Seventy-seven million people live in Ethiopia. Those who need treatment for mental health and addictions issues have only one facility to help them. Amanuel Hospital is located in Ethiopia’s capital, Addis Ababa, and houses 361 inpatient beds with an average stay of 63 days. Limited resources don’t begin to describe the challenges clinicians face in this hospital.
CAMH Occupational Therapists Tara Laing and Natalie Quick saw this first-hand when they visited Amanuel Hospital as part of Toronto Addis Ababa Academic Collaboration (TAAAC). This is an academic partnership between Addis Ababa University and the University of Toronto designed to build and strengthen capacity in medical and other professional programs.
CAMH OTs Natalie Quick (left) and Tara Laing visit the Church of Saint George in Lalibela, a town in northern Ethiopia.
Tara’s and Natalie’s program— Rehabilitation Medicine/ OT— was started to help with the ongoing development of a psychiatric rehabilitation program at Amanuel hospital and to provide teaching and mentoring to staff.
“Rehabilitation and community re-integration are not consistently addressed in their patient care,” says Tara. “When a patient is admitted, the goals are mostly medical in nature and usually consist of making an accurate diagnosis and initiating appropriate medication.”
“We worked together to adapt the group program to make it more structured and recovery-oriented,” says Natalie. “We also worked with staff, clients and families to address any attitudes or practices that would interfere with treatment.”
“It was interesting that they didn’t really have words in their languages for some of the concepts we were sharing,” says Tara. “We worked on developing new ideas for recovery and rehabilitation using metaphors and proverbs.”
Stigmatizing attitudes about mental illness in the Ethiopian community creates many barriers. Other challenges arise from little to no access to printers, internet, paper, pens, phones, and computers. Compounding these limitations are staffing shortages, poverty and lack of infrastructure.
“We appreciated how optimistic and effective they are in their work despite many barriers and limited resources,” says Tara
Strengthening the rehabilitation program at Amanuel Hospital and increasing the opportunity for clients to engage in meaningful activities will continue to be a priority. Part of the work of future OT visits will include building on evidence-based practice and program evaluation.