All refugees in the urban program have been referred to Addis Ababa for a specific reason. This reason can be protection or security issues but in most cases it is because of health problems that cannot be treated in the camps. This means many of the refugees that arrive to the urban program are very sick. DICAC therefore put much effort into facilitating medical and psychological health care as well as providing medicine, rehabilitation materials and special diets.
The social service department is organized with a registration office, a head office and specialized officers that supports with different types of health problems. For example there is one officer working with mother and child health, one with HIV/AIDS, one with gender based violence and one with chronic diseases. The officers provide counseling and refer the patients to different hospitals that DICAC is cooperating with.
The office also works with preventive health care. Through different workshops DICAC tries to raise awareness about issues such as sexual- and reproductive health, HIV/AIDS and maternal health. The trainings are normally held in cooperation with donor organizations such as the UNHCR and are led by DICAC staff and external experts.
The system of ambulance emergency transport in Addis Ababa is underdeveloped and inefficient. There is a general lack of ambulances and it takes a long time for them to arrive, most Ethiopians prefer using the car of a neighbor or a friend in emergency situations. As the refugees often do not have such contacts DICAC has its own emergency hotline that is open 24/7.
DICAC-RRAD office assigns one person from its medical staff as duty officer every week. This person will always be available on the emergency telephone number. The duty officer will assess the situation and make the decision that urgent transport to hospital is needed.
When the duty officer decides that emergency transport is needed she or he will send an ambulance from the main office. The demand for transport is high and persistent but the capacity is only enough for those emergency cases it is intended for. Mainly the transport is provided for bedridden patients, pregnant women and new refugees who have an emergency medical status according to the UNHCR.
During the days there are also care givers on standby, these are refugees who are volunteering to help others who are sick. The care givers are given a special training and then accompany the drivers in the ambulances. They also wait with the patients in the hospital to make sure that they get help and stays in contact with the main office to get approval for the treatment. Each care giver works one week a month and there are always two of them working at the same time.
The emergency support faces key challenges. There is a lack of ambulances as well as care givers. It is a very important service though which also UNHCR has acknowledged by providing DICAC with the ambulances.
Mother and Child Health
DICAC has a special section for mother and child health care. This includes various matters such as ante- and post natal care, family planning, counseling, different psychosocial services and awareness raising trainings.
Pregnant and newly delivered women can come to DICAC for counseling and psycho-social support. DICAC helps the women to prepare for delivery, provides antenatal care follow up as well as gives advice on breast feeding and other post-natal matters including child vaccination and mother and child sanitation. The organization also provides ongoing counseling for HIV positive pregnant women to continue medication and prepare exclusive feeding for prevention of mother to child transmission.
In addition, DICAC advice and supports women with family planning. A number of different methods are offered and women get professional advice to help them chose their own preference.
Awareness Raising Trainings
DICAC conducts awareness raising trainings for about 300 urban refugee women every year. Topics include family planning, sexual and reproductive rights as well as maternal and child health. The trainings are led by different experts from the organization and are held in cooperation with the UNHCR and other donors.
DICAC also supports pregnant women and children between six months and one year with supplementary diet. In addition the organization provides a special bedding allowance. DICAC also arranges a maid servant during the first three months after delivery. This is often a family member that gets support from DICAC.
In addition to this DICAC focuses on a vaccination program where pregnant women get vaccine against tetanus and other diseases by linking the mother and new born baby to their respective health centers. DICAC also conducts home visits to pregnant mothers who have psychosocial or financial problems and provides solutions accordingly. The organization also conducts hospital visits and assesses and solves different problems.
Many refugees suffer from different types of chronic diseases. Some were ill before fleeing but many also developed chronic diseases during their stay in the refugee camps. Examples are tuberculosis, chronic depression, diabetes, liver diseases, epilepsy, heart diseases and Schizophrenia. Many of these diseases are not possible to treat in the available health centers and regional referral hospitals in the refugee camps. Chronically ill refugees are therefore transferred to Addis Ababa where they can get further support from DICAC and in collaboration with health centers.
DICAC provides medication and hospital access to chronically ill refugees. Some of these patients need frequent hospital care, and also this DICAC is able to facilitate. In cooperation with UNCHR the organization also provides complicated treatments, as for heart- and liver diseases, that are directly lives saving.
DICAC is able to provide quality health care for this group that would otherwise be very exposed. Around 950 chronically ill refugees get help and support through DICAC every year.