Since liberation, Eritrea has made unprecedented reduction in infant, under-five and maternal mortality.
It has also been successful in controlling many communicable diseases including malaria, measles and HIV-AIDS. These have been made possible mainly due to the government’s commitment that puts health care at the center of its development plan.
Access to health care within 10 Km radius increased from around 40 percent at the time of Eritrea’s liberation to around 75 percent now, while around 60 percent of the population lives within 5 KMs from a health facility. Today we will look at the progress of health service in Hagaz sub-zone in Anseba region.
There were only two health facilities in Hagaz sub-zone prior to independence, one in Hagaz and another in Ashera. These facilities were small and had limited capacity to serve the people who lives in their surroundings. Now, the number of health facilities in the area rose to six. These facilities are located in Ashera and Kermed, to the south of the center of the sub-zone, in Begu and Glass in the east, Hashishay in the north-west and Daerotay to the west of the sub-zone. Their capacity and quality of service are improving from time to time.
Graduates of the medical school in Asmara, including physicians, optometric and laboratory technicians, mid-wives, pharmacists and nurses, are assigned to the health facilities as part of the efforts to improve the health care services provided in Hagaz sub-zone. This has played a key role in reducing the human resource deficit in the sub-zone. Currently, there are around 70 health professionals in the sub-zone.
The health facilities give all kinds of service to the inhabitants. The health center in Hagaz comprises of ophthalmic department, pre and ante-natal care departments, vaccination units, OPD and permanent care departments, volunteer counseling and guidance center and other units. The other health stations give mother and child care, control communicable and non-communicable diseases and raise public awareness about health care.
Mr. Gebremesqel Gebrehiwet, director of the Ministry of Health’s (MOH) branch in the sub-zone, says “the public awareness towards health is improving and the number of people who go to health centers and clinics is rising. And the practice of traditional medicine is drastically decreasing”.
As Hagaz is located in an area suitable for mosquito reproduction, malaria was one of the most lethal diseases in the area. The other diseases that pose a public health problem in the area include dengue fever and chikungunia. Mr. Gebremesqel says “we have been working to control these diseases in the last couple of years and succeeded in decreasing the death rate caused by these diseases”.
The ultimate aim of the MOH is the provision of modern medical services by setting up health facilities that are efficient, well equipped, staffed and managed to meet the communities’ needs. The health facilities in the sub-zone of Hagaz are equipped with facilities needed for primary health care service. Patients with serious medical cases that cannot be handled by the health facilities in the sub-zone are referred to the regional referral hospital in Keren. The health center located in Hagaz does not have an X-ray machine, forcing patients to travel to keren. But soon the service will start to be given and physicians will be assigned to the health center in Hagaz to do the job, Mr. Gebremesqel says.
Each of the health facilities has its own pharmaceutical unit, and the pharmacy of the health center in Hagaz is digitalized for an efficient and effective delivery of service.
The ophthalmic department and blindness control division now have full capacity to give adequate service to the inhabitants of the sub-zone. Among other things, the facility has a lens production equipment for those who need it and the service is offered almost free of charge.
Mr. Gebremesqel says though sometimes shortage of drugs occurs due to unexpected rise in the number of patients, the health centers provide secure health service.
“Though good progress has been made in reducing the practice of traditional medicine, much remains to be done in terms of raising public health awareness about the use of drugs. One of the most commonly seen problems is the use of drugs, especially antibiotics, without a physician’s prescription. Frequent misuse of antibiotics for simple infections is causing drug resistance problems”.
“As we have worked to raise the public’s awareness about different diseases, we need also to work on raising people’s awareness about the use of drugs. Some people don’t even know that some infections can be healed through simple home curing methods,” Mr. Gebremesqel says.
To mitigate the problem of electric supply, a new secure solar power supply has been installed. This has helped the hospital to operate without any difficulty. All of the health centers in the sub-zone now have their own solar energy supply.
One of the shortcomings of the health service in the sub-zone is the fact that there are only two ambulances for the six health centers. This is making it hard for the health stations in remote locations to send patients to the referral hospital. As a result, patients are obliged to pay a large amount of money for transportation. Residents from the remote areas say that in some cases the amount they pay reaches 2000-3000 Nakfa to reach Hagaz.
The MOH branch in the sub-zone is working to solve this problem and find other better alternatives in consultation with the sub-zone’s Administration.
According to the WHO standards, every health station should have its own ambulance among others. Mr. Gebremesqel hopes this can be met. Telecommunication service is also one of the major hurdles for patients who want to call for help because some of the health stations are located where there is no telephone service.
To ease this kind of problems, especially for pregnant mothers, waiting rooms have been established and the communities often cooperate in contributing money to send patients to the central hospital.
Community hygiene is an integral part for secure progress in the health sector. The MoH branch in the sub-zone advises every household to have its own toilet. This is widely applied in the remote areas. “In the remote villages we are looking to launch open deification free (ODF) and achieve the 2022 target of ODF Eritrea. But many toilets, especially in the villages, are built using mud bricks that can’t withstand rain. The communities are advised to build their toilets so that they may last long.
“We always inform mothers they should visit a hospital eight times during pregnancy, which is very critical for the pre-natal care. Though the number of women who give birth in health centers has increased, we have not yet achieved our target to get all pregnant mothers give birth in the health centers. There are still women who give birth in their homes,” says Mr. Gebremesqel.
Regarding vaccination coverage, Mr. Gebremeskel said that the sub-zone has made significant progress. Vaccination campaigns are conducted in cooperation with the local administrations and schools. The foot medics report to the MoH of the sub-zone all eligible ages to be vaccinated from every village. Last year, 47% of the population was vaccinated for polio and rubella. This was a good experience for the current preparation to vaccinate 70% of the population. Currently, around seven vaccinations are being given.
Hagaz sub-zone has also made significant progress in reducing the harmful traditional practices. Mr. Gebremesqel says, “We have been working for the last several years to make the people aware of the damaging consequences of practices such as FGM, cupping, under-age marriage and other harmful use of traditional medicines”.
Those who are involved in the illegal practices such as FGM are reported to the police and the health institutions and necessary corrections are given to those who commit these kinds of prohibited actions.
The sub-zone has had zero case of HIV in the last three years. It can be said that the HIV prevalence is under full control. The health center in Hagaz has recently introduced a mental health service. Three physicians were trained in the mental health (MH) for the newly acquired MH machines that help analyze data related to mental health problems reported to the hospital.
`The drug vendors in the sub-zone are licensed by the MOH, which allows them to purchase drugs from Pharmecor in Asmara. They must buy drugs from Pharmecor and are not allowed to obtain drugs from any other source. To obtain the license, drug vendors are required to submit evidence of their qualifications and experience in pharmacy. The health committee of the sub-zone routinely conducts supervision on the drug vendors.