Health for humans and animals

"We share information, and all of us know the challenges that a pregnant woman faces during childbirth. I hadn't thought it was important to go to a health facility," says a young Ethiopian woman. She is thirty years old and is a participant in an awareness campaign about the importance of skilled delivery services organised by the SDC and its partner organisations in the Somali Region.

Reducing maternal and infant mortality is one of the goals of the SDC's Jigjiga University One Health Initiative. The project aims to improve the living conditions of the pastoralist communities and their herds. Half of Ethiopia's nine million livestock herders – around one-tenth of the total population – live in the Somali Region. Poor hygiene conditions and undernourishment, but also the close proximity to their animals, lead to health problems. Humans and animals infect each other, e.g. with rabies or tuberculosis. This poses a threat to the herders' food security and consequently their livelihoods.

There are not enough health facilities for either humans or animals, and there is a lack of qualified personnel. In addition to medicines being in short supply, the equipment being used is outdated. All of which means that morbidity and mortality rates in the Somali Regional State are higher than the national average.

To remedy this situation, an interdisciplinary centre of excellence for health has been set up at Jigjiga University in the Regional State capital. Here, the SDC promotes research on the health risks faced by the nomadic pastoralists so that they can be better informed and offered appropriate services. Currently, the centre is analysing COVID-19 tests. "Around 800 tests can be analysed every day," says Lensse Gobu, who is in charge of the SDC's health projects in Ethiopia.

The laboratory is staffed by local lecturers who were trained at the Swiss Tropical and Public Health Institute in Basel. They have already published some 10 studies in reputed international journals. The studies focused primarily on the uptake of maternal healthcare services: of the 450 women surveyed, 27% received antenatal care and 22.6% gave birth with a skilled attendant present. None utilised postnatal care. 43% of the respondents said they had never heard of antenatal care, and 46% did not consider it important to give birth at a health facility.

"If something goes wrong with the normal process or it is taking longer than usual to give birth then we should call for an ambulance to take us to nearest health centre." This is one of the lessons learned by the young Ethiopian woman above. A community health insurance scheme has been set up to cover the cost of outpatient care and medications for 135 member families. "They pay a monthly amount that covers expecting mothers in emergencies," Lensse Gobu explains.

The centre has also developed a Master's programme in One Health. Three female and nine male students graduated from the course last year. One Health focuses on the interactions between humans, animals and the ecosystem to prevent resultant health risks.

One example is the integrated monitoring system introduced in the Adadle district. Professionals from both human and veterinary medicine work together along with experts in natural resource management to prevent, identify and curb the spread of zoonoses, i.e. diseases such as COVID-19 that can be transmitted to humans from animals. They do so by collecting, analysing, interpreting and sharing data. If there is a disease outbreak, emergency measures are taken to swiftly contain it.

The livestock herders also take part in the monitoring system. They have learned to recognise the symptoms of sick animals. In addition to the health aspect, they will soon be able to use new technology developed at the University of Jigjiga that will allow them to preserve surplus milk and meat and boost their income.

The research is also aimed at informing the health policies of authorities in the region and in other countries. In this way, best-practice processes for improving human and animal health that have been tested by the University of Jigjiga can be replicated elsewhere. Cooperation with other Ethiopian, Somalian and Kenyan universities has now been established. The University of Jigjiga has no less an objective than to become the "centre of excellence for the health of the pastoralist communities in the Horn of Africa".