1. Working with professional societies: The Ethiopian Experience Abebe Bekele, MD, FCS Consultant Surgeon: Addis Ababa university Secretary General, Surgical Society of Ethiopia

2. Introduction: Why Gambella? RegionsHIVCircumcision National figure1.4%93% Gambella6%46% 2 Source: DHS, 2005,CSA Ethiopia and ORC Macro 9/12/20152MC report: Arusha

3. 3 Introduction: Why Gambella CharacteristicsCircumcisedUncircumcised Urban Rural 2.4% 0.6% 10.7% 0.6% Oromiya SNNP Gambella 0.3% 2.3% 1.7% 0.7% 9.8% Source: DHS 2005, CSA Ethiopia and ORC Macro

4. Gambella 9/12/20154MC report: Arusha

5. SSE and MC activities Evolved from discussion between two friends - 2006 (from SSE and Jhpiego Ethiopia). SSE came on-board: October 2007, after SA conducted in Gambella and three delivery sites selected. Series of discussions: Resulted in an excellent relationship Currently, one surgeon from SSE consults for Jhpiego Ethiopia. 9/12/20155MC report: Arusha

6. Achievements (SSE and Jhpiego) National MC program launched during the SSE 13 th AGM: January 2008 The three MC sites equipped with full MC utilities: Ongoing Two consultative meetings conducted: Gambella and SNNP MC training tools adopted and used. 9/12/20156MC report: Arusha

7. Achievements (SSE and Jhpiego) MC teaching video about to be completed Huge billboards, brochures, fliers and patient information produced. Recording and reporting formats developed Country guideline developed: Under revision SSE sits at the national TWG 9/12/2015MC report: Arusha7

8. Achievements : Campaigns Three already conducted, beginning October 2009 – 1776 circumcised SSE recruits qualified surgeons, dispatches to Gambella MC campaigns linked to General Surgery out-reach programs Six campaigns planned as of July 5 th. Campaigns are currently independent: SSE Sub-grant 9/12/20158MC report: Arusha

9. Achievements: Trainings Training package endorsed and adopted by the SSE. Center of excellence at the Black Lion Hospital Surgical Skills lab and theatre available. Two trainings conducted: 30 Non-doctors and 5 MDs trained (task shifting) 102 and 256 circumcised Local surgeons (members) as trainers. 9/12/20159MC report: Arusha

10. SSE ‘metastasis’ SSE approached by Jhpiego office. Three volunteer surgeons dispatched to Swaziland. Willing to assist upon request 9/12/201510MC report: Arusha

11. Program Challenges Extreme weather condition: as high as 40 degrees Interrupted electricity, very bad roads Limited fund Distance: Service sites far from the real needy population Inability to provide MC services on regular basis High turnover of trained staffs 9/12/201511MC report: Arusha

12. The way Forward Potential to scale-up the MC program: – More sites in Gambella – SNNPR in the next site – NDFE: SA to be done Mobile MC centers (can we copy mobile VCT centers?) SSE administered dedicated MC centers Bring other societies on board: Nurses…… 9/12/201512MC report: Arusha

13. Thank You Very Much!! Saturday, September 12, 2015 Abebe B. 13