August in Africa- Blog II

Today, I met Solomon Zewdu M.D., who is the Country Director of Technical Support for Ethiopian HIV/AIDS initiatives. He is actually on assignment as an employee of Johns Hopkins University.

Mr. Zewdu grew up in Ethiopia, moving to the United States when he was sixteen years old. He went to high school and college in the United States and then qualified for medical school. He joined the military as a doctor and was ultimately drawn to work on HIV/AIDS prevention with responsibility for Asia and South East Asia, at the Department of Defense.

His wife, an accountant by training, is half Ethiopian. The Zewdu’s concluded it was time in their lives to explore how they could use their training and experience in helping the people of Ethiopia. He joined Johns Hopkins University, and the Zewdu’s (along with their son) moved here to devote their efforts to the fight against HIV/AIDS.

(L-R) Rich McKeown, HHS Chief of Staff; Julie Gerberding, M.D., Director of the Centers for Disease Control and Prevention; Secretary Michael Leavitt; Bishop Abune Samuel of the Addis Ababa Diocese Ato Bedellu Ethiopian Orthodox Church Administrator; and Solomon Zewdu, M.D., Country Director of Technical Support for Ethiopian HIV/AIDS Initiative and Disease Prevention and Control Program, Department of International Health, Johns Hopkins University.

Once here, Dr. Zewdu recognized that an alarming percentage of those who started antiretroviral treatment abandon it a short time later. He set out to find out why.

As a young boy in Ethiopia, Dr Zewdu was part of a devoted religious family. He had attended church every Sunday morning with his mother. He understood intuitively the impact that a person’s faith can have on patterns of behavior. He was not surprised to find that religion was having a major impact on the problem of people abandoning treatment.

The Ethiopian Orthodoxy has more than 30 million followers in Ethiopia proper. It has 30,000 monasteries and churches and 400,000 clerics who perform various religious services. It has its own rituals, customs and calendar. One of these rituals and beliefs involves “tsebel,” or holy water, to heal the sick and cast out demons. There are some 80 sites where this water can be obtained. One of the most prominent is Entoto, near Addis Ababa, the capital of Ethiopia.

The water, which comes from a spring on the mountain, is poured onto the patients or drunk as a healing tonic. The region around the spring has become a safe haven for the sick and those looking for spiritual help. Thousands have actually moved to the region, including a large population of people with HIV/AIDS.

Dr. Zewdu discovered that a perception existed by the local population that holy water, a spiritual remedy, and antiretroviral medication, was not compatible. The result was that many patients were told by their clergy that it was wrong to take the medication and they quit. Dr. Zewdu was determined to deal directly with this problem. He made an appointment with the Patriarch Abune Paulos, the head of the Ethiopian Orthodox Church.

Dr. Zewdu’s discussions with the Patriarch resulted in an opportunity to meet with leaders of the church from throughout the country, and he was given a lengthy period of time to teach them about HIV/AIDS. The result, in May of 2007, the Patriarch declared that both remedies were gifts of God, and “they neither contradict nor resist each other” encouraging HIV/AIDS patients to swallow their drugs with the holy water.

The result of that declaration has turned a serious barrier to people having the benefit of antiretroviral treatment into a significant partnership. Every day, thousands of people go to holy water sites seeking their healing powers. Now, with the introduction of clergy, HIV/AIDS workers like Dr. Zewdu are able to address them in mass, educating them to the importance of the medication. Clinics have also been built close-by to take advantage of the powerful draw of these waters.

I visited the Entoto site to help me understand the nature of this arrangement. Dr. Zewdu and I walked together down a path made muddy and slick by the seasonal rains in Ethiopia right now. We met the clergyman who had originated the site and oversees the activities. I viewed the area where the water is drawn from. Adherents carried a liter of the holy water away in small plastic bottles. Others undressed and were showered with the water.

Dr. Zewdu and his family typify a group of devoted human beings who leave the comfort of the United States, live in difficult conditions, and endure significant hardship to improve the lives of people who desperately need help. They have to learn the local conditions and find ways to integrate western medical advantages with local customs.

