MDCs Giving Aid to Ethiopia

Ethiopia’s health problems are caused by many factors including isolation from modernized areas, illiteracy preventing information on heath practices, the shortage of trained professionals, and insufficient funding. Many countries give generous aid to help Ethiopia meet its health care needs. Cuba, the Soviet Union, and many Eastern European countries provide medical assistance and food aid. Many send over medical technicians and physicians to support local efforts on public heath problems. Other long term aid comes from Western countries. The U.S. gives $10 million annually but does not compare to the main western donors of Italy and Sweden. Western medicine was shipped to Ethiopia with the arrival of missionary doctors, nurses, and other trained persons. Many organizations and missionaries go over to provide technical, medical, and financial assistance to help stop the spread of malaria and HIV/AIDS and help increase the low economy. They also establish hospitals, clinics, health centers and schools. Every April 25th, the world recognizes Malaria Day. It mobilizes foundations and programs to reach universal distribution of long lasting insecticide treated bed nets. The U.S. Government has made a six year strategy to battle malaria globally, especially in Africa. This is a key component to Obama’s foreign assistance strategy and his Administration’s Global Health Initiative. By 2014, the goal is to halve malaria illnesses and deaths in 70 percent of at-risk populations, by accelerating and intensifying malaria control efforts in the high burden countries of sub-Saharan Africa.

After World War II, foreign aid was expanded to Ethiopia. The United Kingdom was the primary donor but has been surpassed by the United States giving $211.9 million between 1950 and 1970. Also during this time the Soviet Union gave $100 million and $121 million from the World Bank. But during the Ethiopian revolution, all this aid was dried up and used on the corrupt military regime. Military agents set themselves up as aid providers from Ethiopia with MDCs to get their aid. These political leaders were corrupt and former commander, Aregawi Berhe stated that 95% of all the $100 million of foreign aid given in 1985 went toward weaponry and support for rebel groups. Rebel soldiers apparently diverting the funding to their own organization to try and overthrow the Ethiopian government. This is an unfortunate event that occurred for over a year as Ethiopia became more poverty stricken and became even more less developed. However, after 2000, aid started to increase again especially from the U.S, the European Union, European nations, Japan, the People’s Republic of China, the World Bank and the African Development Bank. By 2001, aid totaled $2 billion. In this same year, Ethiopia qualified for the Highly Indebted Poor Countries (HIPC) sponsored by the World Bank International Monetary Fund. It is used to help reduce or eliminate the repayment of all the loans from MDCs. This program aims to stabilize the country’s balance of payments and free up funds for economic development. International Organizations such as the United Nations Children’s Fund (UNICEF), World Health Organization (WHO), the United States Agency for International Development and The United Nations Population also give much assistance to Ethiopia. However, even with all this aid, Ethiopia still has trouble modernizing. National income has declined 50% in the last 20 years and at the same time the population is growing by more than 3% each year. Little process was being made in the health of the country until the government established its Ministry of Public Health in 1948. It established hospitals, health centers, clinics and private institutions. Since 1974, only a few health improvements have been made. Governments only spend about 4%-6% of the total budget on health while 7-8 % in the health budget went to salaries.

The United States has traditionally had good relations with Ethiopia, however this changed somewhat during the regime of the Provisional Military Administrative Council, or the Derg. In July 1980 the two countries limited diplomatic ties with one another and even limited economic ties. Since the fall of the longtime Derg leader Mengistu, however, relations have once again improved. The United States reinstated its ambassador in 1992 and in the past decade has fostered Ethiopia with over $2 billion in aid. Also with the ongoing food crisis, droughts and starvation in Ethiopia, the UN World Food Program and individual national programs give assistance and also help with the issue of development. Food donor countries in 2005 agreed to expand development aid. With $50 billion worldwide and $25 billion set aside just for Africa. With a combination of droughts, wars, and natural disasters, Ethiopia has been dependant on food aid from MDCs. Since 1985, overall economic growth has declined and in order to help regenerate the economy, the Transitional Government of Ethiopia (TGE) regulated agriculture to help development. The famine of 1889 wiped out villages and ever since, nutrition and food sources in Ethiopia are dependant on foreign food aid.

