NB. PayPal take 1.4% + 20p from each donation. You can also donate by bank transfer.
Mel Cash

The Lalibela Medical Centre

Rural Clinics in Northern Ethiopia

Funded by Mel Cash and friends

 In conjunction with DEVRA (Development Evaluation Research Advice) a UK registered charity no.1126008

Current crisis: Due to a very poor rainy season the area is in drought and harvests have failed. People are suffering badly and demands on our clinic are even greater. As well helping the local community we are going out to more remote areas with medical supplies and food. We desperately need your help at this time. Just a few pounds goes a long way in Ethiopia so anything you can give will be greatly appreciated. Thank you. 


I met Tilahun Alemu (Tim) 26, whilst on a trekking holiday in Northern Ethiopia in 2007. Since then I have funded him and his sister, Birtukan 22, through university (they have a younger brother, Kibret 18).  Their parents died 10 years ago in an epidemic and they have been looking after each other ever since. Through regular emails over the years we have built a good relationship and this was strengthened when I spent two weeks with them in August 2013 and got to know them much better.


Tim graduated in 2012 as a medical officer specialising in community healthcare and did several student placements in remote rural areas. Birtukan graduated as a clinical nurse in 2013. Kibret is very intellegent and is learning all he can about medicine and management from Tim and Birtukan.



They told me a year ago that they wanted to use their education to help their community and so we have been working together on a plan to set up medical clinics to provide a high level of healthcare in this remote rural area for the first time. I have just returned from another two week trip (Jan 2014) and saw the buiding work begin and we expect to open the Lalibela Medical Centre in June 2014.


The Ethiopian Government is encouraging these clinics and is giving us a free plots of land to build them on in the villages.


They are a very warm friendly and peaceful Coptic Christian community who deserve good healthcare.

For a relatively small amount of money we can make a very big difference and save lives.

The project


Setting up the Lalibela Medical Centre in the town with satellite clinics in two rural villages outside the town.



Lalibela is a small market town supporting a local area with a population of about 30,000. It has a small hospital but with poor management, poor maintenance and lack of funds this cannot provide the population with an adequate service, and it is not free either.


Although it is a poor town with few amenities it is a World Heritage Site with its famous rock churches and although remote (750 KM north of the capital Addis Ababa, which takes two-days by road or one-hour to fly) it does get some tourism which brings money into the community.


There is an obvious need among the town’s population, and tourists, for a good quality private medical centre charging slightly more than the State hospital but providing a much better general medical service. A clinic here is financially viable and will be able to cover the running costs with a permanent medical staff of a doctor, two nurses and a laboratory technician. We can get extra part-time medical staff when needed from those working at the State hospital.


The Lalibela clinic is being build in an excellent quiet location near the centre of town. It is being well made out of brick which is high-status in a town of mud huts and is already the talk of the town. It will have an office and reception area, examination and treatment room, Delivery and post-natal ward with three beds, laboratory and M&F toilets. There will even be a garden and seating area with a nice view.



Bilbala and Bilbala-Cherkos are two remote vallages about 40Km NW of the town and take an hour to reach by vehicle along dirt-track road, and a half-hour to get from one to the other. Both villages have a school and a weekly market. To start with here we will build one-room clinics with only basic equipment and supplies. The medical team will go to the villages to run the clinics one-day a week and village patients will be able to access the full facilities in the town if necessary. Through a community health education programme we expect demand will grow and the village operation will expand over time.

In the villages we still believe that treatment should involve a small cost to the patient because what is free has no value and is more likely to be abused. Here we will charge the same as a State hospital but as money is usually scarce we will operate a credit system and patients can pay their bill at harvest time. Free treatment will be available to orphans and those registered as ‘poor’ by the local Peasants Association. The government provides free medication for some conditions like TB, Malaria and HIV which the clinic will provide.



It is an area of subsistence farming with crop rotation (beans, lentils and sorghum).They have one short rainy season but the rest of the year is completely dry and it gets very arid.


The population is almost entirely Coptic Christian and the area seems safe and politically stable. They are very peaceful and friendly people.


Latest news:


Even a problem has turned out for the best

As building work on the clinic nears completion and I was amazed we had got so far without any problems…….we had a problem. The government has changed the criteria for licensed clinics which must now be bigger and have more rooms than one we have just built. But we have a very simple and ready-made solution. The residential house (that had been built and paid for separately) on the site will now become part of the clinic and Tim, Birtukan and Kibret will live in rented accommodation nearby.

This will delay the opening and increase the building costs a bit but we will end up with a much bigger and better clinic that we ever imagined. Although we still expect it to open in September or October because this is a difficult time for me the official grand opening will probably be in late December which is easier.



The main clinic in Lalibela is now in the final stage of the build and should be finished in July. We then have to get the equipment and supplies. The Doctor and other medical staff have been recruited. They are experienced and serving notice in their current jobs before starting work for us in September. We are planning the official opening in September, probably around the 11th to coincide with a National festival.

