Name: Solomon Teferra Abebe
Career: psychiatrist, researcher
Educational level: PhD
Awards: ‘Model Physician in 2016 in Zewditu Memorial Hospital’: Recognition for innovative service development at Zewditu Memorial Hospital
- Outstanding Contribution to Mental Health in Ethiopia’ an award given on November 21, 2018 at the World Psychiatric Association Africa Regional Congress hosted by Ethiopian Psychiatric Association.
- ‘Best Scientific Research Paper Award of 2019” by the Ethiopian Medical Association at the 55th Annual General Assembly and Scientific Conference held in Addis Ababa.
Certificate of Recognition by Mathiwos Wondu- YeEthiopia Cancer Society for ‘Endless contribution toward strong tobacco control law that complies with the WHO Framework Convention on Tobacco Control (FCTC) and alcohol legislation in Ethiopia, one of the strongest of its kinds in Africa’
He received his medical degree (MD) from Jimma University in 2000. He did his Psychiatry Residency Training at Addis Ababa University in a program jointly run by University of Toronto and Addis Ababa University, the Toronto Addis Ababa Psychiatry Project (TAAPP) in 2008, and then a Clinical Fellowship at the University of Toronto in Canada focusing on Addiction Psychiatry Subspecialty in 2013. He also received a PhD in Psychiatric Epidemiology from Umeå University in Sweden in 2011.
The Ethiopian Herald had a time of togetherness with Solomon Teferra (PhD)
The Ethiopian Herald: What is psychiatry?
Dr. Solomon Teferra: Specialization in medicine and deals with mental disorder.
Herald: What does psychiatrist do?
Dr. Solomon: A Psychiatrist is a medical doctor who specialized in diagnoses and treatment of mental disorder. We diagnose and treat mental disorder. In addition, we do researches on the metal health including basic and applied researches
Herald: What makes the treatment different from other treatments like psychology?
Dr. Solomon: It is a special team of medicine. Every scope of medicine has its own scope of practice. Every special team has its own area. We have specialist for, kidney, heart, skin, eye, urinary system and teeth, among others.
Psychiatrists are specialists for mind. They study how the human brain works, how thoughts are generated, how emotions are generated and proceed, and how human behaviors are processed under normal and abnormal circumstances.
In general, when someone encounters mental disturbance, psychiatrists have ways to correct disturbances by biopsychic social innervations. They fix such complications through different mechanism. In addition, we
often prescribe medicines for mental disorders.
In addition, we fix disturbances through different rehabilitations.
Herald: What does the operational status of the field look like in the country?
Dr. Solomon: We have to see this dividing it into two high and low income countries, because, it is a resource-dependent practice.
In general, it is well developed in the high income countries but there is a huge gap between demand and supply in the middle income and low income countries. Mental disorders account ten percent of diseases. But we say twenty percent of the population suffers from mental disorder.
These affected people need treatment starting from simple counseling to more complex services like hospitalization and long term rehabilitation, among others. These services need resources including skilled human power and equipment. We need policies, strategies, commitments from government and resource allocation.
As a country we are far behind. When you look at human resource, we do have 70 psychiatrys for a population hundred ten million.
In addition, we have very few clinical psychologists, social workers, and councilors. So, human resource in mental health is extremely low.
The aforementioned challenges have seriously affected the service in the country.
In terms of medication supply, the sector is beset by low supply. There is inadequate supply of medication.
In the new draft health policy, mental health has got priority. Before that we had no strategies and polices about mental health. So far, there was no priority about mental health. This is the result of the advocacy we have been doing and the government’s commitments. We had first mental health policy for five years which ended in 2016.
Currently, it has become very common to see people with mental disorder on the street of Addis and state cities and towns. Sometimes you see them jeopardizing the safety of the people and chilling the people. Even they hurt themselves. The problem is real and vivid. So, government should give its full commitment to mental health.
Herald: What should be done to expand the service in the country?
Dr. Solomon: I have been in mental health for fifteen years. The filed is in my blood even I was the president of Ethiopian Psychiatry Association. I was engaged in a lot of advocacy. I was assisting the government in different policy designing, and awareness campaigns in different media.
