A rare case of ancient schwannoma of nasal vestibule causing complete nasal obstruction: A case report and brief review of literature

Birhanu Kassie Reta; Andom Geremew Tesfay; Yordanos Birhane Gebrecherkos; Demelash Darota Dojamo; Yemane Leake Gebremichael; Dirar Medhanie Gebremedhin

https://doi.org/10.1016/j.ijscr.2025.111623

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@HakimEthio

Neonatal and congenital malaria (NCM): a case series in the Tigray region, northern Ethiopia

Yemane Leake Gebremichael; Hindeya Hailu Hagos; Birhanu Kassie Reta; Tiegst Bahta Woldu; Kinfe Redae Berhe; Fantay Gebremariam Gebrearegay; Gebremeskel Kiros Tsegay

https://doi.org/10.1186/s12936-025-05466-8

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Catastrophic Neurological Collapse Following Push-Up Exercise: A Rare Case of Spontaneous Hematomyelia Causing Acute Paraplegia in a Healthy Young Adult

Yegzeru Belete, Abera Kuma, Amanuel Anegagregn, Abdulkerim Girma
https://onlinelibrary.wiley.com/doi/10.1002/ccr3.70633

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A case report on the management of congenital urethroperineal fistula in an adolescent, a rare congenital anomaly

Samuel Fekadu Shiferaw, Mezgeb Gedefe Molla, Yoseph Abebe Feye

https://pmc.ncbi.nlm.nih.gov/articles/PMC11872632/

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🎉 A New Era in Vision Correction at Biruh Vision Laser Eye Clinic!

Biruh Vision has officially launched Ethiopia’s first dedicated Refractive Surgery Unit, offering world-class laser eye treatments that free patients from glasses and contacts.

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• SMILE Pro, Femto LASIK, PRK, PRESBYOND, PTK
• Phakic IOLs / ICL
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• Refractive Lens Exchange with premium IOLs

🎯 Who’s Eligible: Ages 18+ with myopia, hyperopia, astigmatism, or presbyopia.

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• 🎯 50% off for all patients
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• Daniel: 0911111486 / 0911649660
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Adress -Wollo sefer, Birra building, 3rd floor

@HakimEthio

Let’s Build a Stronger Health System together for Future Generations

A resilient and equitable health care system is the cornerstone or backbone of national development. It safeguards public well-being, strengthens productivity, and secures the future for generations to come. In our country, where health needs are high and resources are limited, genuine reform must go beyond slogans.

The time for strategic and inclusive reform is now, not only for the present, but for our children of tomorrow who will rely on the system we create today.

Key Challenges:-

1. Inadequate Health Financing: Low government budget allocations, excessive reliance on donor funding, and high out-of-pocket expenditures limit access and increase household vulnerability.

2. Ineffective Supply Chain: Frequent stockouts, weak logistics, and outdated procurement systems compromise the delivery of essential medicines and medical equipment.

3. Poor Health Information Systems: Delayed or inaccurate data limits evidence-based planning, performance monitoring, and policy implementation.

4. Low Public Awareness: Insufficient health education campaigns lead to delayed care-seeking, misinformed health choices, and a preventable burden of disease.

5. Insufficient Strategic Planning: Disjointed initiatives, inconsistent priorities, and inadequate execution lead to wasted resources and missed opportunities.

6. Misuse of Budget and "Ghost Projects": Funds are often misallocated to non-essential items such as luxury vehicles or incomplete infrastructure while critical services like maternal health and emergency care remain underfunded.

7. Corruption in Procurement: Non-transparent bidding processes, poor-quality construction, and inflated contracts drain scarce national resources.

8. Redundant Leadership: Overstaffed managerial hierarchies and politically driven appointments undermine institutional efficiency and meritocracy.

Sustainable, Action Oriented Solutions for Reform:-

1. Increase Health Financing- Expand domestic health budgets,Establish national health insurance to ensure equitable access, Reduce donor dependency through innovative domestic resource mobilization.

2. Strengthen the Supply Chain:-Digitize procurement and inventory systems,Modernize logistics to ensure continuous availability of essential commodities.

3. Develop a National Health Information System:-Implement real time data systems to improve planning, accountability, and policy response.

4. Promote Health Education and Community Engagement:-Use schools, media, and grassroots platforms to raise awareness and promote healthy behaviors.

5. Adopt Long-Term Strategic Plans:-Create measurable, inclusive, and adaptive plans involving all stakeholders.

6. Align Financing with Priorities:- Prioritize primary care, maternal health, and emergency services, Discourage spending on non-essential, prestige-driven items.

7. Professionalize Health Leadership:- Appoint qualified, ethical professionals based on merit,Streamline management structures to improve accountability and efficiency.

8. Digitize Finance and Procurement:-Use digital tools for real-time budget tracking and procurement transparency.

🔎 Critical Reform Priorities!!

1. Prioritize funding for essential, life-saving services such as maternal, emergency,and primary care over non-essential or luxury expenditures e.g Luxury Cars and unnecessary furniture.

2. Appoint ethical, professionally qualified leaders and ensure regular leadership rotation to promote innovation and accountability. Digitize budgeting, procurement, and financial tracking systems to enhance transparency and prevent fraud.

4. Empower oversight institutions such as the Ethiopian Healthcare Audit and Quality Agency (EHAQ)—to effectively inspect, evaluate, and update standards using revised checklists and transparent monitoring tools.

