The commitment of the community and the government is the secret behind Eritrea’s success, over the years, in the health sector. The massive reduction in mother and child mortality rates, HIV and Malaria and the high immunization coverage are some of the accomplishments the country is praised for.
As Dr. Josephine Namboze, WHO representative in Eritrea, concludes her working tour in the country, she talks about the country’s accomplishments over the years. Having lived in Eritrea for more than three years, Dr. Josephine was emotional during the interview. Q&A wishes the best of luck to Dr. Josephien Namboze.
- -Thank for your time Dr. Josephine. Would you please share with us your personal experience in Eritrea as you are concluding your working tour in the country?
My experience in Eritrea hasn’t just been a work experience. I have enjoyed being here, not as a professional but as part of a bigger family. It has been really pleasant, and I must say that these three and half years in Eritrea have been the best time I have had throughout my professional life.
- -Over the years, Eritrea has been able to record a modest success in the health sector; would you tell us some of the successes?
When you say modest, you are really underestimating what Eritrea has accomplished. The country has greatly succeeded in attaining many positive results in various health sectors. To mention few of the momentous accomplishments, the tremendous reduction in communicable diseases such as HIV, TB and Malaria is amazing. Eritrea is one of the few countries that have managed to bring down the rate of those three diseases to the lowest.
The numbers are extremely low that we have a team discussing a possible elimination for those diseases. Also, talking about the non-communicable diseases, the Ministry of Health (MOH) has come up with a concrete strategy of helping people who suffer from the various non-communicable diseases through partnerships with various organizations. Establishing a cardiac center, which is at Orotta Hospital at the moment and is extended to every sub-zone, is one of the biggest projects the MOH worked on. Not only does this specific department play a great role in assisting patients seek help while it is on its first stage if it is detected early, but it relieves them of having to spend a lot of money since it is completely free of charge.
Besides all the many things happening, I am proud to talk about the persistently high Immunization coverage. Almost 100% of children that are targeted are vaccinated for all the 11 antigens. This is one of the biggest achievements in the region which is really impressive. Eritrea and Rwanda are the only two countries which are able to obtain high immunization coverage amongst the 48 sub-Saharan African countries.
Moreover, what Eritrea has achieved in the reduction of HIV rate is just simply beautiful. The HIV rate in Eritrea is less than 1%. But the 1% is the key segment of the population and that is what the program is targeting, to keep it in the lowest. In addition, what makes me happy is that the government doesn’t focus only on the bigger issues, but on the diseases in smallest rates as well. Diseases like River blindness and trachoma are some of the diseases that are being eliminated and are in a very small rate. I also want to mention the successful mother and child mortality rates which have dropped to a lowest number since 1991.
These are just few accomplishments the country was able to reach in few years. As Eritreans this might not surprise you, but, for me, coming from a foreign country, it is mesmerizing and I wish that people from other nationalities would come and see what is being done here and get inspired.
- -About the Universal Health Coverage (UHC), Eritrea has not only endorsed it but is also working relentlessly to reach everyone everywhere. What is your opinion?
To build on what I have already said, we have defined UHC in three categories
1. We as WHO try to see where our services are; are they reaching everybody everywhere?
2. Are people in the remotest areas able to get health service package?
3. Are people able to affordthe services financially?
Depending on those components, the MOH identifies those patients who don’t have access to the services and managed to work with different agencies such as UNICEF in training doctors who will contribute by at least providing basic health services before the patients reach a health facility. The MOH also plans to build bigger health facilities in the long run.
To protect patients from spending a lot of money, the ministry was able to provide various centers support such as kidney dialysis center for patients to be treated within the country. Also, discussions are going on to establish a cancer treatment center. Although it is expensive, the ministry is discussing ways to have it here so that people won’t have to suffer from the financial catastrophe. I must say that Eritrea is doing things systematically which are done perfectly.
- -What is the level of cooperation that is extended to you by the line ministries?
We work hand in hand with all the ministries. To mention a few, the Ministry of Agriculture runs a program, Minimum Integrated Household Agriculture Package (MIHAP). This program supports the community by providing them with cattle and by helping them grow vegetables so that they may lead comfortable lives. The communities are protected through rich nutrition from the support they get from the MOA. We now have a joint program with the MOH and MOA where we are looking at the ways medicines are used in all those sectors so that people, plants and animals would develop resistance to the microbes. The WHO also cooperates with the Ministry of Trade to reduce the smoking rate among young people by raising taxes and making certain places non-smoking areas.
WHO works with whoever is concerned about health and make sure that people aren’t affected.
- -During your interview at the EPI meeting, you told us that Eritrea stands out as a role model for other African countries, especially countries that have a similar background. What is the role that the country can play in sharing its best practices?
I am privileged to be here and witness all the great works that the country was able to do. I would like to underline one thing; what Eritreans take for granted is the commitment of the community and the leadership. In this country, the leaders say what they are going to do and they actually do it. Another thing I admire about the people is the way the community is engaged in the programs and they are empowered to implement alongside the professionals. I think those two qualities are the secret that Eritrea was able to be successful over the years. It’s not about investments; it is about the commitment of the people and government that allows that interaction. And I think if other countries could learn from Eritrea’s experience and work in strengthening their community’s involvement in everything, they would succeed in getting the same results.
- -Is there anything you would like to say at last before you say good bye?
I have said this before and I will say it again, Eritrea needs to share its great experiences with other countries. I feel it isn’t being adequately shared.
I also want to thank all the people behind all the works. The health workers who are at the remotest places, I am always amazed to see the level of commitment they have, and the support they get from the regional administrators. I also want to thank and appreciate the Minster of Health, Amina Nurhusien. I call her my sister, she has supported me throughout the years and we have worked hand in hand. Also, to all the Minsters for allowing me to have the most beautiful and important three and half years of my professional life. I am grateful for the chance to work with all of them.
I also want to extend my appreciation to everyone involved, the program managers, the directors, we all worked as a family and I am just grateful.
- -Thank you for having us, Dr. Josephine. Best of luck.