Ethiopia is an obvious struggling country which needs as much help as it can get from MDCs. With globalization in mind, many more developed countries give aid in the form of medical assistance and monetary donations. If MDCs keep up there assistance while forgiving all of Ethiopia’s debts, this country has a good chance of modernizing and rising out of extreme poverty. Religion can also play a major role in helping Ethiopia by sending missionaries to voluntarily help out and work very hard to relieve many of the Ethiopian’s burdens.

-Krista E
(photo credit: http://newsimg.bbc.co.uk/media/images/46593000/gif/_46593103_ethiopia_malnourished_226gr.gif, http://a.abcnews.com/images/WN/nm_ethiopia_food_distribution_091028_mn.jpg)

Ethiopia's Struggling Economy

Because Ethiopia’s economy is extremely rigid, it has been difficult for the country to provide healthcare rather, even food for the majority of its people. As a result, issues concerning “brain drain” and the lack of medical facilities, which contribute to widespread disease in Ethiopia, are inevitable. Political problems have contributed to harsh economic policies designed to prevent further influence on its market. However, instead of promoting growth in Ethiopia, these strategies have hindered the economy drastically. Corruption within the government has also been questionable. In order to provide healthcare for its people, Ethiopia must address its economic problems first. Despite the nation’s “double-digit growth,” there are countless individuals who can barely afford a daily meal, nonetheless basic health services. The economy has been affected by political problems throughout the nation’s history. Significant issues concerning the market can be traced to the aftermath of the Ethiopian Revolution.

As a result of a failed coup d’état, the Ethiopian Revolution began in 1975. Since then, Ethiopia has followed strict economic practices enacted by the regime at the time, in which some mandates stated “the nationalization of all rural land, the abolishment of tenancy, the maximum family farm was to be 25 hectares, no one could employ farm labor, peasant cooperative of 800 hectares would be organized”, and “the peasants would be in charge of enforcement of land reform.” These authorizations essentially nationalized banks, insurance companies, both industrial and commercial enterprises, and residences or apartments that were leased. Further political unrest has affected the economy, which will be discussed later regarding trade.

Over the course of the past five years, Ethiopia has experienced double-digit growth of over 10% from its export of agricultural products. According to the 2010 Index of Economic Freedom, the economy relies heavily on agriculture since it contributes to over 40% of GDP (Gross Domestic Product), contributes to 70% of the nation’s exports and employs 80% of the population. In spite of 10% growth, this advancement is over-shadowed by issues this increase has created. Both productivity and employment growth are slow since strict regulations allow little leeway for development; for example, restrictions on working hours are highly inflexible. Ethiopia’s agricultural market is also very fragile since an adverse change in favorable weather patterns may dramatically harm the economy. With the double digit growth, inflation is inadvertent and has actually skyrocketed. In 2008 alone, inflation averaged 44.4%, making the cost of buying food higher, ultimately producing strains for people to afford daily meals. Inflation had been the product of oil and food sales. Because the government controls and subsidizes state-owned facilities and enterprises, petroleum products, and fertilizers, the cost of food and oil is essentially regulated by the government.

Since the government regulates virtually all aspects of the economy, Ethiopia’s financial sector is highly underdeveloped, and economic freedom is hindered. The largest bank, which leads the banking sector, is owned by the government. As a result, the government highly influences lending. Foreign involvement in services such as banking and insurance is strictly prohibited. Investments, after being approved and certified, may still be subject to further restrictions. The inexperienced and understaffed judicial system adds to this problem since well-experienced professionals are necessary in order to properly and efficiently handle accounts, if approved. Starting a business is also difficult. Although establishing a business only takes nine days, well below the international average of thirty five, and obtaining a license takes less than the world average of 218 days, the initial capital investment to start a company remains high. This problem, coupled with strict government regulations, makes starting a business a complicated challenge. Since creating a new business is this difficult, the economy has remained heavily agricultural.

