Tuesday, September 22, 2026
Home Blog Page 39

Critical care access gaps persist: Over half of population outside two-hour surgical radius

0

In East Africa, limited access to emergency medical services remains a significant public health challenge. Recent data reveals that over half of Ethiopia’s population lives more than a two-hour journey from surgical centers.

This substantial geographical barrier is exacerbated by severe infrastructure shortages. For instance, approximately 51 percent of all intensive care unit (ICU) beds and specialist physicians are concentrated solely in the capital city. During a recent discussion on surgical safety, public health leaders, policymakers, and international experts emphasized that urgent medical and surgical interventions are not luxuries but fundamental components of universal health coverage (UHC) and national health security.

Emergency, critical, and operative (ECO) care provides continuous, essential services for patients experiencing acute conditions, from severe postpartum hemorrhage and trauma to acute sepsis in children. While traditionally fragmented across different health sectors, modern public health frameworks now integrate ECO care into a single, unified patient pathway. Dr. Bejoy Nambiar, Health Systems and Policy Advisor at WHO Ethiopia, noted, “Patients do not experience health systems through institutional and fragmented boundaries.” A mother with severe postpartum hemorrhage, for example, requires an unbroken clinical pathway: rapid identification, emergency transport, resuscitation, blood, a skilled anesthesia provider, and surgery.

Timely interventions at primary and district health facilities offer high economic returns. They prevent easily treatable conditions from escalating into expensive tertiary-level care, thereby protecting vulnerable families from catastrophic out-of-pocket costs and bankruptcy.

As Dr. Nambiar highlighted, ECO care is “an essential fiscal policy that shields families from bankruptcy, keeps breadwinners alive, and protects national economic productivity.”

Recognizing this critical need, international health milestones such as World Health Assembly Resolution 72.3 and the broader global strategy for integrated ECO care urge member states to directly incorporate emergency medical care into national policies. Implementing these frameworks ensures that health systems can reliably detect, stabilize, manage, and respond effectively to both everyday emergencies and large-scale public health crises.

A recent discussion, which included representatives from international health organizations, the Africa CDC, the World Health Organization (WHO), and the Ethiopian Ministry of Health, underscored the wide disparities in basic surgical readiness across low- and middle-income countries.

A key issue central to the discussion was the shortage of capnography, a vital monitoring technology used by anesthetists to prevent catastrophic complications during surgery. According to expert data, one in three operating rooms worldwide lacks any capnography service. Furthermore, preliminary studies in Somalia and other regions indicate that over 65 percent of surgical procedures are performed in facilities without basic equipment.

Ethiopia has a long history of leadership in planning surgical and emergency care within the region. In 2016, years before international frameworks were adopted, the country launched the Saving Lives Through Safe Surgery (SaLTS) roadmap, a pioneering, comprehensive national plan for surgery, obstetric, and anesthesia services. This sustained institutional focus on emergency care has led to emergency medicine becoming an established medical specialty, supported by residency training hubs and dedicated crisis/outbreak response teams.

To bridge rural service delivery gaps and address specialist physician shortages, Ethiopia’s health strategy incorporates four key structural shifts, as outlined by health authorities such as expanding specialist training and integrating digital dispatch and monitoring tools.

Despite these significant structural advancements, considerable operational vulnerabilities persist. Critical shortages in both workforce and materials remain; the country has approximately 0.3 ICU beds and 0.5 surgical, obstetric, and anesthesia physicians per 100,000 population. Furthermore, the majority of citizens requiring essential surgeries still face substantial financial burdens, underscoring that surgical safety is fundamentally a broader health system challenge.

Organizations like Lifebox are actively distributing specialized equipment to frontline facilities, collaborating with the Ministry of Health, professional societies, and academic institutions.

Senait Bitew, Chief Program Officer at Lifebox, explained that the organization was founded “to close the implementation gap studied around surgery and surgical anesthesia safety, and to put safe surgical systems, tools, training, and monitoring into the hands of individual surgical teams where the need is greatest.”

