Medical care in Ethiopia and how we help
There are just eight plastic and reconstructive surgeons and forty dentists in the whole of Ethiopia, serving a population of over 85 million. They are virtually all based in the capital, Addis Ababa.
Ethiopia is one of the poorest countries in the world and its children suffer from all the associated impacts on health. According to Unicef, some 381,000 children aged under five years die every year in Ethiopia. There is a dramatic lack of affordable, accessible medical care, especially outside the main cities.
The capital city of Ethiopia, Addis Ababa, can count on a number of large hospitals that carry out surgery to a high standard, including complex reconstructive operations. Project Harar has established partnerships with three hospitals, and collaborated with two others, to treat patients with a range of facial disfigurements.
These high-quality capital-city facilities, however, remain hard to access for the vast amount of people living in the isolated and impoverished areas of Ethiopia. As 85 percent of the population is rural, Project Harar fulfils a vital role providing outreach into the remotest regions so that many more Ethiopians in need can access the national health system.
Project Harar also contributes to the advancement of the long-term capacity of the Ethiopian health system by supporting training missions.
“More Ethiopian doctors are practising in Chicago than in Ethiopia.” Population of Chicago: 2.9m According to the Ministry of Health there are just 144 surgeons and 31 anaesthesiologists. |
The young patients we care for all have one thing in common - they have serious facial disfigurement. But the operations they require couldn't be more different - ranging from the simplest to the most complex.
For children with a cleft lip and/or palate, all that is required to fully repair the lip is a simple operation taking less than an hour. The palate is treated in a separate operation six months later. Project Harar manages this follow up.
In contrast, patients with conditions such as noma - a devastating gangrenous infection - tumours, animal attack wounds, burns and other conditions provide surgeons with some of the greatest facial rebuilding challenges imaginable.
Skin must be stretched, grafted and grown. The doctors must harvest cartilage, tissue and bone from one part of the body to repair and give function back to another. And function is what really matters – the surgery is never only cosmetic. The surgeons always want to give good appearance to our patients, but the greatest priority is giving them independence and dignity.
Please read below about the conditions affecting our young patients and how they are treated.
Project Harar Ethiopia is first and foremost a children’s health charity but we will not refuse to help anyone with a treatable facial disfigurement.
We care for people with a range of conditions, disabilities and injuries, including:
• Cleft lip and/or palate
• Noma, a devastating facial infection
• Tumours, ameloblastomas and growths
• Animal attack, accidents and burns
What is a cleft lip? What is a cleft palate?
Cleft lip and palate is a developmental problem in babies where the upper lip or palate (roof of the mouth) is not correctly joined, leading to a gap in either the palate or lip or both.
It is estimated that one in every 500-750 live births result in a cleft lip and/or palate. Babies can become severely malnourished as they are unable to breastfeed. Without a palate the child cannot speak properly. Teeth often develop at unusual and unsightly angles. Clefts may impede hearing and, if untreated, leave children prone to choking and low self-esteem.
Babies who are born with this condition in the UK are operated on soon after birth, but in most of Africa it is ignored. In Ethiopia the routine operation which rectifies the cleft is too expensive for most families.
Noma (cancrum oris) is an acute gangrenous infection affecting the face. Its victims are usually young children aged 3 – 8 years. Noma was eradicated in Europe and the United States a century ago, save for outbreaks in Nazi concentration camps.
Noma persists in those countries, such as Ethiopia, which border the Sahara, the world’s ‘noma belt’. Noma is not contagious. The victims are mainly young children living in extreme poverty, with chronic malnutrition and lacking immunisation from common childhood illnesses such as measles.
When children have a high fever in a developed country, antibiotic medicines are available. This is not the case for many families in Africa. The children's antibodies that normally protect and fight a virus become 'confused'. They turn on their host body, attacking the soft tissue of the cheek, mouth and nose and causing terrible facial disfigurement.
Some 90 percent of its victims die within weeks of contracting this painful disease.
Though scientists cannot be sure of the prevalence of noma, the World Health Organisation estimates that there are approximately 770,000 survivors of noma, with 140,000 new incidences per year.
Surgeons in Addis Ababa, assisted sometimes by visiting specialists, perform extremely complex surgical procedures on noma survivors in order to give them back normal facial function. Improved function and better appearance give noma victims a new chance in life.
Visit the case studies section to find out more.
Tumours and ameloblastomas - what we can do
Project Harar Ethiopia is finding a growing number of patients with prominent tumours effecting the face and neck. There are many forms of growths which affect children aged as young as two years. Ameloblastomas, a growth in the base of the tooth which can grow aggressively into the jaw and neck, tends to develop in teenagers and young adults.
The Ethiopian and Europeans doctors we work with have enjoyed great success tackling benign tumours. And we do all that is possible for young people with a cancerous tumour where the rewards outweigh the discomfort caused by surgery.
Sadly, Project Harar has identified that on some occasions children and young people with even benign tumours are inoperable due to the sheer size and extent of the growths and the implication for the brain and the blood supply.
This is why Project Harar is doing everything possible to enable and encourage patients to come forward and be treated long before growths become inoperable. We are also working with our partners to build surgical teams able to treat an even wider range of conditions.
Animal attack, accidents and burns victims
Children face a great deal of dangers living in hot, dry, farming areas of Africa, from attacks by wild animals to burns and other accidents.
In Harar, hyenas are a menace especially during droughts when, desperate for food and water, these predators go foraging in areas inhabited by humans.
Electricity for light, heating and cooking is rare in remote areas of the country so the people rely on open flames. Fires can quickly become out of control in the dry conditions near mud and wooden huts.
Sadly, terrible burns from accidents are seen regularly. Each patient requires a long term and painful course of treatment including skin grafts.
Project Harar is discovering a legacy of untreated facial injuries , including a man with a gunshot wound to the mouth received during the Ethiopian civil war, which ended in 1994.
Project Harar Ethiopia is determined to do all we can to ensure people with severe facial disfigurements receive effective medical care at the earliest opportunity. Please support us.
- Medical care in Ethiopia and how we help
- Operations
- Who we help
- - What is a cleft lip? What is a cleft palate?
- - What is noma?
- - Tumours, ameloblastomas and growths
- - Animal attacks, accidents and burns
