RIGHT TO HEALTHCARE IN ETHIOPIA: Then, Now and Tomorrow
The Ethiopian people are always undefeatable. They always unconquerably fight invaders to maintain their country’s sovereignty and freedom. Whenever wars are waged against Ethiopia, they always get unified to react as one and attack their enemies defiantly and aggressively like bees that would fight to death defending their beehive against robbing.
However, whenever they are uncomfortable with and are indifferent to their political leaders, they remain unresponsive. On several occasions, they have been provoked by shortsighted politicians to squabble against each other but decided to offer their deaf ears for not compromising their unity and no matter what, they always choose to live cohesively albeit their ethnic diversities.
Yes, Ethiopia is a home for diversified nations and nationalities with mosaic cultural endowments. Yes, it has its own peculiar alphabets; over 80 spoken languages; and yes, it is a country with a unique calendar and time cycle. Yes, Ethiopia is also a country strongly believed to be rich in natural resources; possessing a total surface area of about 1. 1 million square kilometers; and a population of approximately 100 million. According to the 2007 census, the population living in rural areas is over 80% while the urban percentage is under 20% and out of the total population, about 10% are communities of a nomadic and pastoral lifestyle, leading their lives wandering from one area to the other, without permanent settlement localities.
Yes, Ethiopia is also the owner of a lot of tourist attraction bequests. It has a distinct topography with the highest highland being Ras Deshen with an elevation of about 4,620 meters while its lowest elevation is the Danakil depression, which falls about 116 meters below sea level and reported to be one of the hottest places on Earth.
Yes, Ethiopia is reach in history. Its old historical places such as Lalibela, Axum and the Yes, Ethiopia is also a home for unique fauna and flora including many endemic species.
Importantly, it is a source for internationally known, politically and economically important rivers including the Blue Nile River which makes a greater portion by volume of the Great Nile River.
However, despite all the above unique characteristics; its richness in natural resources; and its tourist attraction bequests, it is ironical and unfortunate that the country is widely known as an example for famine. Due to lack of enduring peace and appropriate policy directions, the country has not been in a position to utilize its potential natural resources. Its people are suffering from all kinds of miserable circumstances and social problems; and the country has been labeled as an example for the poorest countries in the world which served as a source of embarrassment to its citizens.
For years, nature and manmade disasters and wars were common encounters in Ethiopia which, without doubt, hindered progress and limited its capacity to materialize physical access to basic healthcare service, education and safe drinking water to the majority; and to match its meager resources with its fast growing population. Larger portion of the population is living below the poverty line.
Prior to 1991, the worst of all, Ethiopia was in political turmoil. First, the country faced a disastrous revolution that took colossal lives of finest citizens, lost with their accumulated knowledge and expertise that the country had invested on for several years.
Second, miserably and disgracefully, the country was engaged and confronted with external and internal wars that were catastrophic and ruinous in nature and occurred one after the other for several years. The wars that cost the lives of hundreds and thousands of citizens; caused massive displacements and migration; resulted in the destructions of the very few infrastructures that the country had built; wasted the country’s meager resources; left many citizens, from both sides of the battlefields, with posttraumatic stress disorders and injuries, physical deformities and mental health disorders; and resulted in deteriorated socio-economy: poor standard of living, poor environmental conditions, and inequitable social services. Shortly put, Ethiopia’s progress in all aspects has been drugged back by political instabilities that led to sinister wars.
The socioeconomic problems that Ethiopia is suffering from have been historically worst but it is an undeniable reality that they also exist today. However, one should acknowledge the current reality that the people are engaged with firm and unwavering efforts and have demonstrated great determinations to swap the country’s embarrassing image with a bright future. Yet, the bitter struggle for right to basic social services is far from end.
Ethiopia’s healthcare service, education and infrastructure have been among the least developed social and public services. This is largely due to the lack of enduring political stabilities and policies that consistently focus on health, education and infrastructure development. Settlement situations and geographic locations also added a fuel to the fire and further complicated the matter i.e. the majority of the rural people have been residing at rugged hill tops and disconnected villages, making hard for the Government to reach out and offer social services in an equitable manner.
Historically, modern medicine was introduced to Ethiopia around the 16th century. However, it is a creepy story why and how it didn’t make a meaningful progress when compared to the rest of the world. Instead, the healthcare service has been trailing far behind, remained inaccessible and inequitable for centuries; and if available, the service was limited to inner cities and towns which are inhabited by less than 20% of the total population and even in those places, the distribution was not even and suffers from barriers of equity and accessibility.
Indisputably, the healthcare service has been unable to effectively and efficiently treat and prevent basic health problems that the country has been facing. Until recently, the conventional health parameters-including infant and maternal mortality; life expectancy; morbidity and mortality from communicable diseases; and malnutrition-witnessed Ethiopia to be among the most disadvantaged nations in the world.
The rural Ethiopians, being over 80% of the total population, were unfairly and unjustly living in miserable and destitute conditions, deprived of their right to healthcare. As a result, the people depended on using various herbal remedies, religious beliefs, and traditional practices as options to confront and remediate their sufferings and illnesses of different nature for centuries.
When it comes to healthcare service quality, it is ill defined. The quality of healthcare service in Ethiopia seats far behind the present day definition of quality that intends to keep a balance among safety, effectiveness, efficiency, patient centered, timely, and equitable healthcare.
While it is well documented that education is very essential to gaining knowledge and skill that are critical for economic growth, leading a healthier life, innovation, building self-reliance, establishing efficient government systems, and increasing productivity, the distribution and expansion of schools were not even throughout the country. Elementary and high schools were not adequately found within a reachable distance to the majority. Many Ethiopians used to have very limited or lacked the opportunity to tertiary education.
Until recently, availability of infrastructure has been either very limited or absent altogether. This has been even worst in rural areas. In rural areas, roads are either nonexistent, underdeveloped, or are in poor conditions. As a result, the rural Ethiopians lack modern transportation system; are disproportionately suffering from socioeconomic disparities; and are in a difficult geographic location to have access to social services including healthcare and education that the urban dwellers, relatively speaking, are better served with.
In a nutshell, the rural population, being predominant in proportion, has been living in underprivileged conditions. Many inhabit at disconnected villages of rugged terrains and hilltops while some others are living in lowlands including those in nomadic and pastoral lifestyles. These and many more related factors complicated the matter and attribute to the unequal and unjustifiable distribution of social services.
Stay tuned for Part 3.
Federal Democratic Republic of Ethiopia Population Censes Commission. Summary and Statistical Report of the 2007 Population and Housing Census Results. ecastats.uneca.org/aicmd/Portals/0/Cen2007_firstdraft.pdf.