A primary focus of these initiatives is the expansion of capnography, a clinically proven vital monitoring technology crucial for preventing intraoperative deaths during anesthesia. Preliminary findings from studies conducted by Lifebox and its partners reveal striking realities: “One in three operating rooms worldwide has no capnography capability at all,” and regional facility assessments indicate that a high volume of surgical units lack complete equipment readiness. Bitew emphasized that resolving these deficits requires strong ecosystem collaboration, noting that “no single organization or technology can close this gap alone. It takes an ecosystem, and the Ministry of Health sits at the center of this partnership.” To move away from short-term philanthropic dependence, leaders are advocating for structural change. Senait urged stakeholders to “fund these procurements through national budgets,” adding, “otherwise, we cannot always depend on philanthropy.”

The Nile Is not a veto: Ethiopia, Egypt and the end of an old order

0

The Horn of Africa and the Red Sea basin are witnessing a major geopolitical realignment. The issue of maritime trade and security, state sovereignty, energy integration, water governance and regional infrastructure are becoming increasingly intertwined. North-Eastern Africa is, in effect, the scene of a complex diplomatic chess game in which the Nile, the Red Sea, Ethiopia’s quest for diversified maritime access, the GERD and the security concerns of Egypt, Sudan, Ethiopia, Eritrea and Somalia have become inextricably linked.

The evolution of recent developments has made this connection all the more visible. Egypt has escalated its warnings regarding further Ethiopian dams on the Nile. Egyptian Foreign Minister Badr Abdelatty has warned that Egypt will not accept further dams or unilateral measures against its water interests and has reasserted Cairo’s demand for a legally binding framework governing the Nile. Egyptian officials have invoked Egypt’s right to defend its water security, however, and Ethiopia has responded with its insistence upon its sovereign right to develop its natural resources. Water and Energy Minister Habtamu Itefa has rejected the notion that Ethiopia requires another’s permission to develop its Nile resources and has denounced what he described as a colonial mentality towards the upstream states.

These developments highlight the fundamental problem with much of the modern discourse around the Nile, namely the existence of a zero-sum framework in which Ethiopia’s development is presented as a threat to Egypt and Egyptian water-security concerns are portrayed as an attempt to preserve the old order of control. Both arguments rest on elements of truth, but neither offer an adequate framework to govern a shared international river in the 21st Century.

The fundamental fallacy of the zero-sum approach is the portrayal of the Nile as a static quantity of water flowing from an upstream owner’s territory towards downstream consumers. In truth, the Nile is a hydrological system covering different climatic, geographical and ecological zones. The Ethiopian Highlands are particularly important in this system, since the Blue Nile, Atbara and Sobat systems originate in or are significantly fed by the Ethiopian highlands. Studies have estimated that the Ethiopian tributaries contribute more than 85 percent of the Nile’s waters measured at Aswan (although the percentage varies according to season, hydrological year and methodology). This does not mean, however, that Ethiopia therefore owns 85 percent of the Nile – hydrology cannot dictate legal entitlement – just that a physical reality exists that cannot be ignored, namely that downstream Nile security is inseparable from upstream Ethiopian hydrology.

The seasonal nature of Ethiopia’s contribution is equally important, since the Blue Nile and Atbara systems experience dramatic fluctuations associated with the Ethiopian rainy season, while the White Nile provides a more stable contribution during low-flow periods. Effective Nile governance therefore must consider not only annual volumes but also the timing, variability, drought, floods, storage, evaporation, sediment and reservoir operations.

