No amount of doctors training can change the equation but a just system that motivates and continues to inspire the educated to serve and, serve again!

Ibrahim Elemo, M.D., M.P.H | January 30, 2014

The Difficult road in a place called Abba Roba, before crossing Segen River to reach Konso District

The following piece is in response to an article published on ayyaantuu.com about the brain drain of physicians and other skilled professionals from Ethiopia and other parts of Africa to Canada and other western countries. This is not a new story to many people. What is rather new to some of us is the Ethiopian government’s strategy to deal with this tragedy by massively producing physicians. I read this story a day after I called a 36 year school director who ended in a hospital, one hundred KM away from his home town only because he had a headache and found to have hypertension and given some medicine to control his blood pressure; where he came from there is actually a district level hospital. I spoke with the same person 2 days before, and to my best knowledge he was in good state of health.  I called him and his phone was answered by his wife, who told me that he receiving urgent care in a hospital. I asked to speak with him; asked him how he feels and what medicine he was given. His blood pressure at the time I spoke to him was not elevated.  I realized that the poor teacher was suffering not from hypertensive emergency but the side effects of the wrong blood pressure medication about which neither the patient nor the health professional had any idea that it could be causing his symptoms.  His wife initially told me that they are planning to take him to a higher level immediately if he does not feel better. He is given two medicine, a rapid release Nifedipine and Furosemide. He continues to use it thinking that his BP is getting out of control and causing profound dizziness. You can imagine the financial impact of the poor quality of care. It could have costed the poor teacher thousands of Birr until he gets to a tertiary care level or a dedicated physician who reviews his medication, listens to his story well and tells him to stop taking the wrong medicine he was put on. This is the story of thousands of people if not every day, every week in a country where the government’s policy is to deal with the massive exodus of Physicians by overproducing physicians and saturating the domestic market.  They have no strategy of retaining the best of the best but have strategy to use the worst of the worst among communities of people to rule over them indefinitely.  To get back to the main reason why I decided to write this short piece; is reflecting on my own trajectory from “a committed subject”  willing to serve his country to someone soon to be a professional selling his service for a fee in a western country.