The key in this situation was to not force a conclusion whether it was faith people have in the holy water, or the antiretroviral medication that produced positive health improvement, but to engage with religious leaders in a way which caused them to cooperate. In this way, both faith and health are enhanced.

Nearly a million people in Ethiopia are HIV positive. Three years ago, only 900 people were being treated with public money. Today it is more than 150,000. I will talk more tomorrow about the general health conditions in Ethiopia.

Comments

Please don't redefine birth control as abortion. That would be inaccurate and bizarre.

Posted by: McKenzie | August 15, 2008 at 05:58 PM

Mike,

Best wishes for your safe travels, and BIG cudos for your front-line efforts.

RE: "... but to engage with religious leaders in a way which caused them to cooperate. In this way, both faith and health are enhanced."

Maybe someday in America we will be enlightened enough to adopt this...

Posted by: Marshall Maglothin | August 17, 2008 at 01:32 PM

Your refusal to answer with anything other than "No Comment" to Scott Swensons question if 'contraception is terminating a pregnancy' is an act of craven cowardice, and you should be ashamed of your responce,and of the Bush administrations disgusting attempt at a stealth policy change to deny contraceptive services, family planning,and womens rights. You join the rest of the bush crowd as a an arrogant human rights violator.

Posted by: David E. Larson | August 18, 2008 at 08:34 AM

DEAR SECRETARY MIKE LEAVITT doctors have no right to take one single right away from me no matter what it is doctors ask question about what IAM doing in the bedroom what has to do with health abortion is nobody business but womans most people who are against abortion cant have any so they bother people who can have them .

Posted by: alice armstrong | August 19, 2008 at 10:37 PM

I am in favor of leaving womens access to birth control as it is and available to all.

Thank you, Edmund Swiger

Posted by: Edmund Swiger | August 19, 2008 at 11:51 PM

While I do not think any medical person should be obligated to perform an abortion if it is contrary to his/her beliefs, WOMEN MUST CONTINUE TO BE ALLOWED TO CHOOSE...to abort or to carry a child to term and place it for adoption, or of course to raise that child. NEVER must women be forced to travel hundreds of miles to acquire a safe, legal abortion. It is important that our health system place doctors and nurses who see the sanity in abortion. For the numerous reasons a woman may have NOT to give birth to a child. Knowing that child would put undue stress on the ability to feed and clothe ALL family members is one example; knowing the child would be without a father, a pregnant woman feeling that she is emotionally unable to provide the love and stability... Feeding, educating, providing work for EXISTING children and familiesm must win over the argument that any life is better than no life at all.

Posted by: Rev. Anne Clark | August 19, 2008 at 11:54 PM

I think a women has the final right to choose and decide ANYTHING about her body and her physician should support her
decision in any medical way possible. It is her decision and
no one should change that decision in any way.

Posted by: karen borrows | August 20, 2008 at 08:00 AM

Mr. Leavitt:
Please do not further derail efforts to provide essential women's health information & services to those who need it most. Our collective health, well-being and entire world depends on it!
Thank you,
Melissa Bird

Posted by: Melissa Bird | August 20, 2008 at 10:00 AM

Of course people have the right to exercise their conscience. What they do not have the right to do is make MY exercise of conscience illegal if it doesn't coincide with theirs. And then to deny me the opportunity to seek others of MY persuassion, simply compounds the repressive and selective nature of many anti-choice activitists (wherever they make be ensconced).
If men were the ones who got pregnant, this wouldn't have ever become the "football" it now is.

Posted by: Diana Dee | August 26, 2008 at 06:00 PM

The availability of contraceeptives and lagal/ safe abortions is so important that is is no longer just an issue of womens health.

Posted by: MEGG | August 28, 2008 at 11:22 AM

I urge your strong support for the policy to protect pro-life doctors, nurses,medical workers and medical centers from being forced to be involved in abortions. What a terrible assault it is on individual conscience to force people to do something they believe is evil if they want to continue to practice in their medical professions. Our country was founded on the fundamental rights of the individual to follow his/her conscience.

Posted by: Jeanne Owen | August 28, 2008 at 11:43 PM