The 69th Session of the United Nations General Assembly (UNGA) has seen national delegations from around the world convene to debate and dialogue a wide range of topics including, inter alia, a post-2015 agenda, climate change and the environment, conflicts involving ISIL/ISIS, Iraq and Syria, Iran’s nuclear ambitions, Gaza, and the ongoing tensions between Ukraine and Russia. Another important, yet less heralded, meeting occurring is Eritrea’s hosting of a panel on “Innovations Driving Health Millennium Development Goals” – where the country will share the methods for its success. Such a development represents a tremendous leap; only decades ago, Eritrean “society” literally resided within underground trenches, caves in the mountains, and in the harsh, barren deserts.
To the uninitiated, Eritrea’s focus upon and commitment to health began in earnest in the late 1960s and early 1970s, during the early years of the protracted war of independence. In developing a medically sound health system, the Eritrean People’s Liberation Front (EPLF) prioritized: “…proper nutrition; adequate and safe water supplies; basic sanitation; immunization; the prevention and control of endemic disease; health education and curative services” (Pateman 1990: 222).[i]
Although in 1970 it only possessed a single mobile health unit, the EPLF was soon able to boast: having trained 1600 barefoot doctors and forty-one barefoot midwives (by 1985); 418 village health workers and 150 birth attendants (by 1986); thirty functioning health service stations and twenty-two health centers; forty-one mobile barefoot health units; 320 village health workers; 41 radio technicians; 18 dental assistants; 151 nurses; six regional and one central hospital (Pateman 1990: 22).
Of particular note, the EPLF’s central hospital at Orotta, in Barka, and the pharmacy unit hold legendary, almost mythical auras. The Orotta hospital was often distinguished as the “longest hospital in the world” since it was built into the underground maze of trenches and tunnels,[ii] and it was the scene of thousands of operations performed by EPLF surgeons. Equally impressive, the EPLF’s pharmacy unit was made up of twenty-two members, and “…by the end of 1987 it was producing fourteen types of tablets and capsules – two million per month – and hoping to provide…for sixty percent of the population’s needs” (Pateman 1990: 222) Further, it produced 44 different types of medical supplies, including infusions, intravenous fluids, syrups and ointments.[iii]
Yet, even though these efforts were key to Eritrea’s momentous liberation and embodied the EPLF’s commitment to the health of the population, at independence the country immediately faced destruction upon a mass scale, “…everything was destroyed [and there were]…no roads, no electricity, no water.., no education…nothing was there”; for all intents and purposes, Eritrea started from well “below zero.”[iv]
Since that point however, Eritrea has remained staunchly committed to fulfilling citizens’ rights to health, and ultimately witnessed tangible, positive development outcomes – in spite of an array of socio-economic, regional, and global challenges. Such success is the fruit of a self-reliant approach, a capacity to adapt to adverse circumstances, effective coordination, multi-sectorial, cost-effective projects, community involvement enabling improved health-seeking behaviors and widespread buy-in – and the relentless efforts of innumerable men, women, and children around the country.[v] Who could have scripted how a low-income country, located within one of the world’s most volatile, fractious regions, went from surviving in underground trenches and mountain caves, to sharing the lessons of development success at the United Nations?
[i] Pateman, R. 1990. Even The Stones Are Burning. Trenton, NJ: Red Sea Press.
EXTRA SOURCES (health specific)
Photo courtesy of Solomon Abraha – @solomonasmara