1st November 2005
Despite the fact that 80 percent of the rainwater that eventually flows into the Nile falls on Ethiopia, there is a persistent water shortage in many places there. No matter how heavy the rainfall in these places, shortages arise because the water flows rapidly down the steep mountain sides. Reservoirs for water storage are scarce and there have been few attempts at irrigation until recently.
The population of Ethiopia has risen from 45 million when Band Aid took place 20-odd years ago to save those in the famine in Tigray to 73 million now. Feeding an additional 30 million people is not an easy proposition with these water shortages. Nor is food aid from abroad a good solution to this problem as it distorts local markets and impoverishes local farmers.
As I explained before, I am a director of Praxis Ethiopia, an organisation set up to promote initiatives by Ethiopians and get expert international help where needed. On my last visit to Ethiopia I was delighted to meet Horacio Ferriz. He is an internationally renowned hydro-geologist originally from Mexico and now living in California. He is prepared to give his expertise free to help projects in Ethiopia where the local geologists and engineers cannot find a solution.
Horacio knows my main interest is in health issues and facilities and he encouraged me to tell him about the problems I have encountered recently in the health service there which involved water or rather the lack of it.
This was not a difficult task. Dr. Selmanit Assefa is an ophthalmologist with a strong social conscience. She is trying to set up a campaign to encourage mothers to wash their children's faces, especially around the eyes to prevent the development of trachoma. This does not sound too difficult but when one remembers that the water has to be carried over ever longer distances by women and children it becomes a very precious commodity and washing baby's face may get lower and lower down the priority list. And then, what about the quality of the water? It may be filthy river water in which cattle have been wading up stream before it was collected and how will that affect infant eyes?
With the appalling poverty in the country and the dearth of clean water Dr. Selmanit has a difficult task instead of one that would appear quite simple.
Next, to the Ghandi Maternity Hospital in Addis Ababa itself. Here I went to see my friend Sister Tibeb Wolde - Sister Lily to her friends - who is Matron of the hospital. There have been great improvements since I was last there. A French grant built and equipped a laboratory which provides for the measurement of electrolytes, renal and hepatic tests, all required haematology and parasitology. The lab is run by a young woman who emigrated when she was twelve with her family from Ethiopia to Cuba. She trained as a lab technologist there and is one of the diaspora who have returned to help Ethiopia on its way.
Lo and behold, Sister Lily tells me the maternal mortality in the hospital has gone down and the doctors who work there are staying instead of leaving after a short time due to the stress of the working conditions.
"What," I asked Lily, "is your most serious problem now?" "Water," she said. "Water." It emerged that due to the increased use of water the lab there now has trouble pumping it up to the second floor of the two-storey hospital. After a consultation with the hospital electrician (who understood but did not speak English) he, Lily and I decided that what was needed was a bigger pump. When I said I'd see if Development Co-operation Ireland could do anything about it, they both became very excited and said what about a larger storage tank as well? (It is extraordinary to watch what happens to millions of euro here in Ireland in a computer debacle in the Department of Health and Children and to think of what a few thousand euro - maybe even less - could do for a hospital where about six thousand women, many with serious complications gave birth last year.)
Not wanting to exhaust Horacio, I finished with the following story. Dr. Bogalech Gebre is another member of the Ethiopian diaspora who has returned home after years in America. Virtually single-handed she had persuaded people in several areas in the south of Ethiopia to stop practising female genital mutilation. The form practised there has a serious effect on maternal health.
She was given a grant by the European Union to set up a maternity clinic where mothers could give birth in that area, much as Development Co-operation Ireland has done with excellent results in other parts of Africa. She built the clinic near an existing Government Health Centre and got off to a very successful start.
But soon the "water" word was featuring. The amount of work carried out at the old Health Clinic did not strain the water supply there but the new facility required much more and the water ran out. Then it was found that the clinic is on a watershed so that even digging deep might not produce sufficient volumes. And the nearest river was fourteen kilometres away!
Sometimes, Bogae tells me, the family of the woman who gives birth carries enough water with them to wash the blood from the delivery suite after the woman has given birth, but sometimes they do not.
How devastating for Bogae after all of her efforts to help her fellow Ethiopian women to have this happen. Horacio will have to come to the rescue because it seems to be too complex for local help to solve the problem.
Small reservoirs and simple irrigation systems would make such a difference in rural Ethiopia and this they are working at too. I pray no one arrives with majestic Aswan Dam style solutions - the Ethiopians have to make their own initiatives work and not be subjected to our idea of what is right for them.
Senator Mary Henry, MD
