The road from Addis Ababa to Adama is a study in the contrasts of contemporary Africa. Leaving Addis toward the southeast, we see the gleaming concrete and steel shell of the nearly completed tram line that promises to relieve some of the congestion on the city’s clogged roads. We pass block after block of empty housing developments, which, in theory, will fill with the new transit lines.
But the roads themselves remain pockmarked with potholes and bathed in dust and debris. Poorly fed horses stand in the middle of the street; gaunt and unconcerned, routing traffic around them. Older women bend down, their faces straining, carrying hefty loads of discarded plastic bottles wrapped in gauze tarps, presumably for sale or recycling. Alongside the road, drivers of makeshift horse-carts ferry food and other goods to points unknown, reminiscent of scenes out of any number of decades past.
And then, as if turning the page from one era to the next, we arrive at the on-ramp to the recently completed Addis-Adama Expressway. Built mostly with Chinese labor and funded with low-cost Chinese capital, the expressway appears almost like a mirage of an onrushing high-speed Africa. Endless fields of green tef grain speed past. Wind farms spin on hilltops, powering waves of rural electrification. Our pace is now more than double what it was minutes ago as we accelerate towards Adama and the regional public health laboratory for the Oromia region. Traffic, however, remains strikingly below the levels we have just left behind, possibly because few can afford the new thoroughfare’s toll.
In some ways, like the expressway that leads toward it, the Adama regional laboratory reads like a vibrant sign of an emerging but incomplete African future. It was built in 2013 with funding from the US Centers for Disease Control and USAID and operates at reasonable capacity. Brand new lab equipment hums with life in almost every room. Behind an alarmingly marked glass door sits an industrial negative-pressure storage chamber for samples of highly contagious MDR tuberculosis. The Adama laboratory seems like a model of clean, efficient diagnostic technology. And yet, there is still much work to be done.
In the regional lab director’s furniture-packed second-floor office, we call up samples of GIS maps, web applications and Tableau dashboards to review. The director is impressed and enthusiastic. Although Adama regional laboratory is stocked with some of the best in medical diagnostic equipment, its lab information system lacks an analytics front-end. So their diagnostic output tends to be conceptualized in terms of individual patients or samples rather than in terms of populations or overall laboratory processes. GIS and Tableau might change that.
Returning to Addis after a long day of project evaluation, a thought occurs to me. If the laboratories can be networked into the type of integrated and visually rich information environment we’ve been envisioning, then the future of Ethiopia’s public health system might be one where the transfer of essential medical data is no longer contingent on the horses standing in our path.