For a wheelchair user, an uneven pathway can turn a routine visit to a health facility into a difficult journey. For an older person or someone with limited mobility, a steep slope or muddy ground can become a serious barrier to reaching essential services.
At Gondar Gebriel Health Center, these were once everyday challenges.
Today, they are beginning to change—and an accessibility intervention initially supported with approximately ETB 950,000 has helped generate a much larger government commitment of approximately ETB 8 million for further improvements.
When the journey to care becomes a barrier
An accessibility assessment conducted at the health center in December 2023 identified significant physical barriers within the compound.
The terrain included steep level differences, uneven pathways and muddy areas, making movement between buildings difficult for people with disabilities and people with limited mobility.
For someone using a wheelchair, reaching the pharmacy or emergency room could be challenging. For someone using crutches, steep or muddy ground could make movement unsafe. For others with limited mobility, simply moving between service areas could require considerable effort.
The challenge was therefore bigger than providing access to a single building. The route connecting people to essential health services also needed to be accessible.
Building a more accessible route
With support from the United Nations Population Fund (UNFPA), an accessibility modification project was implemented at Gondar Gebriel Health Center in two phases, with a total investment of approximately ETB 950,000.
The first phase focused on creating safer and more accessible connections to key services, including the card room, pharmacy, maternity unit and emergency room.
Ramps and connecting pathways were constructed despite the difficult terrain. Much of the excavation and ground preparation had to be carried out manually, allowing the work to remain within the available resources.
The result was more than physical infrastructure. It created a more navigable route to essential health services for people who had previously faced significant barriers.
Accessibility goes beyond the entrance
The second phase focused on a two-room accessible toilet facility.
But there was a problem: the proposed site was at the rear of the health center, where the terrain was highly irregular and the ground level changed significantly.
Before construction could begin, the area needed to be levelled and an accessible approach created.
This reinforced a simple but important principle:
A facility is not truly accessible if people cannot reach it.
At this stage, collaboration with local government became critical.
Partnership makes the difference
The Ethiopian Center for Disability and Development (ECDD) and the health center engaged the Gondar City Administration Road Construction Authority, highlighting the accessibility challenges and the need to ensure that people with disabilities and people with limited mobility could safely reach and use the facility.
The Authority responded by providing a loader and operator to undertake the necessary earthworks, including excavation, cutting and ground preparation for the access route and toilet construction site.
The support helped overcome a major technical challenge and enabled the second phase of the accessibility intervention to move forward.
The two-room accessible toilet facility was subsequently completed as part of the wider improvements.
What initially appeared to be a difficult construction challenge became an example of how local collaboration can help turn accessibility plans into practical solutions.
A bigger commitment emerges
The impact of the intervention did not end with the completion of the construction work.
During a recent visit to the health center, city officials saw the accessibility improvements and the practical difference they could make to people using the facility.
The changes demonstrated what is possible when accessibility is considered as part of health infrastructure rather than treated as an afterthought.
Then came a much larger commitment.
The health center received approval for approximately ETB 8 million in additional government funding to expand accessibility improvements across the compound.
The commitment is more than eight times the initial investment of approximately ETB 950,000.
The original intervention had helped demonstrate the value of accessibility—and created momentum for a significantly larger public investment.
Beyond the numbers
For people with disabilities and people with limited mobility, the significance of this development goes far beyond the figures.
It means fewer physical barriers between people and essential health services.
It means accessibility is receiving greater recognition as an integral part of a health facility environment.
And it shows how a relatively modest intervention can help inspire wider institutional and government action.
The experience also demonstrates the value of partnership: a health center identified a challenge; disability-focused expertise helped address it; a government authority contributed machinery and technical support; and the resulting improvements helped build momentum for further investment.
When accessibility creates momentum
The experience at Gondar Gebriel Health Center offers an important lesson: the impact of an intervention is not always measured by the size of the initial investment, but also by what it makes possible next.
Approximately ETB 950,000 helped create ramps, connecting pathways and an accessible two-room toilet facility. More importantly, the intervention helped demonstrate the practical value of accessibility and contributed to momentum for an approximately ETB 8 million government commitment for further improvements.
This is not simply a story about ETB 950,000 becoming ETB 8 million.
It is a story about making it easier for a person using a wheelchair to reach a pharmacy.
It is about helping someone with limited mobility move more safely through a health facility.
And it is about creating a healthcare environment where physical barriers do not stand between people and the services they need.
One accessibility intervention has helped open the door to a much bigger change at Gondar Gebriel Health Center—showing how investing in access can create momentum for more inclusive health care.
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