Poor rains bring harsh and widespread damage that reaches beyond simple water shortages. The downstream consequences from crop and livestock failure create a dangerous spiral: Hunger and malnutrition lead to increased rates of infectious disease that drain resources and suppress productivity, which, in turn, leads to further food shortages and hunger.

At the same time, lack of water limits the use of sanitation and hygiene practices, and the few water sources that do exist become centers of overcrowding and contamination as well as reservoirs for disease. he combination of malnutrition, overcrowding, and contamination can destroy a community. Carter Center Photos

Managing health in disaster situations requires specialized interventions and, thus, explicit training. In response the 2002-2003 drought, the Ethiopia Public Health Training Initiative began a project to combat the frequent drought-related health and nutrition problems. The initiative was in a unique position to provide assistance to the affected communities because of its established training model wdithin the colleges and universities. Ethiopian faculty and students were the impetus for the drought response project, a testament to the personal and community empowerment fostered by the initiative.

Every health student is required to complete a practical field training component in his or her senior year. Usually these assignments are in nearby communities and in conjunction with a university-related health center. In response to the drought, 2,191 students were deployed instead to drought-affected communities to fulfill their practical experience. In a remarkable display of dedication and compassion, many of these students stayed on past their required time commitment to continue providing these essential services.

Staff and students deployed by institution, region, and population benefitted

At the completion of this field intervention, it was determined that because droughts are a recurring problem for this region, preparation and training are needed to prevent and manage future droughts. The Ethiopia Public Health Initiative agreed to build on the existing university partnerships to develop and integrate drought response training into the curriculum.

Major topics of focus include:

Nutritional/Therapeutic Feeding
With the severe crop and livestock shortages, quality becomes as important as quantity. If limited foodstuffs are available, it is crucial that the most nutritional and beneficial foods are consumed. Therapeutic feeding is often for the severely undernourished, usually children.

Epidemic Control and Preparation
The most common disease outbreak associated with the drought in Ethiopia was malaria. Under Trained 2,000 health workers nourished children are the most at risk for contracting malaria, although during a drought adult cases are also more frequent. In addition, diarrhea rates dramatically increase, as it most often is caused by the spread of bacteria and parasites through contaminated water supplies. Controlling an epidemic involves unique strategies not normally utilized in basic health care services

Maternal and Child Health Mothers and children are the most severely affected by droughts because they are often already malnourished or have compromised health. Specific interventions, such as immunization, therapeutic nutrition feedings, and malaria prevention, need implementing to improve the health of these vulnerable populations.

Immunization Programs
The droughts in Ethiopia often occur in regions with particularly poor health indicators and extremely limited health services. Improving basic health services, such as increasing immunization rates, especially measles immunizations, in nondrought years, will go a long way to reducing the levels of disease and death during future droughts.

Summary of preventive activities by training institution