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Thank you for “Dispatches From Ethiopia — A Firsthand Look on the State of Neurology Training” (July 2). I serve on the Addis Ababa University department of faculty, and had the privilege of acting as external examiner for the 2008 Inaugural and 2009 Second Board Examinations. This testing, comparable to the American Board of Psychiatry and Neurology examination, albeit oriented toward regional diseases and practice conditions, culminated in the graduation of eight neurologists.

These new graduates, from the only neurology residency program in the Horn of Africa, bring the total number of neurologists in Ethiopia to 16 — or one per 5 million people. This figure may seem hopeless by western standards, but it is unquestionably a momentous success for the poorest, most underserved region on the planet. Moreover, the impact of a neurologist in Ethiopia is magnified because he or she will train the primary care physicians who actually diagnose and treat the majority of neurological diseases — an absolute necessity given the fact there are no neurologists for the millions living outside of Addis Ababa.

The success of this program may be attributed to the devoted chairman Dr. Guta Zenebe and his highly dedicated staff — eight new neurologists remain in Ethiopia, seven employed in the department of neurology — as well as a confluence of other factors including support from the Ministry of Health, Addis Ababa University Medical Faculty, and a host of local medical and non-medical staff members.

Additionally, there are myriad international groups and individuals providing an extraordinarily broad support network including, inter alia, the People to People organization, International Brain Research Organization, European Federation of Neurological Sciences, World Neurology Federation, Washington University, Mayo Clinic, Medical University of South Carolina, Medical Universities in Italy, Belgium and Norway, and individual neurologists from more than half a dozen states in America. The range of support includes training courses, teaching lectures, conference scholarships, overseas training opportunities, continuing education materials, books, journals, and medical equipment — essential for the growth of this new training center.

This residency program is a model for third world neurology services, and deserves our continued support — it must be allowed to thrive with goals of increasing the number of neurologists, initiating an appropriate geographical redistribution of neurologists, pursuing relevant sub-specialization, developing the planned collaborative neuroscience center incorporating neurosurgery, and promoting research initiatives.

James C. Johnston, MD, JD

Seattle, WA