This leads us to one of the most important but frequently misunderstood questions in the debate, namely the issue of evaporation. Lake Nasser, created by the Aswan High Dam, is located in an extremely hot and arid environment. Scientific estimates of annual evaporation rates vary according to methodologies and climate conditions, but the losses are substantial, commonly estimated in the range of roughly 10-16 billion cubic metres per year. This does not make the Aswan High Dam irrational or an “environmental calamity” – far from it, since the dam has provided Egypt with tremendous flood-management, storage and energy benefits. But this demonstrates, however, an important hydrological principle, namely that where water is stored can make a decisive difference. Storage in a hot, arid environment can lead to substantial evaporative losses, while storage in a cooler, higher-altitude environment can have vastly different evaporation characteristics. The GERD is located in the Ethiopian Highlands, in a substantially different environmental and topographic setting than Lake Nasser, with a different reservoir geometry and operational purpose. It would therefore be scientifically simplistic to claim that every cubic metre stored upstream is automatically a cubic metre “saved” downstream. Reservoir evaporation characteristics are determined by surface area, climate, humidity, wind, water temperature and operating levels, but logically the question of whether storing and regulating water in different climatic zones can lead to overall hydrological efficiencies should be raised.

The stronger argument, therefore, is not that upstream storage is inherently good and downstream storage inherently bad – it should be about optimizing the location and operation of storage according to basin-wide efficiency instead of regarding downstream storage as inherently superior to upstream storage.

The GERD itself is frequently portrayed in political commentary as a mechanism through which Ethiopia will “take Nile water from Egypt.” This description, however, obscures the project’s principal purpose, namely that the GERD is fundamentally a hydropower project. Water passing through the turbines generates electricity and then continues downstream. Hydropower generation is therefore fundamentally different from consumptive irrigation use. While reservoir filling and operating decisions can temporarily alter the timing and volume of downstream flows, the question is not so much whether the GERD “uses” Nile water but rather how the dam can be operated so that Ethiopia can generate electricity while downstream countries receive predictable and protected flows, particularly during prolonged drought? That is a technical and diplomatic question capable of negotiation.

The GERD may also have regional benefits, since regulation of seasonal flows can assist in flood management and provide operating benefits downstream while sediment retention can reduce sediment loads entering downstream reservoirs. These should not be exaggerated as automatic outcomes due to their dependency on the actual operating regime and downstream infrastructure, but they demonstrate that the GERD should not be considered merely through the lens of Egypt-Ethiopia confrontation.

The same logic applies to electricity, since Ethiopia’s expanding generation capacity creates the potential for broader regional electricity trade – with Sudan, Kenya, Djibouti, South Sudan and potentially other markets. The GERD, therefore, fits within a wider regional energy strategy, not merely as a water-control instrument.

This leads to a larger conceptual question, namely that instead of asking only, “How much water belongs to each country?” the Nile Basin should increasingly ask, “How can the countries of the basin share the benefits, risks and responsibilities generated by the river?”

International water law has evolved considerably beyond the old notion of absolute territorial control over international rivers. Modern law focuses on equitable and reasonable utilization, participation, cooperation and the obligation to take appropriate measures to prevent significant harm. The UN Convention on the Law of the Non-Navigational Uses of International Watercourses reflects this principle, without establishing a universal rule where a single riparian state possesses exclusive ownership of an international watercourse.

This is important, since the legal debate concerning the Nile is frequently polarized into two competing extremes, namely that of an alleged unlimited Egyptian historical entitlement on the one hand and unlimited Ethiopian territorial sovereignty on the other. Neither provide a sustainable legal or political foundation for the future.

The modern approach requires all riparian states’ interests to be balanced, considering geography, hydrology, climate, ecological conditions, population, economic and social needs, existing and potential uses and the effects of one state’s utilization on others.

The 1929 Anglo-Egyptian arrangements and the 1959 Egypt-Sudan Agreement remain central to the historical dispute. Egypt and Sudan continue to give considerable importance to them, while Ethiopia has consistently rejected the proposition that agreements to which it was not part can establish an exclusive allocation regime binding upon Ethiopia.

