My name is Fikre Seife Gebretsadik, but everyone calls me Fikre. I was born and raised about 300 kilometers north of Ethiopia’s capital city Addis Ababa, in one of the most Trachoma endemic farmland areas. In fact, I too was affected multiple times as a child, as well as my parents, close family members, friends and pretty much many people I knew growing up. It was one of those things that we had learned to deal with. You know whether we caught soil transmitted helminths or trachoma, we’d stay home from school until we got better, then go back to school, get sick again and stay home for months sometimes in a bit of a cycle. At the time we didn’t know that we could get medical help for these ailments.
“When I think back to those days and reminisce on the circumstances in which I was brought up and when I think of the current situation, the work I am currently doing gives me deeper meaning.“
Fikre Seife
Though many things have changed over the years I realize that not much has changed at all as many still suffer from the same diseases I grew up battling. I often think of how privileged I am to be working in the very same field that benefits the community I grew up in and I get emotional. The majority of the Ethiopian population are farmers and low income earners. Having come myself from a similar background, I fully understand what the challenges and obstacles could be especially when trying to implement preventive measures against NTDs.
I find it unfortunate that these diseases, though preventable, are predominant in poverty stricken areas and in turn, exacerbate the poverty cycle because of the impact it has on people’s ability to fend for themselves while either caring for their loved ones or themselves. At the time we didn’t really know the type of impact these diseases would have on the development of a child and how much more it contributes negatively to the poverty cycle that the communities are already trying to break away from.
The NTD program as a health program was only started a little over a decade ago so the concept of going to a health facility to seek help for some of these diseases that we basically grew up with was unthought of – no one knew they were preventable or that quick relief options existed. Knowing what I know now about how preventable trachoma is and understanding the benefits of Mass Drug Administration campaigns I am dedicated to raising awareness and doing more to help my country not just as a professional in the field but also as a fellow countryman.
I had always wanted to be a doctor. It was a job that was revered and respected but most of all there was a high demand for qualified doctors where I grew up. I remember, one of my close relatives who was heavily pregnant couldn’t get to a health facility in time to give birth, granted the closest health facility was miles away and transportation was nonexistent so she never made it and though I was in 9th grade I always felt bad that I couldn’t do anything for her.
That was one of the first memories that made me want to become a doctor but as life often goes that didn’t happen in the way my childhood heart dreamt it, as I was somehow never assigned to the medical school during placement after our 12th grade University entry exams. The choices I had given myself for my future were limited – if I wasn’t becoming
a doctor I was going to be a public health officer. My drive to somehow contribute to the medical field was initiated by my dying relative but it was intensified by my visits to family members in the capital city where medical facilities looked well equipped and women didn’t give birth at home; I was inspired from a young age to want better for the community I grew up in.
I started off by getting my Bachelors degree in public health, after which I was immediately assigned to be the primary health care unit director of a health center in the Tigray region of Ethiopia. As the head of a primary health care unit my main task was of course to ensure that patients got the curative care they’d come for but my elemental task was making sure that preventive measures were given priority.
Ethiopia’s Health care policy is first and foremost one of prevention and my mission as director was to ensure that the 18 health extension preventive care packages were being implemented across the unit and communities I was serving. About a year after my position as director in Tigray, I requested to be moved to a different region so I could be closer to my family where I ended up working for two years. During those two years, I was focused on simultaneously supporting health promotion activities such as ensuring that mothers and babies got vaccinated in time, encouraging births in medical facilities and encouraging the use of birth control and the like. That was the experience that allowed me to have hands-on involvement on the medical side as well as in the advocacy work that was required; and that was around the time work on trachoma MDAs was started and my entry into the world of NTDs slowly but surely began.
After three years of serving as a primary healthcare unit director I landed a vacancy advertised by the Ministry of Health for a regional technical assistant role in the Somali region where I worked for a period of two years and nine months. My objective during that period was to strengthen and build the capacity of the WHO approved main 6 building blocks of the health system which include logistics management and human
resources management among others. It was after serving close to three years in that role that the Ministry of Health integrated me back; I was asked to pick between working on Tuberculosis (TB), Malaria or the NTD program.
At the time I had felt more comfortable working on the TB program because it was something I was very familiar with and I remember thinking if I don’t make the cut my backup would have been the Malaria program because I had no clue what the NTD program even was, other than a vague understanding of what the MDAs were the notion was brand new to me. How I ended up being the National NTD Coordinator baffles me sometimes because if it wasn’t for the then Director of the program I would have probably been somewhere else in life.
The director at the time advised me to consider the NTD program because of my background in coordinating MDAs, trichiasis surgeries and the like and encouraged me to look at the opportunities the new program would open for me in terms of the space it would allow for contributions as opposed to mature programs with ample experts in the other fields.
“I was convinced to give [the NTD program] a shot in 2016 and so I became the Schisto STH national focal person and here I still am years later.“
Fikre Seife
Since joining the NTD program I have continuously kept myself abreast of updates in the industry because over time I found it to be my calling – the more I read and learned the more I realized how closely related to my childhood experiences the work I was doing was. Somehow it feels like I have found a way of avenging my community by working on eliminating these diseases that have been impacting us. When the previous national coordinator resigned I got promoted and I have now been serving in this role for a little over 5 years.
I have since pursued my Masters in Epidemiology which allowed me to strengthen my career and most importantly to contribute more holistically to the NTD sector. Where we have reached now, after a decade of work, is promising to me because we are currently working on submitting the elimination dossier for trachoma and lymphatic filariasis since we have reached the WHO approved threshold for both diseases and this is the kind of progress that keeps me striving.
What I am most proud of in all these years of serving my community and my country in the NTD sector is by how well the healthcare system is structured; it is a system that is robustly laid out from the bottom to the top of the chain and it is a system that is streamlined within itself as well as one that is aligned with other sectors such as the water and sanitation ministry and the education ministry for example.
The biggest hope I have is that the current success stories that we can show prove in fact that eliminating these diseases will eventually be a reality. At the moment we are a country-led program with up to 80% if not more of the activities being implemented by locals and where we struggle is the funding gaps that we have at the national level when it comes to prioritizing NTDs despite the budget that is allocated towards NTDs. My wish is to make sure that the communities take their health into their own hands and that we start working towards a more sustainable approach by ensuring that communities take up the mantle – I want to see community ownership and community engagement vis a vis NTDs and hopefully one day we will no longer need to keep seeking the outward help to fill the financial gap we face in the sector.