Between 1983 and 1985, a deadly cocktail of adverse events, including recurring drought, failed harvests, food scarcity, two decades of wars, and other anti-government conflicts raged throughout northern Ethiopia and present-day Eritrea. These events ultimately led to the Ethiopian famine.
The famine killed 1.2 million people and compelled 400,000 more to flee the country. In 1984 alone, more than 300,000 people perished, and by 1985, around 2.5 million out of a population of 40 million were starving.
Josh Ghaim, an Eritrean by birth, was around 12 years old. His mother worked for the Swiss Red Cross at the border between Sudan and Ethiopia, where they set up refugee camps.
What Ghaim witnessed impacted his life decisions from there and onward. He vividly recalls there was no room even to properly bury the children who were dying due to malnutrition, starvation and primary diseases.
“Often, they were buried in a field outside the refugee camp, just outside one of the cities in Sudan,” he told Atlanta Black Star.
“For me, just thinking about all those children dying due to famine, lack of basic medicine and hygiene, and common [treatable] infections were a significant factor in why I decided to focus on health care,” he added.
Later, Ghaim moved to the US for college and studied biochemistry.
He went on to work in the consumer health space. However, two years ago, he accepted the position of chairman of the African Diaspora Network (ADN). This California-based nonprofit mainly focuses on mobilizing Africans who live outside the continent and connecting them with entrepreneurs, startups, and health care platforms to leverage their knowledge to help African countries.
The brain drain of African health care workers began in the 1960s and 1970s, with many medical students receiving international scholarships in Europe or North America but not returning home after graduating to avail better opportunities in the West. In the 2000s, motivated by attractive salaries and development opportunities, nurses, too, began migrating.
The development and improvement of healthcare systems in African nations are crucial. A 2022 study by the World Health Organization (WHO) found a severe shortage of health workers in Africa, despite countries’ efforts to strengthen the workforce. The study surveyed 47 African countries and revealed that the region has only 1.55 health workers (including physicians, nurses, and midwives) per 1,000 people, falling below the WHO threshold of 4.45 health workers per 1,000 people required to provide essential health services and achieve universal health coverage.
However, things are changing thanks to initiatives undertaken by immigrant African health care professionals.
The ADN participated in the 2023 Grand Challenges Senegal, an initiative by the Bill and Melinda Gates Foundation. This initiative draws from the lessons of COVID-19, helping ADN deploy external knowledge to aid in vaccine manufacturing, health care entrepreneurship, home diagnostics, digital health, and more in Senegal.
“Local teams often tackle the local challenges but are supported by members of the African diaspora, some of whom may be from Senegal or other parts of Africa,” says Ghaim.
Moreover, they identified a startup in Rwanda to conduct a pilot on telehealth, with funding provided by the Gates Foundation. The goal is to offer technical support and digital health platforms to enable remote consultations in Rwanda, potentially from a central location in a city like Kigali. It engages expatriate African medical professionals who speak the same native language as the patients and can easily connect with them. They work with local African health care workers to offer quality care by leveraging advanced technology like home diagnostics and AI systems, making health care more efficient.
The pilot checks if Rwanda is ready for a digital platform by looking at cellphone use and internet availability. The goal is to create central spots in remote areas where people can talk to doctors from cities like Kigali or Nairobi.
“Initially, we’re focusing on Rwanda. We believe this model could succeed in numerous other locations, especially in Kenya and Ethiopia,” says Ghaim.
Moreover, through its Builders of Africa’s Future program, ADN works with ten companies or entrepreneurs across Africa annually, whether they operate for profit or nonprofit, and provides training, grants, and funding through partnerships established by the organization. Additionally, the Network mentors and supports these companies and entrepreneurs to ensure their success.
However, it is not the only Diaspora-led initiative focused on improving health care on the African continent.
In 2011, 12 Ethiopian physicians who were close friends gathered to discuss ways to help their country.
Access to modern health care in Ethiopia is limited, especially in rural areas where it’s almost nonexistent. Most health care facilities are government-run, and although the country produces general practitioners and a few specialists through its medical schools, it’s not enough to meet the increasing demand for health care services.
“Whenever we traveled back to Ethiopia, we saw people struggling to access high-quality medical care. People frequently travel to countries like Thailand, India, South Africa, and Kenya to receive the medical attention they need,” said Tesfaye Fanta, an internal medicine specialist and president of the Ethio-American Doctors Group (EADG) who is originally from Ethiopia but is now based in North Carolina.
They agreed to form an organization, the EADG, to reach out to more physicians of Ethiopian origin globally and explore establishing a tertiary hospital capable of providing high-standard medical care in Ethiopia.
The idea was a success, and 350 Ethiopian-origin physicians were soon on board, contributing close to a million dollars to start a Joint Commission International-accredited hospital. EADG secured land from the government to construct a medical facility in the capital, Addis Ababa.
“We have experts working on the hospital’s development, which will be built in three phases. The first phase, costing up to $ 150 million, will include a 300-bed hospital, 80 examination rooms, an outpatient department, and a cancer center,” Fanta told Atlanta Black Star.
This first phase is expected to be completed in the next three years.
In the second phase, specialty hospitals will be established based on significant health issues, such as cardiology, cardiovascular services, specialty hospitals, and training centers. The third phase will involve constructing a 5-star hotel and convention center to support medical tourism.
“We have acquired enough land for all three project phases and are seeking investors to join us,” he added.
This is a for-profit hospital, but it will also have a nonprofit arm. Those who can pay must do so for their care. However, for those who cannot pay, funds will be obtained from the nonprofit arm of the hospital.
The hospital will be primarily run by doctors who are part of this project, most of whom are based in the United States, Canada and Europe.
“Many of them are interested in returning to Ethiopia to serve. Some will go for short periods, like six months to one year, while others plan to relocate permanently,” Fanta said.
Outbound medical tourism costs African countries millions of dollars in exchange revenue. These initiatives seek to reverse that trend. However, these tremendous efforts by expatriate African health care professionals have their share of challenges.
For EADG, the biggest challenge has been securing sufficient funding. However, Fanta said that the organization recently secured an investor who is genuinely interested in the project and willing to work with them. But for the subsequent two phases, more funding will be needed.
“The biggest challenge we face in Africa is that not every country has the same level of regulatory processes,” Ghaim said.
He said some countries make it easy to get approval, while others require more effort to navigate the process. This makes it difficult for ADN to transfer ideas between nations. However, he added, some countries have made significant progress and could serve as models.
Cost is also a significant factor. “There are many things that people in big cities can afford, but those in remote areas may not be able to,” Ghaim said.
Despite the challenges, both Ghaim and Fanta are hopeful.
In addition to the EADG and ADN efforts, there are other burgeoning diaspora-led initiatives, such as Flying Doctors Nigeria, the first air ambulance service in West Africa, which transports victims of medical emergencies.