History, however, cannot be easily erased. Those agreements form part of the political history of Nile governance and explain Egypt’s profound sensitivity towards changes in upstream control. History also cannot be used to permanently freeze the basin within an institutional framework without the participation of all contemporary riparian states.

The constructive solution is therefore neither to pretend that the old agreements never existed, nor to regard them as an immutable constitution for the entire Nile Basin. It is to create a modern basin-wide framework incorporating the legitimate interests of all riparian countries.

That is why the Cooperative Framework Agreement is important. Its entry into force in October 2024 represented a significant institutional development for Nile Basin cooperation and created a pathway towards a permanent Nile River Basin Commission. Whatever disagreements remain surrounding the CFA, the underlying institutional question is unavoidable, namely that a river shared by multiple sovereign states cannot be governed indefinitely without a permanent basin-wide institution in which upstream and downstream countries participate.

The answer should be no.

The Nile requires a permanent institution capable of coordinating hydrological data, drought planning, flood management, environmental protection, infrastructure development, electricity cooperation, sediment management and dispute resolution. Such an institution should not become an instrument of either upstream or downstream dominance. Rather its purpose should be collective security.

At the same time, an Ethiopian-centered argument should not disregard Egypt’s security concerns. Egypt is overwhelmingly dependent on the Nile for freshwater. Its population, agriculture, cities and economic life are concentrated along a narrow river corridor in an otherwise arid country. Therefore Egyptian concerns about unpredictable reductions in Nile flows are not imaginary.

The recent statements by Foreign Minister Badr Abdelatty demonstrate the seriousness with which Cairo views further upstream developments. His warning against further Ethiopian dams and invocation of Egypt’s right to defend its water security represents a sharpened rhetorical position than ordinary diplomatic protest. Recognizing Egypt’s vulnerability, however, does not logically lead to recognizing an unlimited Egyptian veto over upstream development.

Security must work in both directions.

Egypt requires water security. Ethiopia requires development security. Sudan requires flood, agricultural and water security. The other Nile Basin countries require energy, food, environmental and economic security. Therefore, a sustainable settlement must provide security to all of them simultaneously.

For Ethiopia, the Nile question is inseparable from development. The country possesses enormous hydropower potential and continues to face major electricity-access and economic development challenges. The GERD represents not merely an engineering project, but an expression of Ethiopia’s attempt to transform its natural geography into productive economic infrastructure.

That aspiration should not be confused with a claim to unlimited use. A responsible Ethiopian position must acknowledge that upstream sovereignty carries downstream responsibilities. Equally responsible downstream diplomacy must acknowledge that downstream dependence does not create a permanent right to upstream stagnation.

The objective should be development without significant harm, security without monopoly, and sovereignty with responsibility.

The Nile dispute cannot be entirely separated from the wider geopolitical transformation of the Horn of Africa. Since Eritrea’s independence in 1993, Ethiopia has remained landlocked and heavily dependent on external maritime corridors, particularly Djibouti, for international trade. Ethiopia’s search for diversified maritime access is therefore not simply a question of naval ambition. It is connected with economic resilience, trade costs, logistics and national development.

At the same time, maritime diplomacy must respect the sovereignty of coastal states. The most sustainable model is therefore not one of territorial confrontation but of commercial partnership: long-term port leases, logistics corridors, joint infrastructure investment, port-operating partnerships and mutually beneficial transit arrangements.

Such arrangements could turn the Red Sea and Gulf of Aden from arenas of rivalry into engines of regional integration.

The danger is that separate strategic disputes could start to reinforce one another. If the Nile dispute becomes militarized while maritime access becomes securitized and if Eritrea, Somalia, Sudan, Egypt and Ethiopia increasingly align according to competing security blocs, a water dispute could evolve into a much broader regional confrontation.

