The impact of military conflict and political instability on community-based health programs and the importance of a bottom up strategy for achieving longterm change are examined among the Oromo ethnic group in Wallega Ethiopia. The Oromo Relief Organization with 200 trained health workers set about to establish a network of village-based clinics after the Mengistus regime was toppled in May 1991 and supplies and equipment were lost from the few clinics that existed. There was considerable community support in the provision of buildings manpower and even food. There had been little development since the World War II. Sanitation and a clean water supply were absent. The task was to provide curative services for the full range of water-born intestinal parasites and provide health education sanitation and solutions to other environmental health problems. The village health worker training program trains community workers in the essentials of good nutrition in the importance of building latrines and in water source management techniques. Maternal-child health programs are being undertaken. Oral rehydration therapy techniques are being taught to replace traditional methods of drinking a cupful of wild buffalo blood. Unfortunately political trouble is brewing. Regional elections in June 1992 were not held in Wallega and other areas in the south. International pressure is being exerted for peaceful settlement of the ethnic differences. A large foreign aid package which would help in areas such as Wallega is at stake. Hopefully the rural population will be able to sustain itself until full community-based health programs are established.
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