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March 15, 2016

Locally trained specialists bring new hope for lung disease patients in Ethiopia

By Dr. Neil Schluger, head of the Division of Pulmonary, Allergy and Critical Care Medicine at Columbia University, and Senior Advisor for Science and Education for Vital Strategies.

In Ethiopia, a silent epidemic has been taking lives for centuries. This country of over 90 million people bears an enormous burden from tuberculosis and lung disease on the African continent.

Widespread poverty and a lack of roads and rural hospitals have all contributed to the prevalence of this treatable and preventable disease. But yet another factor allows this condition to remain prevalent: a lack of trained pulmonary physicians.

In 2005, there was only one lung health specialist working in the public sector in Ethiopia. Under such conditions, the possibility of controlling, let alone eradication tuberculosis, is a fantasy.

With that in mind, I set out to help bring a change to the status quo and in 2012, began the East Africa Training Initiative, an immersive program designed to bring some of the world’s leading experts in lung health to train Ethiopians to be pulmonary physicians.

Doctors from Europe and North America volunteer to travel to Addis Ababa, the nation’s capital, for two-week periods in order to lecture and work with the Ethiopian fellows.

In January, I travelled to Addis Ababa to assess the program, now in its 4th year.

The two fellows currently going through the program, Tewedros Haile and Dawit Kebede, are finishing their first year. I recently observed them at Black Lion hospital as they worked through their daily schedules, making their rounds in the ICU and providing pulmonary consultation services. In addition, I gave several lectures, met with the senior leadership of the Department of Medicine and the Addis Ababa University School of Medicine, and helped to identify several research projects for the fellows.

To see the growth of the fellows, and to observe the deep desire of the supporting house staff to learn as much as they could, was incredibly moving. It’s a dedication derived from knowing that this work is critical to the lives of so many Ethiopians.

By next year, the program will have trained seven pulmonary physicians. Those who have completed the program have already embedded themselves firmly in their work. Dr. Amsalu Binegdie, now the head of the Pulmonary Division at Black Lion, formed Ethiopia’s first ever Ethiopian Thoracic Society, which has held two annual meetings and which also serves as an important source of advice and information on lung disease for the Ethiopian Ministry of Health.

I left Ethiopia assured that the East Africa Training Initiative is on a strong footing. The fellows and trainees are clearly proud of what they do, and work to a high standard. The program has created a culture of professionalism at Black Lion that now sets a standard for other medical services in the Department of Medicine there. That culture is now held as a model for other services, and has received recognition from the Ministry of Health.  Through the development of a group of trained pulmonary physicians and the creation of the Thoracic Society, the Ministry of Health is now engaging with the program’s graduates and faculty on important public health policy matters related to lung health in Ethiopia.  Simply put, lung health now has an address in Ethiopia.

There is still a long way to go, but I can’t help feeling proud of what’s been accomplished so far, and there is every reason to be excited about continuing this relationship for a long time to come.

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