Ethiopia Ails: The Triple Faces of Disease & Struggle

If you are currently residing in Ethiopia, you most likely have heard in the past few months that someone near you -it can be family or friends or maybe a neighbor- have

• fallen ill from foodborne disease, flu-like illness, or another infectious disease, or

• been recently diagnosed with diabetes, hypertension, cardiac disease, cancer, or some chronic illnesses, or

• suffered traumatic injury from a fall, workplace, or road traffic accident.

This makes you wonder, how many people around you are actually in good health? What does this mean for your future? Is it a coincidence or is there something more to it? 

Let`s talk numbers! 

None of us are immune from diseases. At one time or another, we have fallen ill or will fall ill. Globally speaking billions of people suffer from various diseases annually. According to recent data in Ethiopia;

• 1 in 15 people has diabetes.

• 1 in 5 people has hypertension, with men (1 in 4) being more affected than women (1 in 5).

• 1 in 20 people lives with cardiovascular disease.

• Nearly 1 in 2 workers experience a work-related injury, with the highest risk in construction, especially in Addis Ababa.

• In 2017, 69 in 100,000 people died from injuries, mainly due to road accidents, falls, self-harm, and violence. These deaths are highest among men, children under 5, and youth aged 15–24.

• 1 in 30 people suffered from injury-related disability.

Seeing these numbers, you are right to think Ethiopia is facing an immense health crisis. We can say with confidence that these problems alone are enough to strain a nation’s healthcare system by creating crippling public health challenges. Yet, we have not included infectious illnesses in the picture! What if we include casualties of the raging civil war that is engulfing the country?

This number is huge. Ethiopia is struggling with these immense health problems that affect every household in one form or another. Ethiopia is ailing. The battle to recovery and a healthier community is not an easy one for the country. It is laced with many challenges. The country is facing not one not two but three faces of diseases. In medical terms, it is said Ethiopia is faced with a triple disease burden. 

Communicable Diseases: The Persistent Foe

Communicable diseases have dominated Ethiopia`s health profile for decades if not for centuries. As their name entails, these diseases are transmissible from a diseased individual to a healthy one. They are caused by infectious agents like bacteria, viruses, and parasites. They are often linked to poverty, poor sanitation, and inadequate healthcare access. Hence, they are the dominant foe plaguing the community.

In contrast to the developed world, Ethiopia still struggles to keep these communicable diseases at bay. The country`s economy is growing and urbanization is increasing, thus theoretically, communicable diseases should decline or at least be easier to control.

But, is that the reality? Are these communicable diseases really disappearing? What does the recurrent acute watery diarrhea outbreak in Addis Ababa entail?

The reality is that the inadequate healthcare infrastructure, the recurrent drought, and the social unrest prevailing in the country have made it impossible to control these diseases effectively.

Subsequently, Ethiopia was among the 30 high-burden countries for TB in 2021, with an estimated 143,000 cases and an incidence rate of 119 per 100,000 people. The prevalence of HIV/ AIDS is rising again despite positive progress in its prevention. Ethiopia is among the hepatitis B Endemic countries. Malarial outbreaks still occur in rural lowland regions, despite efforts to curb its spread.

However, communicable diseases are only one-third of the picture 

Non-Communicable Diseases: The Emerging Threats

Noncommunicable diseases have come into the picture in the last few decades. Traditionally, they used to be named diseases of the wealthy. They are now a growing concern in Ethiopia impartially affecting the rich and the poor. Unlike communicable diseases, these diseases don`t just appear overnight. They creep silently, often going unnoticed until complications arise.

This stealthy nature is a bad combination for the poor health-seeking behavior of many Ethiopian communities. In a culture where medical visits are often reserved for severe, debilitating symptoms, NCDs thrive unnoticed. Thus, these silent killers keep on creeping in the background while the unsuspecting patient keeps living his / her assumed healthy life. They are mostly discovered at a late stage after permanent damage has happened, when medicine can do little to avert the problem.

Recent data suggest that non-communicable diseases in Ethiopia are rising at a significant level. That is why you might have heard - in passing or in your close circle - that somebody is unknowingly living with high blood pressure or diabetes. The even harsher reality is that many people only become aware of their condition after developing kidney failure, liver failure or heart disease. It is not so rare to hear of individuals who seemed fine but are now paralyzed due to a stroke—or worse, have succumbed to sudden death at a younger age.

The tragedy is that it could all have been prevented. These grave diagnoses could have been avoided with yearly, checkups and prompt follow-ups. However, the country still struggles with these nightmares, unable to wake up 

Injuries: The Overlooked Crisis

Injuries have a devastating effect on the individual and the health system. Injuries might be incidental, happening in moments, however their effect remains for years. Despite common belief, the effect of injuries on the health of the country is not dismal. When they happen, injuries/ mass causalities can strain the capacity of the local health system, scouring resources that could have been used for pressing health concerns.

Despite Ethiopia having one of the lowest vehicle numbers per capita, the country shockingly ranks among the world's deadliest countries for road accidents. In 2021 alone, over 4,000 lives were lost on the roads. Beyond traffic accidents, poor occupational safety standards and crowded urban environments, have led to a surge in fall-related injuries. And then, there are the country`s recent conflicts. Though exact numbers are not available these conflicts have left thousands wounded, disabled, and in desperate need of care, further burdening the health care system.

But the problem doesn`t end once the wound heals. Many survivors live in the cruel reality of chronic pain, long-term disability, and the psychological weight of what they have endured. Recent data indicate that of 100,000 people in Ethiopia, 3328 suffer from injury-related disability. This is not just a statistic. This is a story of lives changed forever, carriers cut short, and families thrown into psychosocial and financial challenges.

Injuries don`t just wound an individual they scar a nation. Ethiopia cannot afford to look away.

Looking into these three threats to the Ethiopian health system alone doesn`t paint the full picture. 

The Combined Front: Communicable Disease, Non-communicable Disease and Injury

The effect of these diseases on the health care system and/or the individual is neither simple nor direct. We can not simply add the numbers and estimate the impact. These health challenges are deeply interconnected, creating a multifaceted crisis. At times they create a combined front further straining the health system.

For instance, in sub-Saharan African countries, Cancer caused by infectious agents like cervical cancer and hepatocellular carcinoma are highly prevalent. Individuals affected by chronic diseases

like diabetes, hypertension, and cancer are at a very high risk of having infectious diseases due to their weakened immune systems. Injuries resulting in significant activity limitation increase the risk of having vascular accidents like stroke. Conversely, patients with some form of ailment are more likely to suffer injuries.

The health infrastructure of Ethiopia is not yet ready to handle these created matrices of problems. However, the fight is only starting. The Ethiopian Ministry of Health, in collaboration with international and local actors, has been making a concerted effort to combat and control these health challenges. While the battle is tough, progress is being made.

With sustained commitment and continuous collaboration with stakeholders, Ethiopia can work toward a stronger, more resilient healthcare system. This united front can create a healthcare system that not only treats diseases but actively prevents them. 

Ethiopia’s health story is still being written. By taking action now, we can rewrite it for a healthier future 

Your Perspective Matters!

What health challenges have you observed in your community?

Have you or someone you know been affected by any of these issues?

Share your experiences and insights in the comments below.

Together, we can spark a conversation that leads to real change! 

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Resources

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