I’m in eastern Ethiopia with Henock Gazahegn of PSI. PSI is doing a great job here in providing safe drinking water with the PUR packets. We recognized PSI at the Clinton Global Initiative with the Live, Learn and Thrive Partnership Award for providing more than 200 million liters of clean drinking water in Ethiopia and thereby preventing millions of days of diarrheal illness and saving thousands of lives.
We got up at 5 am today to drive out of Addis Ababa to the eastern part of Ethiopia. During the drive, it’s good to hear from Henock that the PUR program continues to grow. Today, we’re going to visit an area that has some of the highest use of PUR in the country.
The rainy season has recently ended so there’s a lot of green shrubbery and grasses on the landscape that is typically very arid. Even with the rains departed for only a few weeks, it’s already dusty. Our drive has all the typical obstacles that I encounter in the developing world since our vehicle shares the road with people, donkey carts, and herds of goats and cattle. We have to stop frequently for a herd of cattle to cross the road and one obstinate cow isn’t very accommodating in letting us cross a bridge.
We’re spending today in and around Metahara which is the home of the largest sugar cane plantation in Ethiopia. It takes us more than an hour to drive across one part of the plantation. There are many villages or camps of workers and their families scattered around the plantation. Our first visit is with a woman named Mamitu Fikre. She’s a volunteer at the local hospital and has been trained by PSI to help show people how to use PUR.
Mamitu takes us to her home to meet her family. Her husband, Haile Kassa, has a good job at the sugar cane factory as a security guard and makes $1.50 per day. However, with Mamitu’s encouragement, the family has gotten into the business of making PUR treated water and selling it to their neighbors. Haile tells me that they make $1 per day in profit from selling PUR-treated water and the PUR packets.
They’ve been selling PUR for a little more than a year and recently bought a refrigerator so that they could provide cold treated water. They tell us that lots of their neighbors use PUR. While we’re chatting, one of their neighbors comes to buy 3 packets of PUR. This is a family business so their son Yabsira helps with preparing 5 to 6 batches of PUR each day. They buy nearly 500 sachets of PUR every month.
Henock tells me that there are now about 45 of these water vendors in Ethiopia and that they have a sustained business. PSI has had the most success in approaching people who already sold water and showing them how the vendors could increase their business and customer satisfaction by providing clean and safe drinking water by treating with PUR.
We visit the nearby water source which is the irrigation ditch for the sugar cane. We witness that the water meets all needs in this area. It’s a hot day, so boys are enjoying a swim in the ditch while others bath themselves. Right beside this, people gather their drinking water. It’s no wonder that there has been a lot of illness from diarrhea in this area and that there is now high demand for the PUR packets.
We say goodbye to Mamitu and Haile and drive outside the plantation to meet with Zeritu Endris of UNICEF. There has been severe malnutrition in this area and UNICEF is working with the government health clinics to provide nutrition therapy along with safe drinking water.
Shewaye is a health extension worker who provides support in this clinic. She goes from family to family measuring arm circumference to identify malnourished children. The malnourished children then receive Plumpy Nut and/or PUR packets. Shewaye tells us that ideally, they’d get both at the same time, and when they do the children can quickly recover.
She tells us that the water sources in this region are very contaminated. She explains that diarrhea from the unsafe drinking water aggravates malnutrition. Because the water in this area is very dirty, people like PUR very much. Shewaye says that with Plumpy Nut and PUR, the children can recover in 2 to 3 weeks. Not only is malnutrition a problem, but they lost 2 children and a mother from cholera this year because of the unsafe drinking water. Because diarrhea is a big cause of malnutrition, Shewaye says that it’s more important to have PUR than Plumpy Nut in this region. But, she’d prefer if UNICEF is able to provide both of them.
Our next stop is to the Ilala Health Station and we meet with Tigist Daadhii, another community health worker. She tells us one of the advantages of PUR is that people can find it in the local market and so it’s accepted. She shows us the records where she provided PUR to 300 families during the cholera outbreak. Similar to the other clinic, they’re currently out of both PUR and Plumpy Nut. She tells us that UNICEF is working with the government to help improve supply and that even for essential medicines they are out of stock about 50% of the time.
We meet some local pastoralists who have come for treatment at the clinic. The weather beaten old men are seeking treatment for some skin problems. They have a hard life living in this arid area tending their livestock in the heat. The desert-like conditions are great for camels and there are lots of them in this part of the country. Several of the pastoralists depend on the camel as a source of transportation, milk and meat. I’m not used to seeing a lot of camels and find them fascinating animals. 
We drive across the plantation to visit a town outside the sugar cane plantation called Minjar. The living conditions here are about the same as in the camps inside the plantation. Mekdes Mshaaw is a new mother of little Pagim. She and her husband are laborers in the nearby cotton fields. She shows us how they take the dirty water out of the nearby irrigation ditches and make it clear. She’s also a water vendor to supplement her income.
The PSI sales manager for this area tells me that PUR sells very well here with about 50,000 sachets sold in a month. We visit many of the shops and see that some of them are doing a good business selling PUR. One trader isn’t very happy because the availability of PUR has cannibalized his sales of water that is transported from a nearby town. But, he’s covering his bases by selling both the PUR packets and the water in jerry cans.
One trader, Yasin, sells a lot of PUR. In the rainy season when the water sources are typically dirtier, he’ll sell about 1000 packets a week and then sales taper down to about half of this during the dry season. He uses PUR at his own house and is quite thankful to have it.
It’s clear that PSI is doing a great job in targeting PUR to an area that really needs it. My next stop will be to learn about PSI Ethiopia and Family Health International’s efforts to provide PUR to people living with AIDS.
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