December 01, 2006

Ethipiopia special report: We've lost five staff in one ward

Dr Wondewosen Desta
Dr Wondewosen Desta with 6-year-old Nudana Muhamed

MEDICS on the frontline of Ethiopia's fight against Aids are increasingly dying of the disease themselves. On World Aids Day, Metro Chief Reporter AIDAN RADNEDGE discovers the grim reality of the risks at one typical hospital in the country's stricken capital.

I have to be satisfied just prolonging someone's life a little.' Dr Wondewosen Desta is depressingly realistic about how much or little he can do, running perhaps the most beleaguered children's ward in Aidsridden Ethiopia.

Every day at least 40 HIV-positive, emaciated children are checked in for a lengthy hospital stay, with hundreds more sent away, sure to return again soon.

But it is not just the survival rate among his young patients that concerns him – but also among his staff.

In this ward alone, five employees, including two top doctors, have died in the last few years after contracting HIV in the course of their duties.

It could be during a rushed blood transfusion, using inadequate protective gloves. Or a fatal infection could follow when blood gushes from a patient's wounds into a medic's eye.

Doctors, nurses, administrators and cleaners all run equal risk, in wards where used needles and toxic gunge spill from the bins.

The Zewditu Memorial Hospital began as a US mission facility 40 years ago, before being confiscated by the Communist regime ruling Ethiopia from 1974 to 1991.

The current government hails it as a flagship hospital, despite the mould-encrusted walls.

Malnourished, wide-eyed children perch in cage-like beds on the wards, each one looking much younger than the ages given on the bedside charts.

Those employees who are not sickened or killed by infection are often driven away by despair.

'We've lost our friends,' Dr Desta sighs. 'The way procedures work here is not good for keeping our people safe. We don't have drugs to treat people just after they have been exposed to infected blood – and it can happen so easily, so quickly, when the place is busy.'

Staff have their hands full, coping with the youngsters needing treatment for HIV and diseases such as TB that exacerbate problems.

About two-thirds of the 600 children on the hospital's books are under five. Six are thought to have contracted HIV through sexual assault.

Two-year-old Mersi Kassahum shows a chubby, baffled face on a barrel-chested torso yet a stick-spindly pair of drip-fed legs.

She is HIV-positive, just like 23-yearold mother Nardos, both condemned by a father and husband long since fled, leaving them and a ten-strong extended family abandoned on the outskirts of the capital.

Nardos seems philosophical as she insists: 'I don't want to really worry very much about HIV. What's done is done. So I have to live with it, for myself and my daughter.

'This is the only outlet that could mean my child survives. It's not important to worry about something that's already been done. It's not worth worrying about my husband now he's left. There's nothing I can do about it.'

Mersi has been admitted here for the sixth time. In another white cage bed, blinking and grimacing under fluorescent light, 16-month-old Amanuel has been in for just a few days.

Brought in with diarrhoea, tests revealed HIV – like both his parents – as well as associated tooth and jaw corrosion and patches of sores across his tender skin.

Paediatrics director Dr Desta sighs: 'Nistartine would be the right drug for his oral problems, but it's too expensive for us – we have to use a $2 gel and hope for the best.

'It's all so frustrating, for us and for the family. My friends are giving up their jobs – it's too much, to see 50 or 60 per cent of your child patients with HIV. Most of them have repeated admissions. I have to be satisfied, just prolonging someone's life a little.

'If we treat this child properly, he may make it to school one day. But more than a third don't get to celebrate their first birthday if we can't treat them.'

Engeta Muhamed, 30, watches over his son Nudana, six years old but looking more like a baby.

Engeta says his wife left him to bring up the boy alone, a hard task anyway for a more-often-than-not unemployed labourer.

His best daily wage would be $1.50, barely adequate for food and meaning he often has to go begging.

'He's still coughing, he's not feeding well,' Engeta explains. 'He'll probably have to stay here a month – after that, who knows? Of course I'm worried.

'I'll have to leave my boy here and go out looking for work, but I can never earn enough. Every life's like that here – everyone has to beg.'

Source: www.metro.co.uk

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