Trade is also another issue which contributes to the unstable economy. Throughout the 1990’s, Ethiopia had engaged in war with neighboring Eritrea due to rising tension, stemming from past political conflicts regarding Eritrean independence and border disputes among the two nations. As a result from the war, Eritrea has closed its roads to Ethiopia. Ethiopia, a land-locked country, relied heavily on extensive Eritrean ports in order to export its products. Since then, Ethiopia has relied on Djibouti, whose coastline is only one fifth the size of Eritrea’s, for export.
Consequently, the cost to export goods is very expensive, but primarily due to the lack of infrastructure in Ethiopia. Only 15% of the 23,812 kilometers of all weather roads are asphalt. There is also rugged terrain and lack of sufficient vehicles to transport goods. In order to offset these costs, the government has enacted strict regulations on the price of imports. The price of imports has risen; however, this does not resolve the issue of lowering the cost of both expensive exports and imports. According to the 2010 Index of Economic Freedom, “Import taxes, import restrictions, restrictive foreign exchange controls, services market barriers, non-transparent government procurement, import licensing, cumbersome customs clearance, and inadequate infrastructure add to the cost of trade.” Despite the government’s attempt to prevent rises in the costs of imports and exports, the costs of any product are controlled by the government. This has caused the value of the Birr, Ethiopia’s currency, to fluctuate. Therefore, many have questioned the possibility of corruption within the nation, despite the fact that Ethiopia is a free market.

Ethiopia claims to have a free market. In free market, there are two sectors, private and public. In Ethiopia, the public sector is controlled by the state. The so-called private sector however, is not authentically private, because these businesses, known as parastatals, are owned by political parties. Parastatals ignore the terms and regulations that private enterprises must strictly adhere to. While they have complete access to public finance, the capital that is generated by them does not go towards the federal treasury, which is why this “private sector” is not a public sector. With strict regulations, and the presence of parastatals in almost every area of the economy, such as agriculture, mining, and manufacturing, it is difficult for genuine private businesses to thrive. Therefore, the government has control over every part of its economy. It is also questionable where the income that these parastatals have generated goes to.




Fortunately, the future of Ethiopia’s economy is not as bleak as it appears. Improved health services, although humble in number, are a significant sign of the economy’s improvement. It is reported that health coverage is at 98.1 % up from 38% in 1991. 10,709 health posts were established within the first thirty months of a new health-extension program. The amount of hospitals has risen from seventy two in 1991 to one hundred forty three by 2008. With globalization, both the world community and religious communities are able to be aware of Ethiopia’s delicate economy. Therefore, international agencies have taken a proactive stance concerning the nation’s economic situation. Although parastatals cannot be completely eradicated, the World Bank and IMF (International Monetary Fund) have enacted policies designed to encourage authentic private business growth and hinder the spread of parastatals. Therefore, the economy can develop and place more emphasis on its healthcare. Foreign aid has also helped reduce Ethiopia’s plight. Organizations, such as the WFP (United Nations World Food Program) and CRS (Catholic Relief Services) have provided food and health services for Ethiopians who seek help. With knowledge of Ethiopia’s plight, foreign aid coupled with involvement of the Ethiopian government can ease the country’s economic situation first, in order to resolve its lack of healthcare.

-Katie

HIV/AIDS and Malaria Prevalence in Ethiopia

By: Krista G

Due to the extreme economic problems Ethiopia is struggling with, the low education rates within the country, the issue of “brain drain,” and the lack of health care facilities, disease is very widespread. Diseases that are one hundred percent preventable and/or treatable in more developed countries, such as the countries within Europe and North America, are mass murderers in Ethiopia. Two of these deadly diseases are HIV/AIDS and malaria. Although malaria is not even seen in developed countries and HIV/AIDS is able to be treated, they are serious diseases in Ethiopia that take the lives of millions each and every year.

According to UNAIDS, Sub-Saharan Africa remains the region most heavily affected by HIV worldwide, accounting for sixty-seven percent of all people living with HIV and for seventy-two percent of AIDS-related deaths in 2008. Although it is very difficult to get exact statistics due the lack of knowledge about HIV/AIDS in

Ethiopia, the small amount of testing centers, and the many people that do not receive testing, it is estimated that as of 2008, Ethiopia had 890,000 people living with HIV/AIDS. When ranked based solely on the number of people living within the country that have HIV/AIDS, Ethiopia is ranked eleventh worldwide. Based on the HIV/AIDS prevalence rate compared with the entire population, Ethiopia is ranked twenty-fifth. The adult HIV prevalence rate (ages 15-49) is at 2.1%. An estimated 530,000 women and 92,000 children are HIV positive. There are 650,000 orphaned children due to HIV/AIDS, meaning that one or more of their parents has died from the disease, and 67,000 AIDS deaths per year (hivinsite.ucsf.edu).

