International development: Southampton's epilepsy service in Ethiopia

Southampton’s epilepsy team, in conjunction with the Tropical Health and Education Trust (THET), have been supporting an epilepsy treatment programme in rural Ethiopia since 1998.

Ethiopia has a population of about 80 million, 85% of whom live in rural communities with limited access to medical care. Epilepsy is at least as common in Ethiopia as it is in the UK, yet the vast majority of people with epilepsy in Ethiopia do not have access to treatment.

In rural areas it is still commonly believed that epilepsy is due to possession by evil spirits and many people are afraid that they will ‘catch’ epilepsy if they touch somebody with the condition. People with epilepsy in rural Ethiopia are, therefore, not only at increased risk of injury and death from untreated seizures, but are also stigmatised and excluded from their communities.

Initially, in collaboration with colleagues at Jimma and Gondar University Hospitals, nine nurse-led epilepsy clinics were set up at rural health centres around Jimma and Gondar, 330km south-west and 750km north-west of the capital Addis-Ababa respectively.

Access to drugs is limited and Phenobarbital is the only anti-epileptic drug that is consistently available. Nevertheless the programme has been successful in that more than 8000 people with epilepsy have received treatment and 80% of those attending clinics have experienced a major reduction in seizures (50% completely free of seizures). Successful treatment has transformed the lives of many people who are now accepted in their communities and are able to lead normal lives.

In 2010 the Trust with their partners in Jimma and Gondar were awarded a grant to expand the treatment programme by the International Health Links Funding Scheme (IHLFS), an initiative of the UK government’s Department for International Development (DFID). Nurse-led epilepsy clinics are now running at 17 rural health centres. Members of the epilepsy team in Southampton have developed training materials and support an annual training programme for health centre staff and health extension workers. Key staff from Jimma and Gondar University Hospitals have also benefited from short periods of training at Southampton General Hospital.

There is still much to be done, but it is hoped that the epilepsy clinics that have been established around Jimma and Gondar with the help of Southampton’s epilepsy team will serve as a model for the rest of Ethiopia and other low income countries.