October 26, 2006

JERUSALEM — Ethiopian doctors are learning to fight their country’s massive AIDS epidemic in a clinic run by Israeli doctors, who have extensive experience treating HIV-infected Ethiopian immigrants.

As elsewhere in Africa, AIDS is a major health issue in Ethiopia, where hundreds of thousands of Ethiopians are infected with the HIV virus that leads to AIDS — up to 4 percent of Ethiopia’s population — according to doctors at Hadassah Hospital, where the two-week clinic is taking place.

That rate roughly carries over to Israel, forcing the Israeli medical profession to deal with the same kinds of cases facing Ethiopia.

The doctors said there are about 2,000 Ethiopian immigrants who carry HIV or have AIDS, about half the total for the entire Israeli population of 7 million. About 110,000 Ethiopian immigrants and their children live in Israel now, according to an advocacy group, the Israel Association for Ethiopian Jews.

“Even though they are currently living here, they still share the culture — the people are the same,” said Dr. Tilahun Degefa, one of the eight doctors and two nurses from Ethiopia participating in program.

The program arose from U.S. President George W. Bush’s emergency plan for AIDS relief, which allocated $15 billion to battle AIDS worldwide, including $84 million in Ethiopia.

Anti-retroviral drugs have been available in Israel for a decade, but have only become affordable in Ethiopia over the last three years, said Dr. Teklu Belay, coordinator of Ethiopia’s national anti-retroviral program. At the clinic, Ethiopian doctors can draw on Israeli research and its approach of monitoring patients outside the hospital, he said.

“The type of experience doctors get here cannot be given in Ethiopia,” said Dr. Shlomo Maayan, head of the AIDS center at Hadassah Hospital and coordinator of the clinic. “We tell the experience of treating patients for the last five, sometimes 10 years, including all the ramifications and all the complications.”

Also, a team of social workers, case managers, pharmacists and nutritionists help track psychological and social impact of the disease. This comprehensive program helps determine what factors can derail patients from the strict drug regimen.

“The reasons that people will not take their medication or will or will not behave responsibly with their virus are psycho-social and very often culture-bound as well,” said Estelle Rubinstein, the social worker in charge of monitoring the patients. “The central life issues have to be dealt with if people are going to continue to live, which is what the medication is now making possible.”

Since the program started four years ago, Maayan said the program has trained about 50 doctors. In turn, they have taught as many as 250 doctors in Ethiopia. “The number of patients who have benefited is in the thousands,” he said.

Of the 250,000 eligible for treatment, however, only a small percentage receive currently receive anti-retroviral medication, Mayaan said. “It means we still have a lot of work to do.”

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Jason Harris

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