There are many obstacles that stand in the way to HIV prevention, testing, and treatment in the country. “Eighty-five percent of the population lives in rural areas and suffers from a severe lack of access to public health services. There is also a critical shortage of physicians (an estimated 1,200 in public service practice) and other trained health care workers. Further, per capita expenditures for health from all sources is only US$5.60 compared to US$12.00 per person in the Africa region as a whole” (africanservices.org). This lack of healthcare has only quickened the spread of HIV in Ethiopia, and it is estimated that fewer than ten percent of people know their HIV status.

Globalization and religion are seen as major helping efforts in combating HIV/AIDS in Ethiopia. There are many groups of religious missionaries, volunteers, and organizations today, such as the African Services Committee, that are volunteering in trying to stop the spread of HIV/AIDS. These organizations set up testing units to bring HIV prevention education and free, confidential testing to people in Ethiopia, especially in rural communities. There are also programs where volunteers meet monthly with families who have HIV positive children, monitor treatment, provide nutritional supplements, treat infections, and provide referrals to educational resources for their children. One of the major reasons for the spread of HIV in Ethiopia and the main reason why more women than men have HIV/AIDS is prostitution. Organizations like the African Services Committee are able to create opportunities for women formerly engaged in sex work by launching an HIV prevention leadership and outreach program. Most importantly, many organizations are able to provide antiretroviral treatments to prolong the lives of people with HIV/AIDS and also give out condoms to help prevent the spread. The people in Ethiopia need to be educated on this topic and must also be given treatment opportunities that they would otherwise not be able to afford in order to survive.


Malaria is another major public health issue in Ethiopia, with about 9 million malaria cases annually, and only 4-5 million cases that are treated. The issue of malaria began with the epidemic of 1958 and resulted from the increased number of the Anophele Gambiae mosquitoes. This was due to the excessive rainfall and temperatures that were higher than normal. Today, P. Falciparum and P. Vivax are two common malarial parasites in the region, with the former considered the more severe of the two. Malaria represents the largest single case of morbidity in Ethiopia, killing about 70,000 per year, and

is responsible for about twenty percent of deaths for children under five years of age. Malaria is prevalent in seventy-five percent of the country, putting over 50 million people at risk, and large scale epidemics tend to occur every five to eight years due to climatic fluctuations. Children and pregnant mothers are among the most vulnerable. “Malaria is also known to speed up the onset of AIDS in anyone
who is HIV positive. Those living with HIV in high-risk areas are also amongst the most vulnerable” (unicef.org).

Globalization and religion have been taking a central role in the prevention of malaria cases. “UNICEF is currently working with the Ethiopian Government and other bodies to create the Roll Back Malaria or RBM program, the largest anti-malaria campaign in Ethiopia's history. It aims to reduce morbidity and mortality of malaria by half by the year 2010” (unicef.org). They have successfully completed this, as it has been reported that there has been a fifty-four percent decline in malaria cases and a forty-eight percent decline in malaria deaths. The most important efforts made by missionaries and global organizations have been the widespread distribution of Insecticide-Treated Mosquito Nets (ITNs). Millions of ITNs have been distributed so far, successfully decreasing the spread of malaria, reducing the mortality rate for children under five by fifty percent, and significantly reducing the percentage of people who become reinfected after already being cured. The fight against malaria

can not be won with the use of ITNs alone. Organizations such as UNICEF are assisting the Ethiopian government by providing millions of treatments with the new anti-malarial drug, Coartem, as well as enacting programs to educate the Ethiopian people on the disease and how it is contracted and spread.

