Construction Health Center

Strong need for health center Burka Faya!

Urgency
Ethiopia is a country with a population of 105 million. Almost 50% of the population is younger than 18 years. It is a beautiful country, but health care is poorly organized. The number of doctors per person is worryingly low (1 on 36,000) and many doctors work in expensive private clinics. Hospitals run by the government have a bad reputation. For the poor, access to basic health care has always been absent and the situation seems to worsen even more.

The organization TTAF (The Three Aid Foundation) feels the need to address this issue and therefore took the initiative to build a  Health Center with a number of smaller satellite clinics south of the capital Addis Ababa. In that area, it has been committed for 18 years to helping the poorest of the poor, with programs for small-scale microfinance, education for the blind and organizing medical missions with local doctors who are specialized in eye care. TTAF therefore knows the needs of the local population.

Project
Early 2021, the construction of the relatively large-scale Health Center named Burka Faya was started. In Amharic this name means ‘source of health’. For an Ethiopian, this is a very appealing name! After an energetic start, unfortunately, there came a difficult period in the project. The Covid-19 crisis with all its travel restrictions took its toll. Besides, the project also had to contend with the international logistical problems and steep price increases of construction materials. All in all, this delayed the project by more than a year and a half. Fortunately, under the leadership of two Ethiopian project managers from TTAF, Ayano Burka and Zenebe Ayele, hard work is being resumed since August 2023. It is expected that the opening ceremony of the Burka Faya Health Center could take place in April or May 2024.

Sashamene is the city where the Health Center is being built and is located about a 4-hour drive south of the capital Addis Ababa. Because of its location and the roads available, the city is well and easily accessible from all directions. It is one of the most densely populated areas in Oromia with nearly 3 million inhabitants. For the entire area, there are only 4 government hospitals and 2 private hospitals. The need for good medical care is very high and cannot be filled in the short term.

TTAF is well acquainted with the situation in Sashamene, because in this area so-called eye-missions (medical missions, focused on eye problems) are organized annually by TTAF. In addition, Ayano Burka has been living there for the last few years, so he has good contacts with the city council and the local population.

A clinic providing first aid
In Ethiopia, we recognize 3 levels of healthcare facilities: clinic, health center and hospital. Everything is tightly regulated from the government. A clinic provides the most basic care. A hospital should facilitate 100 beds with the necessary medical team. In between is the health center. In the Dutch context, this can best be compared to an extended family doctor’s office, where primary care can be provided. In addition, there are 6-10 beds and there is a facility for deliveries. The whole is under the direction of an experienced physician. The Health Center focuses on the following areas:

• General care; daily consults, prescribing medicine, small medical procedures
• Care for mother and child; assistance for pregnant women + childbirths
• Eye-treatment; blindness is a common issue and for instance cataract surgery is very effective
• Treatment of tuberculosis and HIV/AIDS; TBC is a common and lethal disease.
  

Free healthcare for the poorest
The Health Center has the objective to treat 20%-25% of the patients free of charge, in order to make health care accessible to the poorest. Free of charge means that they, like every other patient, have to pay a small registration fee, but that the consults, medical exams and lab-tests are all for free. Selecting the poorest is fairly simple, because the Ethiopian government already provides this group with a special “pass” that gives them free access to certain basic facilities.

I’m especially moved by the great number of young girls that get pregnant, drop out of school, live on the streets and get socially isolated. That is a big problem in this region. With the right means and clear information-sessions we hope to address this problem – Ayano, projectleader

Partnering with the local community and institutions
The local community is involved in the development of the Health Center. The local people requested support of the plan from the local government. The mayor of Sashamene is personally involved, because of this request. In the Health Center surgery is not possible for example. That is why partnering with the other healthcare institutions is of great importance. Burka Faya has already made connections with the following: the local public hospital of Sashamene, the Grarbet Hospital in Ziway (eye clinic) and Batujera and with Hamlin Fistula Hospital in Addis Ababa.

Unique Selling Points of the new Health Center
The new Burka Faya Health Center is different from many existing clinics. From the very conception, a sustainable business model has been considered from a business perspective. We are therefore convinced by the following USP’s:

• Sustainable and a financially independent business model, where risk diversification is an important aspect!
• Profits do not go to shareholders, but instead are invested in scaling up the program
• The poorest of the poor also get access to health care through a poor fund securing free help for 20-25% of the patients.
• In the longer term, building a network structure where multiple clinics are connected to the central Health Center.

Impact
Each year 50,000 patients will be served; in the course of next 5 years 250,000 patients will benefit! The clinic will be professionally run and will have great impact on various issues, like:

• Better accessibility: hundreds of thousands of people will soon benefit from a clinic within a reasonable distance. Many patients are unable to travel long distances; they do not have motorized transportation or they still go by horse and carriage.
• Better access to medicine: due to a lack of well-managed medicine stocks, many of the existing healthcare centers have large deficits of medicine.
• Better preventive action: a clear example is prevention of Trachoma. It is a common eye condition that can lead to blindness. With good hygiene and awareness (flyers) these conditions can easily be prevented.

Investment and running costs
Realizing the Health Center will require quite an investment. The starting point of the entire plan is that the TTAF Foundation and its donors will provide the investment capital to realize the construction. After a short start-up phase, the Health Center should be able to run financially independently based on its own income. The latter, by the way, is not wishful thinking, but has already been proven in practice. In fact, Ayano Burka has a similar clinic in a nearby region of Kofele. The costs for the realization of the new Health Center total €950,000.

MissionInvest is committed through its network to realize € 240,000 in donations for this amazingly beautiful project. As of December 2023, approximately € 92,000 is still needed! This amount is needed to purchase medical equipment and equipment such as beds, incubators, wheelchair, ultrasound machine, blood testing devices, etc.

After completion of the Health Center, the plan for phase-2 is to continue building a network structure of satellite clinics connected to the larger Burka Faya Health Center. The average cost per satellite clinic will be approximately € 250,000.

MissionInvest has been involved in various projects in Ethiopia for many years; over the years a bond has grown with the country and its people. The very inadequate health care is distressing, which is why we would heartily recommend this project. Not only because it meets urgent needs, but especially because of its business approach and financial sustainability! With such an approach, we can really make a difference!