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Introduction: Endocrine therapy for breast cancer (BC) patients is highly underutilized in rural Ethiopia and other African countries. Objective: This study aims to assess the feasibility of and adherence to tamoxifen therapy in rural Ethiopia. Methods: We ascertained the hormone receptor (HR) status in 101 women diagnosed with BC from January 2010 to December 2015 and who had surgery in Aira Hospital, in rural Ethiopia. From 2013, tamoxifen was offered to patients with HR-positive (HR+) tumors. Prescription refill records and a structured questionnaire were used to assess receipt of and adherence to tamoxifen. Results: Of the 101 BC patients tested for HR status during the study period, 66 (65%) patients were HR+ and were eligible for tamoxifen treatment. However, 15 of the HR+ patients died before tamoxifen became available in 2013. Of the remaining 51 HR+ patients, 26 (51%) initiated tamoxifen but only 9 of them (35%) adhered to therapy (medication possession rate ≥80%, median observation 16.2 months). After 1 year, 52% of the patients were still adherent, and 9 patients had discontinued therapy. The reasons for non-initiation of tamoxifen included patient factors (n = 5), including financial hardship or lack of transportation, and health care provider factors (n = 12). Conclusions: Endocrine therapy for BC patients seems feasible in rural Western Ethiopia, although non-adherence due to financial hardship and a less developed health care infrastructure remains a major challenge. We postulate that the implementation of breast nurses could reduce patient and health system barriers and improve initiation of and adherence to endocrine treatment.

Back ground: Disasters are parts of human life; they will never ask for permission to occur in particular area. The world over, they have been caused disastrous complications, disrupting human lives, and exposing the world economy to untold cost. In times of disasters, hospitals are among the most crucial institutions as they are considered as sanctuaries where victims seek ministration. Although major disasters are always to be expected, past disasters and more recent events shows that communities are not yet fully prepared. Objective: The study was intended to assess current awareness, attitude, and practice of the health care workers regarding disaster preparedness and to find out what arrangements were in place should a disaster occur at the hospital. Methodology: The study utilized both quantitative and qualitative research methods. Data collection was made through self-administered questionnaires and semi- structured key informant interview. A total of 290 respondents were participated in the study. Data analysis: Quantitative data were analyzed using descriptive statistics with Epi-info and Statistical Package for Social Sciences (SPSS). Qualitative data were analyzed after organizing into themes and summaries. Result: About half of (50.8%) health care workers had good knowledge about hospital disaster preparedness and its plan. The remaining 49.2%) had low knowledge. Their general attitude towards the issue was largely positive as 64.8% of respondents had favorable attitude. Low practice (8.3%) of disaster preparedness at the hospital was observed. Moreover, the hospital had neither nor disaster preparedness plan nor other forms of arrangements and preparations for occurrence of disasters. Conclusion and recommendations: The present study found that the health care workers at the hospital had fair awareness and largely positive attitude on disaster preparedness. As the national health policy has not given sufficient attention to hospitals disaster preparedness, there were negligible arrangements in place at the hospital. Therefore, much effort is still expected from all stakeholders including Federal Ministry of Health and managements of hospital.