Finally, one crucial point that must not be overlooked is the recent nationwide concerns raised by health professionals. While leaders proposed solutions in response, these commitments must be implemented without delay.

Health system reform in our country is not about impressive statistics or aesthetic presentations. It is about equity, service, and measurable impact. Every birr must serve the health and dignity of the people not to lost to inefficiency or corruption. Let us act now with resolve and responsibility to build a health system that not only serves the present, but safeguards the health and dignity of future generations!!

Reference:-
1. https://pmnch.who.int/news-and-events/news/item/20-06-2025-harnessing-ethiopia-s-collective-strength-to-advance-the-nation-s-health-goals

2. https://www.vitalstrategies.org/new-initiative-launched-in-ethiopia-to-strengthen-health-data-and-save lives

3. https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0004470

4. https://p4h.world/app/uploads/2025/06/Strengthening-primary-health-care-in-Ethiopia.x80726.pdf

✍️ By Jafer Aliyi (Bsc, MPH).

@HakimEthio

When Nobody Leads: The Disappearance of Ownership and Hope in Ethiopian Public Hospitals

By a senior physician working in Ethiopia’s public health system

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Introduction

In many parts of the world, becoming a department head or medical director is a career milestone marked by honor, competition, and respect. In Ethiopia’s public health system—especially in the war-affected region of Tigray—the opposite is true. Physicians actively avoid leadership roles. They are assigned reluctantly, often by default, and leadership carries neither privilege nor power. It is a burden, not a goal. The result is a system that drifts without direction—one in which no one owns problems, and few believe improvement is possible.

This manuscript is a reflection from within. It is not detached analysis; it is written by someone who has worked in these hospitals, among these colleagues, facing the same pressures. It is not a statement of moral superiority. It is an attempt to honestly describe why so many of us have disengaged, what it has cost us, and what might be done to rebuild trust and responsibility.

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1. The Leadership Vacuum

Today, in many government hospitals in Ethiopia, physicians are uninterested in leadership. Department head roles are avoided because they bring no financial return and constant conflict. In some surgical departments, newly graduated specialists—former students—are appointed heads simply because no one else will take the position. These reluctant leaders are not given any budget, authority, or team. Their role is purely administrative. When things go wrong, they say, "I never wanted this job. Find someone else."

Leadership that is begged for cannot carry accountability.

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2. The Collapse of Ownership

Physicians are often present in public hospitals only during their scheduled tasks—rounds, operating room sessions, or outpatient clinic hours. Once their duty is over, they leave quickly, usually for private clinics where their income is meaningful. When problems arise—like missing surgical drapes or a broken autoclave—no one stays to ask why. No one walks to the sterilization room. No one checks. The surgery is canceled, and the surgeon walks away.

No one feels responsible. And so, the system deteriorates—not just from poverty, but from a complete breakdown of moral ownership.

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3. Why Ownership Disappeared

This collapse did not happen overnight. There was a time when physicians were present, engaged, and invested. But over time, private hospitals multiplied, salaries stagnated, and hope died. Many of us began to speak about our hospitals as if they were foreign places: "the system is broken," we say, without seeing that we are part of it.

Nobody wants a guilty conscience. So, we justify. We say: the pay is unfair; the government doesn’t care; leadership is useless. And we’re not entirely wrong. But over time, this justification becomes detachment. We protect ourselves by convincing ourselves: It’s not my job.

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4. The Bitterness of Choosing Integrity

Some of us believed we could give equal attention to public hospital patients and still make a decent living. We hoped the government would eventually build a strong system. We didn’t want to hustle around different places. We wanted meaning. But over time, that choice made many of us bitter—and financially strained. Others who embraced private practice early advanced quickly. Some now own hospitals.

There are moments when we feel guilt. But we don’t regret trying to serve fairly. We don’t think we were fools. We know that self-interest exists in us like in anyone. But we tried. And trying should not be punished.

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5. A Vision for Reform

We need a new structure, grounded in reality and dignity:

Hourly-Based Scheduling: Let doctors choose to work 1, 2, or 3 days a week. Pay fairly and audit attendance and presence.

Leadership with Incentives: Pay medical directors and department heads well. Give them time flexibility, clear budgets, and visible authority.

Presence Tracking and Quality Metrics: Monitor senior presence in wards, OPDs, and ORs. Make accountability measurable and respectful.

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6. A New Kind of Hospital

Some of us dream of starting a hospital supported by donors and philanthropists. It would:

Pay health workers per case or task, not per month.

Offer services at 30% of the cost of private hospitals.

Provide fair but flexible income for workers.

Unlike government hospitals, this system would create motivation through fairness. Unlike private hospitals, it would not exclude the poor.

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Conclusion

This is not just a leadership crisis. It is a moral crisis. A crisis of hope. A crisis of institutional soul. The public hospital can be redeemed—but only if we stop pretending, start restructuring, and honor those who still try to do what is right.

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Acknowledgment:
Parts of this reflection were shaped through extended conversations with ChatGPT, an AI assistant developed by OpenAI, used as a tool for reflective dialogue and drafting support. All thoughts, experiences, and conclusions remain solely those of the author and their colleagues.

Fasika Amdeslasie Gebrekirkos MD, MHPE, FCS-ECSA, FAIMER Fellow, Associate professor of Surgery, Gastrointestinal and laparascopic Surgeon, Quality Assurance Director of Ayder Comp Specialized Hospital.

@HakimEthio