This is where the current rhetoric is particularly dangerous. Egypt’s increasingly forceful language about protecting its water security can be interpreted in Addis Ababa as an attempt to constrain Ethiopia’s sovereignty. Ethiopia’s categorical insistence upon its right to develop its resources can simultaneously be interpreted in Cairo as evidence that Ethiopia intends to act with disregard for downstream security. Each side’s defensive narrative can therefore become the other side’s evidence of aggression. That is the classic security dilemma.

The way out is not another round of competing historical claims but a new framework of shared security.

Ethiopia can generate electricity. Sudan can benefit from better flood management and coordinated agricultural planning. Egypt can receive greater predictability of flows and stronger drought-management guarantees. Nile Basin states can cooperate on hydrological data. Regional electricity markets can expand. Infrastructure corridors can connect inland economies with Red Sea ports. Joint investment can create economic interdependence strong enough to make confrontation increasingly expensive.

This is not naïve idealism, but strategic calculation.

The fundamental resource is not simply the water itself, but the economic value generated by predictable cooperation around the water.

A future Nile settlement should therefore guarantee transparency in dam operations; establish jointly agreed drought indicators and emergency procedures; recognize equitable utilization; protect downstream interests without creating an upstream veto; establish benefit-sharing mechanisms; strengthen permanent basin-wide institutions; and connect water diplomacy with electricity, food security, transport, port development and climate adaptation.

The Nile does not have to produce one winner and one loser.

Egypt cannot move the source of the Nile. Ethiopia cannot move Egypt downstream. Sudan cannot escape the river system connecting the two. The other Nile Basin countries cannot be treated as spectators to a dispute between Cairo and Addis Ababa. They have something more powerful than a shared resource: shared hydrological destiny. The task of diplomacy is to transform that interdependence into a source of cooperation.

The August 2026 confrontation between Cairo and Addis Ababa demonstrates that the old zero-sum narrative is powerful. Egypt continues to demand protection against unilateral upstream developments while Ethiopia insists on its sovereign right to develop its water resources. The distance between these positions is considerable.

But the confrontation also clarifies what must change.

The Nile cannot be permanently governed through colonial-era assumptions, unilateral upstream action, downstream vetoes, military deterrence or competing historical narratives. It requires a modern bargain: a bargain where Ethiopia’s right to develop is recognized, Egypt’s water security is protected, Sudan’s interests are respected and the wider Nile Basin participates in determining the river’s future.

The strategic choice before the Horn is therefore not merely between Ethiopian sovereignty and Egyptian security. It is between zero-sum rivalry and shared security.

The Nile can remain a fault line dividing the region.

Or it can become the backbone of a new regional order – where water, energy, infrastructure, maritime connectivity and economic interdependence transform a historic source of confrontation into the foundation for cooperation.

The choice is ultimately political, not hydrological.