The building work has presented interesting challenges that we don't get here. There are no building supplies available in the region and they all had to be trucked up from Addis Ababa (2 days along hazardous roads). So everything needed for the first stage of the build had to be bought in one go. Then they had to make their own hollow concrete blocks (bricks) because they were uneconomical to transport so far. And then everything needed for the final stage had to be transported on one go. Tim has done a brilliant job of organising this but, wisely knowing his limitations, took on a professional construction engineer to supervise the final stage.

All the local community know about it (it's the talk of the town) and are eagerly waiting for the clinic to open. The local town officials have visited the site and expressed their support and thanks for what we are doing.


The Lalibela Medical Centre


The Medical Centre will start off with a full-time medical team of a Doctor, laboratory technician and two nurses. Extra part-time medical staff will be available from the State hospital when needed. We are offering to pay a higher salary than at a State hospital and should be able to get a good team together.


Tim has shown excellent management skills already putting this project together and will continue this in the overall management of the clinics. Birtukan has only recently qualified as a clinical nurse so we will recruit one with more experince to join her. Kibret is learning a lot of nursing skills as well as nutrition, health and hygiene. He can work as both medical assistant and assistant manager.


The clinics will provide emergency services, light surgery and other general medical treatments including optometric eye care, gynaecology and obstetrics, TB, HIV and anti-malaria treatments.


Update: March 2014

Tim, Birtukan and Kibret now live in a new mud house built on the clinic site (this was separately funded)

Building work on the clinic is now well under way with Tim supervising the work and they all make sure the workers on the site are happy and well fed too. The foundations, concrete floor and corner pillars are all completed. Building materials were bought in bulk in Addis Ababa and taken by truck (2 days) to Lalibela but this is not economically necessary for the hollow concrete blocks HCB needed to build the walls. They are now going to make these themselves on-site which will save a lot but will slow the build down by a few weeks.

Unfortunately, internet connections are very very slow and intermittent and it has been imposiible for them to send any pictures so far.

Tim will travel extensively through the area to educate the communities about the services provided and the benefits available. The centre will promote better community health through public awareness programs and will provide education on reproductive health, family planning and preventative healthcare. It will work in collaboration with the local government health office and medical institutions.




Financial sustainability


Once the clinics are set up the project should become self-financing through the income from patients and has the potential for the village clinics to grow. 




We have purchased a 350Mt Sq plot of land in Lalibela and are now building the clinic.


The clinic will be 125 Mt Sq and have:


  • Reception room
  • Labouring delivery and postnatal room (for 3 patients)
  • Examination, treatment, procedure and injection room
  • Laboratory
  • Instrument processing room
  • Male & Female toilets
  • Outside – incinerator and placenta pit


The building cost will be about £12,000


The building cost of the one-room clinics in the two villages will be about £3,000 (on free plots of land). 


The cost of equipment and supplies will be about £12,000


Initial support of running costs £5,000










Charitable status


DEVRA (Development Evaluation Research Advice) is a small UK Registered Charity (No:1126008) run by a close friend of mine which has been involved in development projects in Nepal and Ethiopia for many years. By channeling the funds through a Registered Charity we are able to take advantage of Gift Aid and it also means the finances of the project will be properly audited.


DEVRA is not taking any administration costs and we are not using any local agencies. I expect to visit the project twice a year and will pay all my own expenses. All donations go directly into the project.





For a relatively small amount of money we can make very big difference and save lives.




Thank you for your support

Mel Cash




How to donate
You can make a doantion through Paypal from our homepage.
Or to avoid us paying the Paypal commission donations can be made by bank transfer:
Account name: DEVRA
Account No: 65271939
Sort code: 08-92-99
(Reference "Ethiopia")
DEVRA (www.devra.org) is a small UK Registered Charity (No:1126008) run by a close friend of mine which has been involved in development projects in Nepal and Ethiopia for many years. By working with and channeling the funds through a Registered Charity we are able to take advantage of Gift Aid and it also means the finances of the project will be properly audited.
Please contact me below for more information.
Thank you, Mel

the following errors were found:"; $lang_noname = "You did not enter your name"; $lang_noemail = "You did not enter your email address"; $lang_nosubject = "You did not enter a subject"; $lang_nomessage = "You did not enter a message"; $lang_nocode = "You did not the validation code"; $lang_wrongcode = "You entered the validation code incorrectly. Please note that it is case sensitive"; $lang_invalidemail = "The email address that you entered appears to be invalid"; // Success $lang_sent = "Your email has been sent. The following message was submitted:"; // Width of form inputs. Must include unites, e.g px $input_width = "300px"; // How do you want the title aligned? $title_align = "left"; // Can be left, center or right // To format the title text. If you are not confident with css then probably best left as it is $title_css = "font-weight: bold; font-size: 120%;"; // Colour of error message $error_colour = "red"; // Must use HTML compatible colour // You can choose whether to display Powered by BELLonline PHP mailer script at the bottom of the mail form // I understand that some peopme might not want to show our link, but we would appreciate it if you could // Possible options are yes or no $showlink = "yes"; // Thanks for using the PHP mailer script, I hope you find it useful! ?>