Opinion

Why building medical capacity in Oromia is our ‘fierce urgency of now’

GudataHinika
Written by Mohammed A

Thank you, Mr. Chairman, for your kind introduction.

Friends, it is a tremendous honor to be here with you today. Not just because of the collective brainpower in this room, but because today, I am standing before an audience that holds the future of a potent and powerful society ready to blossom. 

We are here today because, as it is in Gadaa, we are called when the time is right. And friends, Our Time is Now. 

I am here to speak on Medical Capacity building in Oromia. Our talk today focuses on the core philosophy and formula that my team and I have fine-tuned in our successful mission work in Oromia since 2003. I will take you through the E-H-A concept of EDUCATION, HEALTH AND ACTION and very clearly show you how these three, when taken together, can uplift a society. 

I believe when applied on a larger scale, this methodology will create sustainable medical capacity for the entire region and ultimately the nation. I’d like to start from the perspective we, in the diaspora, and the rest of the world, are familiar with. 

Let’s look at Ethiopia’s place in the world today. On the world stage, Ethiopia has gained much recognition for being an economic success story. The African Economic Outlook and African Development Bank report that in the past decade, Ethiopia has made rapid progress. It has maintained a robust, real GDP growth average of 10.9 percent. Ethiopia ended the last fiscal year with an economic growth rate of 9.7 percent, with agriculture as the economy’s largest contributor. Ethiopia is the 12th fastest-growing economy in the world.  

How was this achieved? Well, to move the nation forward, government vision focused on agriculture — specifically by moving away from subsistence agriculture to commercial farming for local consumption as well as for export.  

As we all know, Oromia is the nation’s food belt. So many of these plans impact Oromia; specifically, Oromo farmers, whose lives are tied to the land. This strategy also hits home for those of us whose villages; relatives and history are in Oromoland. 

Despite this brisk economy, Oxford University’s 2014 Multi-Dimensional Poverty Index cites Ethiopia as the second most-destitute country in the world. The country’s national average shows 58 percent living in severely poor and destitute conditions. Perhaps even more distressing is that Oromia, the nation’s agricultural “hope” is also the nation’s the second-poorest region, where 90 percent of Oromos live in severe poverty and destitution. 

Is this possible? Can both these contrasting situations exist in the same area at the same time? Can both be true? Unfortunately, my friends, the answer is YES. 

The inequitable distribution of resources speaks for itself. Construction, paved roads and new infrastructure dot the landscapes of major cities. Meanwhile, more than 80 percent of Oromo households do not have access to electricity or sanitation, more than 75 percent do not have access to potable drinking water. I can enumerate even more but I know you all get the picture.

I realize the root cause of this unfortunate situation is based in what I call the “Inequity Triad” — the Unholy Trinity of illiteracy, poverty and disease. Combined, these three spark a host of causes and effects. And in their worst form, they breed ignorance, desperation and greed. 

The more important question, then, is this: How long will we watch in silence? What actions can we take toward sustainable, constructive change? Upon examination of other nations that transitioned out of poverty, patterns of success emerge. Primary of which, is the involvement of multiple sectors — not just government.

Countries such as China, South Korea and Singapore take this thinking a step further by encouraging, harnessing and maximizing efficiencies and capabilities of the private sector. Clearly, the private sector and we, in the diaspora, play a significant role in building capacity in Oromia.

How then, do we bridge the gap between us, here in the diaspora, and our brothers and sisters back home to generate productive, collaborative action? First, we must work harmoniously to promote the equitable distribution of resources. Second, we must strive to provide access to opportunities in education, health and community engagement. Third, we must collaboratively encourage the community’s full participation in the decisions that affect them. So as we speak up against inequity, let us also act with responsibility. Together let’s make our voices louder, stronger and undeniable. There is power in a unified voice. And even more power in unified action. 

We are now at a crossroads and our challenge is to make the leap from “Yes we Can,” to  “Yes we Do.” We know that life-saving resources in Oromia are scarce. We know that Medical Capacity is limited. Who is better equipped than we, the Oromo diaspora, to create change? We represent the most powerful engine for advancements in science, technology, medicine, education and business. And let me assure you, for any efforts you invest, the returns far exceed expectations. Oromia is rich with opportunity. Community spirit is ripe with anticipation. With one call for action, many will respond. 

Did you know that the average drop out rate in rural Oromia from grade school to high school is nearly 90 percent? Why so high? And how do we change this trend? It’s because schooling STOPS when there are no accessible schools, libraries, or technology to help most of these kids — especially girls.  

The starting point, therefore, is Education. 

It is what enables literacy and enlightenment. It opens the doors of comprehension and abstract reasoning. It dispels myths and prejudices. It breaks the shackles of ignorance and allows us to participate more deliberately in the world. “Education,” as Nelson Mandela has said, “is the greatest weapon we can use to change the world.

I know this to be true because this is what my wife, my team and I have been doing in rural Oromia since 2003. We have been able to build schools and libraries; and provide scholarships to elite institutions so deserving students can pursue their studies toward lucrative careers in medicine, law, business, engineering, nursing and more. 

The hopes and dreams of rural families burn bright in their children. Unfortunately in most of rural Oromia, that opportunity is distant; prosperity is dim and the path is rocky. But it’s there. All we need to do is shine a light. 