Eyob Amare

0

 
2. Education: (የት/ት ደረጃ)
    BA in Marketing Management


3. Company name: (የመስሪያ ቤቱ ስም)
    AB’ren Leather Crafts


4. Title: (የስራ ድርሻህ)

Owner, designer and manager


5. Founded in: (መቼ ተመሰረተ)
        2017 E.C


6. What it does: (ምንድነው የሚሰራው)
    Leather products and accessories


7. Headquarters: (ዋና መስሪያ ቤት)
    Addis Ababa around Gerji


8. Start-up capital: (በምን ያህል ገንዘብ ስራዉን ጀመርሽ/ክ)
    100,000 birr


9. Current capital: (የአሁን ካፒታል )
    460,000 birr


10. Number of employees:(የሰራተኞች ቁጥር)
    4


11. Reason for starting the business: (ለስራው መጀመር ምክንያት)


     To promote Ethiopian handmade leather products


12. Biggest perk of ownership: (የባለቤትነት ጥቅም)
    Knowing about management of resources and empowering others


13. Biggest strength: (ጥንካሬህ/ሽ)
    Taking lessons from my failure and trying again


14. Biggest challenge: (ተግዳሮት)
    Market place and raw material


15. Plan: (እቅድ)
    Export my local product


16. First career path: (የመጀመሪያ ስራ)
    I was employed in one mirror factory


17. Most interested in meeting: (ማግኘት የምትፈልጊ/ገው ሰው)
    Francis Pierre Laborde


18. Most admired person:(የምታደንቂ/ቀው ሰው)
    Myles Munroe


19. Stress reducer: (ጭንቀትን የሚያቀልልሽ/ለህ)
    Praying, listening to inspiration thoughts


20. Favorite book: (የመፅሐፍ ምርጫ)
    Poor Dad Rich Dad by Robert T. Kiyosaki


21. Favorite pastime: (ማድረግ የሚያስደስትህ)
    Watching movies, sometimes traveling


22. Favorite destination to travel to: (ከኢትዮጵያ ውጪ መሄድ የምትፈልጊ/ገዉ ስፍራ)

Paris


23. Favorite automobile: (የመኪና ምርጫ)
    

Nissan

Phone number; +251920196948

Africa endorses new push to protect children from Polio and other preventable diseases

0

African health ministers have endorsed a new regional strategy aimed at giving every child the best possible start in life, with stronger immunisation systems and community-based health services expected to play a central role in protecting children from polio and other preventable diseases.

The strategy was endorsed during the 76th session of the World Health Organization Regional Committee for Africa in Addis Ababa. It calls for coordinated action across health, nutrition, social protection, water and sanitation, education and finance, recognising that child survival and development depend on more than healthcare alone.

For polio programmes, the approach places renewed emphasis on reaching children who are missed by routine immunisation campaigns, particularly those living in remote, conflict-affected and underserved communities. Stronger primary healthcare systems, reliable health workers and better coordination between national and community authorities are considered essential to sustaining vaccination coverage and preventing the virus from spreading.

The regional commitment comes as African countries face a projected shortage of more than six million health professionals by 2035. Ministers approved the Health Workforce Management Programme in Africa for 2026–2035, which aims to train, employ and retain three million additional health workers across the continent.

Africa had nearly 5.72 million health professionals in 2024, but this represented only about 46 percent of the workforce required to meet the continent’s health needs. WHO said the gap threatens the delivery of essential services, including immunisation, disease surveillance and outreach to children in hard-to-reach areas.

Polio eradication depends on more than vaccines. Health workers must identify missed children, maintain accurate vaccination records, monitor suspected cases and respond quickly when poliovirus is detected. They also play a critical role in engaging parents and communities where misinformation, distrust or access barriers can prevent children from receiving essential doses.

The new workforce programme seeks to address these challenges by improving health-worker planning, expanding quality training, creating employment opportunities and retaining staff in areas where they are most needed.

“Our Member States have recognised that training health professionals is only the beginning,” said Dr Mohamed Yakub Janabi, WHO Regional Director for Africa. “This programme turns evidence into concrete action and political commitment into sustainable investments for Africa’s health workforce and, ultimately, for the health and well-being of our populations.”

The programme also highlights the economic case for investing in health workers. WHO estimates that closing Africa’s workforce gap would require an additional USD 4–6 per person each year, while every dollar invested in health workers could generate up to USD 10 in economic benefits and roughly 30 times that amount in broader social returns.

The newly endorsed child-health strategy calls for support to parents, caregivers and communities, who are central to ensuring that children survive, grow, learn and thrive. Its cross-sector approach links immunisation and primary healthcare with nutrition, clean water, sanitation, education and social protection.

For countries working to end polio, the strategy offers an opportunity to integrate vaccination into broader maternal and child-health services rather than treating campaigns as isolated interventions. Such integration can help strengthen trust, improve access and ensure that children receive other essential services at the same time.

Deliberations at the Addis Ababa meeting are expected to shape Africa’s health agenda over the coming year and beyond. For the continent’s polio programme, the message is clear: protecting children from paralysis and other vaccine-preventable diseases will require sustained political commitment, stronger health systems and a workforce capable of reaching every community.