Ethiopia is a severely underdeveloped country where HIV/AIDS and malaria are two major epidemics that annually take the lives of thousands. Through the continued help of globalization and religion tactics, such as giving out treatment, sending educated professionals to Ethiopia to care for the sick, educating people on the diseases, and donating money to the Ethiopian government or organizations that help combat these diseases, Ethiopia will be able to save millions of innocent lives and continue on a slow path to becoming self-sufficient.

(Photo Credit: http://www.avert.org/aids-picture.php?photo_id=3086, http://www.appletreeblog.com/?p=6123, http://www.unaff.org/2006/f_malaria.html, http://www.earthinstitute.columbia.edu/news/2006/story03-27-06.php)

Ethiopian Healthcare -- Brain Drain

By: Susan

Ethiopia has been plagued with one of the world's poorest health care systems due to a variety of problems. One significant cause of the complete lack of health care in the country is the brain drain- a loss of trained professionals to another country. Brain drain is not only unique to Ethiopia as it has had some past or present affect on almost every country in the world, but Ethiopia has been one of the most greatly affected countries.
Brain drain was not always a problem that plagued Ethiopia. Prior to the 1974 revolution, almost all Ethiopians who obtained higher education in the country remained in the country at the completion of their education. Also, a large percentage of those who attended universities overseas returned to Ethiopia. However, the negative environment created as a result of political persecution and the Red Terror during the Derg government, which was a communist military dictatorship, caused a significant emigration of highly trained professional Ethiopians to other countries, and this emigration still exists to this day.

Statistical information on the brain drain is confusing and conflicting as there are no long-term, reliable macro statistics for the documentation of the problem. However, the information since the revolution has been consistently depressing, most prominently in the science, engineering, and medicine areas. Based on studies, Dr. Dejene Aredo reports that 35% of Ethiopian students officially sent abroad for study between 1968 and 1996 failed to return. The least likely to return were those trained in medicine and the higher the level of education, the more likely they would remain in their adopted country. Dr. Yoseph Hassan Mengesha reported that 50% of Ethiopians who went abroad to complete their studies have not returned home in the past 10-15 years. Dr. Yohannes Kebede explained that Ethiopia trained 2,491 general practitioners between 1988 and 2001. Of those, one-third have left the country seeking better employment opportunities, which leaves 1,366 physicians working throughout Ethiopia in 2001. This means there is only one physician for every 47,000 people in Ethiopia. Another mind-blowing statistic is that there are more Ethiopian-trained doctors practicing in Chicago than there are in Ethiopia alone.

There are many "push" and "pull" factors behind the brain drain. Looking first at the push factors, one of the significant causes, as mentioned before, is political persecution. The political environment consists of poor human rights practices, a backlogged court system, intolerance of political dissent, lack of academic freedom, civil conflict and war, illegal regime change, and favoritism based on ethnic affiliation. Ultimately, all of these are the political push factors, or reasons for the brain drain. There are also a number of economic reasons such as difficult living conditions, a weak economy, high unemployment, low wages, and considerable poverty. Ethiopia's poor economy combined with political instability are the two principle causes of the brain drain.
There are also many pull factors that are literally pulling the educated out of the country, and these are even harder to overcome because they are completely out of Ethiopia's control.
The high wages and strong economies of countries in North America and Europe are very enticing. There is also a more peaceful political environment and a high standard of living in these so called adopted countries. Trained professionals chose to come to these countries because they get the opportunity to fully exercise their training, and there is predictable career advancement and job mobility. Work institutions have up-to-date equipment and provide benefit packages for health care, insurance, and retirement. Visa policies in certain countries also often promote brain drain. In addition, once immigrants are already in the country, its easier for them to obtain permanent residence. As a result of these desirable factors, in addition to the push factors from before, brain drain is amplified.

Although certain factors push trained professionals from Ethiopia and pull them towards more desirable countries, there are other personal factors that ultimately keep these professionals from going back. Most of these professionals are married, have families, have children, and have become accustomed to life in their adopted country. One of these professionals, Philip Emeagwali, stated that “an African professional will not resign from his $50,000 a year job to accept a $500 a year job in Africa.”