Let’s shape the future beyond primary grades and past high school. Let’s ensure kids stay in school through scholarships. Let’s inspire them to set their sights higher — on university education and beyond. Let’s cultivate a range of careers to plug the brain drain. 

The country needs all sorts of professionals, working from within to improve and harness our resources. And then, let’s set our sights on becoming a resource for brainpower for the rest of world, just as India and China and even Mexico are doing. 

The gains made in education will automatically extend to health. Because an educated household is a healthy household. The World Health Organization, in its constitution, asserts that health is not a privilege. It is a basic human right and everyone is entitled to enjoy the highest standards of health regardless of race, religion, political belief or human condition.  

And if we believe we’re doing right by providing subsistent, survival care, we are grossly misguided. It is vital that we — as providers and as recipients of care — STRIVE FOR THE HIGHEST STANDARD of health. Because, “Of all the injustices,” as Martin Luther King, Jr. said, “injustices in health care are the most shocking and inhumane.”  

The context in which Dr. King made this declaration is even more extraordinary because he said this at a time when people of color were lynched for the most mundane activities, such as watching a movie or crossing the street. So for Dr. King to call out health access, as THE MOST shocking and inhumane, at such a time, is a wake up call for us today that benefit from the opportunities these heroes fought and gave up their lives for. 

In our experience, the success of health policies, disease control, health promotion and the provision of patient-centered care are vitally dependent on the people who provide it. No amount of regulation will make a difference if the care providers themselves do not have the proper understanding, skills or training to provide a higher standard of care. 

Understanding this, our task is to ensure that we cultivate, train and sustain the potential of every member of the health care team. From lowest to highest — from aide to expert. 

These are what my team and I focus on as we transfer knowledge and develop curricula in collaboration with our partner schools, hospitals and clinics. It’s not enough to grow in principle; it is vital to address the daily health activities happening now — on the frontlines. 

In her keynote address to the World Health Organization Conference of European Ministers, Dr. Gro Brundtland, former Head of the World Health Organization and former Prime Minister of Norway stressed what we in rural Oromia know so very well. She said, and I quote

There can be no real growth without healthy populations. No sustainable development without tackling disease and malnutrition. No international security without assisting crisis-ridden countries. And no hope for the spread of freedom, democracy and human dignity unless we treat health as a basic human right.  

Unfortunately, the health disparities in rural Oromia and her urban neighbors are so vast, that there is not enough community health workers to address rural needs. Many of the people we served during our last mission had not seen the doctor in their entire lives. And often, many patients die just trying to get to the hospital because emergency care and transport are scarce.

To address this, we are developing a “Health Campus” in Negele Arsi to bridge this gap in care. At the heart of the campus is an acute care hospital that will provide general medical, surgical and emergency care to a radius of 100 kilometers, and a service area of 1.2 million people. The campus will also be home to a College of Health Sciences, which includes nursing, midwifery, pharmacy, medical schools. Graduates are expected to serve the community for a minimum of three years. This, we believe, is a viable way to address the brain drain that has been plaguing rural Oromia for generations. 

This effort has already brought progress and opportunity never before experienced in this area. The hospital campus itself was a trash dump in the middle of a shantytown. Clearing it sent a message to the community that they had more dignity than to live in squalor. Construction of the hospital brought jobs; and even more jobs came with the development of hotels and other commercial establishments. The government also did their part by putting in roads and utilities. 

My friends, this is HOPE in action. We have succeeded in creating an environment where health, opportunity, progress and education are thriving. Friends, these efforts are not just ideas. They are rooted in sustainable results. So I invite you to consider the possibility of turning a dream into a cause — and a cause into a movement. 

So yes, I am very aware of how ambitious these initiatives are. I know that these are daunting tasks. And perhaps these may be impossible plans from which to expect results. But I am no stranger to impossible dreams. Because I am proof of my grandmother’s belief that if you want to go fast, you go alone, but if you want to go far, we go together. 

I believe that my impossible dream would have remained just that if I had continued on a lone journey. But when taken up by just one other person, one other believer, it became a cause, and that cause — which was soon owned by others who cared — became a movement. 
Today, schools and computers and roads exist where none existed before, a trash dump is now a health campus and with a hospital ready to serve. 

And thanks to many of you, I have learned that … 

… when we fight for healthcare and education as the fundamental rights of every human being, 
… when we redefine our personal and professional values in favor of making long term commitments to the greater good, 
… when we choose to leave our narrow, immediate comforts and expand our vision to include societies in need, we plant the seeds of transformational change. 

As someone who has taken your journey, I know how hard we’ve all worked and continue to work on this fast track of success. Now that we’ve achieved it, why not expand our reach? 

Why not go farther together and change the world? 

So I invite you to re-envision our future. A future that will take us far, because we’re better together. As you’ve learned today, EHA’s model has been very effective. But what we’ve managed to do is just a drop in the bucket. 

Let’s replicate this model throughout every corner of Oromia. 

I am asking you, as today’s Gadaa — to come together and forge a legacy of HOPE for Oromia, one that will live on and flourish for generations.

*This is a keynote speech presented by Gudata Hinika, MD, FACS  at Oromo Studies Association Conference on August 3, 2014 in Washington DC. It was first published on Facebook by OSA’s ougoing president Ibrahim Elemo. We republish it here with  only few formating changes. Image via Hinika’s public profile. 

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