In addition, I had opportunities to look at best practices globally. The best practices show us that there is no one-size-fits all kinds of package.
Every country has to identify its priority problems and there should be commitment from the government that has to be translated to policies. So, it has to be explicitly included in the national health policy and in concrete action plans which can be implemented and evaluated.
Likewise, sufficient resource has to be allocated. We need to increase public awareness because in our society mental disorder is solely attributed to evil spirit, sorcery, and other supernatural causes rather than considering it as any other diseases.
If our society is not using psychiatry, things are not going to be fruitful. We have to deepen awareness in the community so that we can awaken the society to the advantages of the services that are available. It should go side-by-side with the policies and resources the country can afford.
Then, evaluating the interventions through different research activities and adopting different effective interventions elsewhere are necessary. Since it is a process, it takes time. There is no short cut.
Now, the world is espousing the idea of integration, easily people can get services. We have rehabilitation service only at Emanuel Hospital but if we integrate it to the existing hospitals and clinics, people easily can get the service.
So, task sharing with the general health services providers is also advocated as one of approaches to improve access. Provision of basic services, like medications and therapies which are evidence based and effective, is also recommended.
To face the challenge and do what we could, we have to train our human resources and build our capacities. We have to see to integrations of the services, medication, continuous evaluation, among others.
Herald: What is the role your institution is playing in terms of solving the shortage of the psychiatrists and to fill the gap between supply and demand?
Dr. Solomon: Like any other universities, Addis Ababa University Department of Psychiatry has three missions which are well-known. These missions include teaching. So, we teach problem-solving mental health professionals. We have been training clinical psychologists, psychiatrists and mental health epidemiologists in Ph.D. We have master’s program in clinical specialization and PhD program. It is real and it is our comparative strength. In fact, we have the only PhD mental health epidemiology in Africa.
So, we are training professionals in this regard.
The second mission is research. I am the PR of the principal investigator of four research projects. One of them is the largest human genetics study in Ethiopia since 2016.It operates in collaboration with Harvard University and MIT of US.
We also have research project which aims at developing novel approach, we have studies which evaluate adaptation of interventions, and we have studies which look at the distributions and types of mental disorders in the country. So, we have research projects that spans from basic researches to applied researches, molecular research, epidemiology and so on.
In terms of research activities, we are the second in the sub-Saharan Africa after South Africa. We have built a very strong culture of research in our department. In addition, we produce a lot of publication to the review journals.
The other mission is community service. Community service is the application of knowledge we generate and also we use the community as the resource for training our students. We have different clinics across the cities’ hospitals and health centers. We provide services and treat patients daily.
Likewise, we also participate on the community awareness campaign through different media.
We run different institutions that serve the community like Mental and Society of Ethiopia which helps people with mental disorders and as well as campaigns like fighting stigma.
Our departments fulfill the three missions of Addis Ababa University.
Herald: What causes mental disorders?
Dr. Solomon: Again I go back to the biopsychic social model. It is very famous in mental health. It integrates biological causes like diseases of the brain and mental disorders. It includes genetic predisposition. In addition, mental disorder runs in families through genes.
Addiction is also one the causes for mental disorders and different diseases including HIV. Other diseases which affect the brain, can lead to mental disorder.
Another cause is psychological. Stress can lead to mental disorder, emotional problems, violence, disturbances, and among others, can lead to mental disorders. Moreover,
social problems like poverty, deprivation, breakup of families, abuse within the family, unemployment, war, natural disasters, and displacement are the risk factors for mental disorder.
Biological factors are the risk factors for some.
Finally, I want to convey the messages for different mental health and stakeholders. My first message for the government is “Mental health is an integral part of health we cannot give full service without considering the mental health. It has to be an important component.
It has to be accorded focal attention.
My message for the public is mental health is not the result of curse or other supernatural attacks. Most people are suffering from mental health due to disturbances in their brain which are treatable and correctable. So, it is better if they bring the people whom they love and care about to health centers. The other challenge lies in stigmatization. Mental health problem should be treated along with other diseases. We have to give them love and care. Then we can assure their full health.
The Ethiopian Herald Sunday Edition 28 July 2019
BY AMBO MEKASA