The brain drain has ultimately caused a vicious cycle. Emeagwali states that brain drain has hindered the creation of a Middle Class in Ethiopia and thus there are those who are extremely poor and those few who are rich who go on to corrupt military and government officials Originally, as a result of political instability, professionals leave the country searching for better opportunities. As a result of a decrease in professionals, the economy and the health care of the country as a whole decreases. This in turn dissuades professionals from returning, hence causing an even further decline. This is extremely significant in Ethiopia, which was lacking in health care from the start. Now, as a result of this brain drain, the country is having an extremely difficult time caring for the people of the country, and one of the most notorious problems is dealing with AIDS and other diseases. If solutions for this brain drain, which has robbed Ethiopia of its talent, are not found, it can ultimately mean a slow death for Ethiopia.

Many are looking for ways to reverse the brain drain. One of these proposals is reducing the outflow of professionals by strengthening their economy, improving governance, and increasing political freedom. One of the first steps for Ethiopia would be to create an accurate and continuing database of the impact of the brain drain. This will hopefully show the hindering effects on Ethiopia's development. Another step would be to reward, develop, and challenge trained Ethiopians who stay in the country. Loans and assistance should be provided and more funds should be made available for research. Efforts need to be taken the improve technology up-to-date. There should also be a focus on education and building health-related infrastructure as opposed to the focus of sending Ethiopians out to get a good education elsewhere.

However, there is only so much the country itself can do. This is where the global word and religion come into play. Through globalization and realization of the worlds problems, other more-developed countries should understand the importance of education and should try to help lesser-developed countries get on their feet to climb the ladder of development. Anything from big grants and funds to small food supplies from other countries can help Ethiopia. Religion can also play a role. Missionaries from outside the country could come to Ethiopia and help. Internal religions can also be of assistance. There are a variety of religions existing peacefully in Ethiopia, however, they seem to be taking a bystander's position. If they cooperated to form some kind of system that educated the people of the political, economic, and social problems, many changes could come about. The first step to anything is to be aware, and if religions simply made the people aware of problems such as the brain drain, it could be a major turning point for the brain drain, the problems, and Ethiopia as a whole.

Ethiopian Healthcare-- Its Nonexistance

By Pauline





Health care is a topic that has plagued many countries- MDCs and LDCs alike. Ethiopia, a country with one of the world's poorest health care systems, has sought to improve their situation; however, the health care system in that country is still deemed wholly inadequate.

There are a number of problems that are linked to the inadequacy of health care in Ethiopia, some being the "brain drain" of Ethiopian medical practitioners and assistants out of the country, inaccessability to hospitals and medicine, communicable diseases such as HIV/AIDS, and unsafe traditional practices within Ethiopian culture. Infant mortality rates are relatively very high, with a nationwide average of 77 infant deaths per 1,000 live births in the last five years. Also, the low availability of health care professionals with modern medical training, together with lack of funds for medical services, leads to the use of less reliable traditional healers that use home-based therapies to heal common ailments which are unreliable.

This has created a large problem. Ethiopia has no health care.

In order to help create a better environment for Ethiopians in desperate need of medical assistance, Ethiopia has taken strides towards a better health care system. Western medicine came to Ethiopia during the last quarter of the nineteenth century with the arrival of missionary doctors, nurses, and midwives. Also, a number of countries were generous in helping Ethiopia meet its health care needs. Cuba, the Soviet Union, and a number of East European countries provided medical assistance. Researchers at Yale School of Medicine's Department of Epidemiology & Public Health recently traveled to Ethiopia to award healthcare managers and workers with a Yale certificate for completing a year-long program that featured extensive training and practice in various areas of hospital and healthcare management.

With the help of other countries, Ethiopia can have a health care system that every citizen deserves. Because religious groups in Ethiopia are not educated in proper health practices, they may not be able to do much when it comes to the health care system. Religious missionaries from other countries, though, can be sent to help donate items as well as help teach proper hygiene and other medical necessities.

It is important that globalization and religion positively influence Ethiopia's situation, because every human being deserves to be taken care of.

(Photo Credit: http://www.msf.org.au/uploads/pics/ethiopia-40987.jpg, http://www.savethechildren.org.uk/assets/images/ethiopia_13357.jpg
http://ethiopia.adoption.com/uni/cms/Image/international/maps/Ethiopia.gif)