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Forty-five minutes by car southeast of Ethiopia's capital, down a dirt road shared by vehicles, donkey carts, and schoolchildren, a modest building enclosed by high stone walls stands outside the town of Debre Zeit. Inside, patients sit on benches waiting for medical attention. Bishoftu Health Center is the primary medical facility serving the 65,000 residents of this sprawling agricultural community.

Clad in a white medical jacket, Rahel Terefe Bogef darts between dim examination rooms and the bright outdoor corridors of the health center, splitting her time between patients and a visiting group of African ministers who have come to observe the facilities for the day. They have traveled from across the continent to learn firsthand how the Ethiopia Public Health Training Initiative, assisted by The Carter Center, is helping to educate 5,000 new health officers such as Bogef to serve the country's population.

Bogef, who has worked at Bishoftu for four years, since graduating from Alemaya University, is one of an estimated 800 health officers in the country forming a revolution in qualified health care providers helping to fill an alarming void left by the migration of skilled health professionals to wealthier countries. Similar to physician assistants in the United States, health officers oversee medical centers in Ethiopia; physicians usually are found only in hospitals.

People here suffer daily from maladies such as diarrhea, malnutrition, malaria, and HIV/AIDS, yet nearly half of Ethiopians do not receive any health services. Bogef said officers like her are helping to change the face of health care delivery in rural Ethiopia: "Patients can now see health officers regularly, and many complicated cases can be managed in our health centers instead of having to transport patients to hospitals."

For more than a decade, the Ethiopia Public Health Training Initiative, a partnership between The Carter Center, Ethiopian government officials, and faculty from seven Ethiopian universities, has tailored detailed health science curricula and workshops to address specific health care needs in Ethiopia and provided much-needed lab and research materials for universities. These have strengthened the education of thousands of health care workers, improving health care delivery for 75 million rural Ethiopians.

The need for skilled health workers is a continentwide issue in Africa. Ministers from Nigeria, Uganda, and Benin touring the well-equipped labs and exam rooms of Bishoftu Health Center were participating in a February 2007 conference in Addis Ababa to discover how methods of the Ethiopian health care initiative might translate to their countries.

"Several ministers expressed a desire to return to their home governments and relay Ethiopia's unique health education model, with the hopes of adapting its elements to their own countries' situations," said Dr. Joyce Murray, director of the Ethiopia Public Health Training Initiative. "But even if these countries do not immediately replicate the program, the conference is a success, as we've planted the seeds of the initiative's philosophy and introduced a lot of possibilities for the future of these countries."

Photo credit: Carter Center/ A. Fiorente
Health Officer Rahel Terefe Bogef (second from right) records her patient's information at Bishoftu Health Center near Debre Zeit, Ethiopia.

Photo credit: Carter Center/ A. Fiorente
A child is examined by a health officer at Haramaya Health Center in Ethiopia.

Photo credit: Carter Center/ H. Wondimu
Outside Bishoftu Health Center, a woman and her child wait for a checkup. Health officers provide improved services to thousands of rural Ethiopians who would otherwise have to travel great distances to receive care.