Re-imagining Medical Clinics in Ethiopia
By Meagan Parrish 

By improving conditions at one rural clinic, Mulu Yayehyirad hopes to boost the health of many for good.  At the Bichena Health Center, tucked into picturesque northwestern Ethiopia, two things never seem to abate: The buzz of flies and a long line of patients. 

For those suffering from ailments common to the area—tuberculosis, malaria or AIDS—this is their only option. They wait for hours while in small rooms, thin, dirt-stained curtains separate those receiving care from the clinic’s stretched staff. Until recently, power would often go out, leaving women in labor with nurses who had nothing but the flicker of a flashlight to guide them. 

It’s these images of health care in Ethiopia that have never faded from Mulu Yayehyirad’s mind. 

Born and raised nearby, Yayehyirad lived a relatively comfortable life compared to many in the region. Her parents were business owners and her family one of the lucky ones who could afford better care. But her parents also passed along another gift—a lesson in helping others. 

“They took in everybody who walked into their house,” she says, her voice light at the memory.

It was that example that perhaps inspired her to become a caregiver. Marrying and relocating to the United States, she became a nurse. 

All the while, Yayehyirad never forgot Bichena. While the crippling famine that brought the country into the spotlight in the ’80s has faded from international view, the nation remains plagued by widespread poverty and poor access to decent medical care. Yayehyirad knew she could help. 

“My eye-opener was seeing how medical supplies in [our] hospitals went to waste. I thought, ‘Wow, it would be nice to get these supplies back home,’” recalls Yayehyirad, now a researcher at the University of Wisconsin Carbone Cancer Center.

Yayehyirad imagined how to facilitate simple upgrades that would make a world of difference. The result is her nonprofit, Clinic at a Time. 

Founded in 2007 and run out of her home, the name implies plans to improve clinics throughout Ethiopia one by one (a goal she holds for the future). But her current work is focused on Bichena, one improvement at a time. 

Her first misson? To build a waiting room. The nondescript building lacked shelter for the 80 to 100 patients who arrive daily only to be left, literally, out in the cold.

“Many would get sicker just from going there,” Yayehyirad explains. 

With the help of fundraisers, individual donations and proceeds from an Ethiopian cookbook she created, titled, “You Can Make Injara,” the waiting room was completed in 2009. Other improvements have followed, including a generator, new hospital beds and lab equipment. But Yayehyirad says there is more to be done. 

“Sometimes I feel like I’m trying to scoop water with a teaspoon from the sea,” she admits. 

At the top of her to-do list today is funding an ambulance to help those in remote areas access the clinic and building a dedicated childbirth room. And from there? Moving from this clinic to the next, improving the health of many as she goes. (MP)

Mulusew Yayehyirad
Madison nurse improves health care half a world away 
By Kathryn Kingsbury

When Mulusew Yayehyirad was growing up in Ethiopia, her parents demonstrated an approach to life that continues to motivate her today. "My parents taught me that when you have enough for yourself, don't be greedy," she says. 

"Share it with others." As successful business owners in a country where four-fifths of the population earn less than $2 a day, Yayehyirad's parents were quick to share their luck. They took about 15 of their younger siblings, cousins, nieces and nephews into their home and raised them, building extra rooms to house them all. On religious holidays, the Orthodox Christian family would celebrate by cooking huge feasts. But, before sitting down to dinner, they brought most of what they had prepared to the public square where homeless people gather. "Nobody eats at the house until [my parents] feed the homeless first," says Yayehyirad (pronounced "yah-yay-HYEErod").

It's that kind of generosity that inspired Yayehyirad, a registered nurse who works in the intensive care unit at St. Mary's Hospital, to found Clinic at a Time, a nonprofit organization dedicated to improving medical services in her native Ethiopia.

The idea for Clinic at a Time took root a few years ago when Yayehyirad's hospital department was replacing old medical equipment.

It occurred to her that many of the hospital's discards were more up-to-date than what the clinics back home owned. In fact, many Ethiopian clinics lack even the most basic necessities, like syringes, exam gloves and even sinks.

