our role to Ministry of Health was tantamount to a diplomatic or ambassadorial one.

What inputs did the Ministry of Health enjoyed from your advisory role?

In collaboration with, the Federal Ministry of Education we ensured the delivery of adequate training, supervision, mentoring and quality, timely and practical outputs for the Medical Schools. I was also responsible for overseeing technical and academic support are given for each teaching institution, providing professional, technical and management assistance for developing and establishing the national medical qualification exam. Besides I was charged with the task of coordinating and leading the overall process of quality medical education system establishment in addition to acting as a liaison person between all parties involved in medical education.

Likewise, I mobilized and coordinated necessary resource for quality medical education work with MoE, HERQA, professional association and the medical school consortium. I as well monitored all the developments of the medical schools regularly. Moreover I was responsible for the teaching-learning process. Hence, I revised, developed and streamlined the curriculum. I introduced the new Modular-PBL based curriculum to the new medical school, headed the Technical Working group of the new medical schools and led the newly launched Hospital Based Residency program of Gynecology/Obs and Surgery. I also worked with Ethiopian Society of Obs & Gyn and Surgery to harmonize curriculum for resident doctors, worked with the Academic vice presidents and school deans on issues undergraduate and resident students. What is more, I was responsible for international relation regarding medical education, for recruitment of international staff, who were responsible for service delivery and teaching medical students.

Can we conclude that the desired goal is achieved?

The case related with the memorandum of understanding between the university and Ministry of Education was very difficult to solve. For example, all lecturers were under the Ministry of Education whereas the hospital is under the State Health Bureaus of the Ministry of Health. Hence, in order students go from a certain university to hospitals, the state health bureau and the university has to be involved. As our team was so impotent, we used to make frenetic efforts going from one university to state bureaus and other offices. At this moment in time, there are thirty-three medical universities. This is really one of our standouts. We have successfully solved scores of problems.

We almost did diplomatic or ambassadorial works for the Ministry of Health. There are medical schools for those who do not have hospitals at this point in time. We have to make sure that we have a confluence of tasks and purposes. Literally, we are in a very good shape at the moment. We have to keep up the momentum taking quality into account. Always progress has to be there. The difference in the country's medical posture before I came and now is very huge. Though challenging the work that we undertook is heartening.

What is the intended target of the set up Medical Ethics and professionalism committee?

The Medical Ethics and Professionalism Committee, which is under the Federal Ministry of Health, was established seven or so years ago. There is ethics committee in the federal state composed of scores of professionals drawn from different Societies, among others, surgical, gynecological, midwifery, nurses, pharmacies, internal medicine and the like. All of them are part of the ethics committees. Whenever malpractice surfaces, the cases come to our attention specially when patients die following malpractices, negligence, among others. This time, we see the case thoroughly and decide whether the case resulted from malpractice, negligence, and the like. If we sniff something fishy, we send investigative experts into the societies. For example, if a mother dies undergoing operation, we will send the case to gynecologists. We exam and finally decide based on the result.

What measure do you take if the medical doctor proved guilty?

We may decide “This chap should not work for the next two years. We may as well revoke his license. We also coerce wrong doers to undergo further practice under on job training. More often than not, when every case comes to us, we carefully get all the necessary investigations. At this point in time, we have launched medical ethics committee in different parts of Ethiopia such as Oromia, Tigray, Amahar, Benishangul, Gambella and what have you. Currently, there are ethics committees under regional health bureaus.

Brief us about the newly opened Women and Health alliances International

Women and Health Alliances International is a non-political and non-profitable organization mainly working in obstetric emergencies particularly in the fistula and pelvic floor disease. It was an organization which worked for the last seven years but I later joined as a country Director. It is mainly working with Gondar, Jimma and Asella universities. WAHA works in Gender based violence and emergency in AWD & DOllo refugee centre in somali state. It also works in Arsi Zone, Oromia state, and to renovate 42 health centers. We make sure that Ethiopia is striving to curve the maternal death and maternal mortality. Due to various reasons, mothers are still not getting the service they are supposed to within the touching distance.

Early marriage and labor-related problems are some of the causes of fistula. By the time mothers reach to a hospital, the baby may not come out, they may be very young and thus it will cause necrosis of the uterus. It may as well cause Fistula which is a slit between Uterus and vigina or Rectum and vigina. This being the case, there will be continuance of urine and feces leaving long term effect.

In order to avoid that we go to rural areas with the intention of raising awareness regarding Fistula and its medication. We as well send them to Gondar university and others to have operative surgery. In fact, repairing is not the answer. The foul odor such patient exude result in stigmatization by her partner, husband, families and the rest. Reversing the trend is our focus area, we are reintegrating them to the society.

How do you reintegrate recuperating patients?

Once, the operative process has been done in Asella or Gondar, we send them to our own reintegration centers in Dabat found in Gondar. Right after, they go out of the hospital, they will be trained for two months for special skills. For example, in Gondar there is a reintegration center where patients are taught to do wavering, embroidery and the like and sell yields in the local market of Gondar.

In that association, we will help them to put their money together. After they stayed for six months, they collect money of the sale and will acquire micro finance skill taking training given by local governments. We are facilitating that. They will get the loan to run small scale industries. We are facilitating their fields of engagement. We are achieving the intended target in this regard.

By the same token, identification of cases, raising awareness, giving surgical treatment, supporting psychologically and what have you are some of our responsibilities. We intervene in addressing emergency water shortage specifically where there are refugee sites. Redressing gender is parity is among one of our focus areas.

 

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