While malaria, HIV/AIDS, tuberculosis, meningitis, and complications in childbirth are the leading causes of death in Ethiopia, and with an average life expectancy of 42, the country has fewer than three physicians per 100,000 people (World Health Organization) – most of them practicing in the larger cities such as the capitol of Addis Ababa, and virtually none of them serving the majority of Ethiopians, who live in rural areas.

Moreover, the costs of living and health care are increasing. “It has become nearly impossible for the majority of the population to go to private hospitals and clinics,” says CAAT founder and executive director, Mulusew Yayehyirad. “People become more and more dependent on public or government-owned clinics. As the country’s population and medical needs rise, those government-owned clinics have become overcrowded and unable to fulfill the needs of the patients. People are forced to travel up to 10 hours by foot to get to the nearest run-down, under-equipped clinic.”

If a person in need of medical care is lucky enough to make it to a clinic, says Mulu, they’ll likely find that it is “not equipped to provide basic health care to pregnant women, TB patients, HIV patients, immunization for children and those in need of minor surgery. The majority of those clinics don’t have running water and shelter for the patients and their families. The buildings are run down due to lack of proper maintenance.”

Click here to read more of Mulu’s experiences and reflections about health care in the Bichena community.

Health conditions for women and children are particularly dire. About one in 10 infants dies before their first birthday (World Bank) and for every 100,000 childbirths, 850 mothers die (World Health Organization).

Almost 60% of women marry before age 18 (National Committee of Traditional Practices of Ethiopia); women give birth to 6 children on average (United Nations Population Division). And at least 80% of females ages 15 to 49 have undergone female genital mutilation (FGM) (UNICEF), an ancient traditional practice that can result in a variety of physical and emotional complications.

• Immunizing mothers against tetanus
• Clean infant delivery conditions
• Drying and wrapping a baby immediately after birth
• Promoting breastfeeding
• Treating infections with antibiotics
• Insecticide-treated bed nets to prevent malaria ($3 each)
• Vitamin A supplements to prevent blindness and death (2 cents each)

Ethiopian clinics are in need of some basic necessities – many of which are inexpensive, and simply taken for granted, in the United States. Education on nutrition and sanitation is needed. Means of transportation, so that those in rural areas can avoid traveling long distances by foot, are required. CAAT believes that these and other improvements are within reach.

During her visit, Mulu took the photographs that appear on this page. Mulu’s photos of people grouped outside the clinic reveal the facility’s lack of any sort of waiting room. After traveling as many as 10 hours by foot to reach the clinic, the sick must wait outdoors – often overnight, often in the rain – before it’s their turn to receive medical care.

Once inside the clinic, the situation is not much better. There are few medications and medical supplies, and no sanitation. Records are kept haphazardly if at all, and the rooms provide uncomfortable beds with no privacy – and minimal isolation for those with infectious diseases.