The Ethiopian government spends less than $6 per person on health care annually. "I thought, well, what if I start collecting these things and sending them overseas?" she says. She got permission from her supervisors and told friends about her plans. People came forward to donate money for additional supplies and shipment costs. "Well, if you're donating money, I should have a nonprofit organization," she told people. So, working with her husband and fellow Ethiopian, Muluken Tilahun, that's exactly what she did.

Clinic at a Time officially launched inMarch 2007. It has no paid staff and little overhead; Yayehyirad runs it out of her home. The funds raised go directly to support health care improvements in Ethiopia. The organization's first major project is underway: a waiting room at the regional health clinic in Bichena, Yayehyirad 's hometown in the northwest Ethiopian province of Gojjam. The project was requested by an advisory board made up of respected community members and elders in Bichena. 

'Waiting' Takes on New Meaning 
To Americans, a waiting room might not sound like a health care priority. So forget all your images of magazines and fish tanks. The cramped clinic building at Bichena is so small that patients must wait outside for their appointments, often after traveling to the clinic up to 10 hours on foot. "When they come to the clinics, they sit outside in the rain or the sun," Yayehyirad explains. At night, temperatures drop significantly. "They sleep overnight, for two days or three days or whatever it takes, until they get their medicine."

When Yayehyirad came to the United States in 1993 with Tilahun, who had a scholarship to Michigan State University, she saw that many of the difficulties people face in her home country are entirely preventable."When you live in it, you don't know any other option, so you think that's how the world is run," she says.

Health problems that are easily treated in the United States, such as infections from cuts or dehydration from diarrhea, can quickly become life-threatening in Ethiopiabecause most people don't have access to clean water and well-equipped clinics. "Even the minor things that can be treated with antibiotics are taking millions and millions of people's lives away," Yayehyirad says.

Women face their own set of challenges. They tend to get married and have children at an early age, leading to serious medical problems. 

According to UNICEF, one in 27 Ethiopian women dies in childbirth, and one in 12 babies dies in infancy. AIDS is a growing problem; nearly one in 20 Ethiopians is infected with HIV, and most of them are women and girls.

Kathryn Kingsbury is a Madison-based writer.

WAUNAKEE (WKOW)-- While many have complaints about our country's healthcare system, it certainly could be worse.

A nurse at St. Mary's in Madison knows first-hand that not everyone is as fortunate as we are, and is doing something about it.

Mulu Yayehyirad is "Someone You Should Know."

Mulu calls Waunakee home now.

But she was born and raised in the northwestern part of Ethiopia.

As with many developing countries, there is a lack of basic necessities and conditions to treat the sick are substandard.

Being a nurse herself, Mulu understands what it takes to take care of people.

This tiny clinic serves a half-million people each year.

Among many of the deficiencies, there are no ambulances to transport people.

So patients show up on wooden beds carried by family and neighbors.

Some have traveled 7 to 8 hours just to get to the clinic.

The doctors and nurses try to do the best they can with what they have.

"There's no running water so as you can see they keep the water in those containers in those buckets there," said Mulu. "Either to wash the baby, to clean up things."

Mulu can not turn her back on her first home.

"People die because of diarrhea because there's no IV fluid to replace the dehydration and things like that, so that's what I'm trying to do," says Mulu.

Mulu is helping through the non-profit she and her husband founded in 2007 called Clinic at a Time.

"I was fortunate enough to have all the things that I had growing up, but next door neighbor and people you went to school with, people you know in the neighborhood they are suffering because of this kind of condition in the clinics," says Mulu. "So you just can't ignore something like that."

Mulu knows the difference the simple things we take for granted can make in Ethiopia.

Her first project was building basically, a waiting room.

"Most of the clinics are lack of is the shelter area, so when people come from rural areas for medical help they stay outside and there is no shelter," says Mulu.

Mulu hopes to do even more.

"Once you see it, growing up watching people suffer, it is very hard to just not think that it ever happened and not to do anything about it," says Mulu. "Even if it helps one of two people to survive from unnecessary death, then it's worth it."