Dr. Merhawi Tesfamariam

Dr. Merhawi Tesfamariam is a senior pulmonologist and tuberculosis specialist at Orotta Medical Surgical National Referral Hospital in Asmara — Eritrea's largest hospital and the country's primary national referral centre for specialist medical and surgical care, operated by the Ministry of Health. With 14 years of clinical experience, he is one of Eritrea's most experienced respiratory medicine specialists.

Eritrea carries a significant tuberculosis burden — as does much of sub-Saharan Africa — and tuberculosis management forms the core of his pulmonological practice. Dr. Tesfamariam trained in internal medicine and pulmonology within Eritrea and completed advanced TB management training through WHO and the International Union Against Tuberculosis and Lung Disease (The Union), gaining expertise in DOTS protocol implementation, MDR-TB management, and contact tracing. He coordinates Eritrea's national TB programme services at Orotta Hospital.

He has undertaken educational observerships at hospitals in Ethiopia and Sudan, the nearest countries with more developed respiratory medicine infrastructure, and has implemented WHO-standard respiratory protocols at Orotta Hospital.

Dr. Tesfamariam completed his medical degree at the Orotta College of Medicine and Health Sciences in Asmara — Eritrea's national medical school, established to develop the country's indigenous physician workforce. He undertook internal medicine and pulmonology training at Orotta Hospital — the country's largest hospital and sole national referral centre — gaining extensive clinical exposure to TB, respiratory infections, and NCD in a high-volume, resource-limited environment.

He completed WHO and The Union TB management certification including DOTS protocol, contact tracing, and MDR-TB management training. He has attended WHO-supported workshops on respiratory medicine in Africa, including training in spirometry performance and interpretation, and non-invasive ventilation (NIV) application in resource-limited settings, ensuring his practice aligns with current international respiratory medicine standards.

Dr. Tesfamariam's clinical practice is anchored in tuberculosis diagnosis and management. He performs TB diagnostic workup including sputum smear microscopy, GeneXpert MTB/RIF molecular testing, and culture and sensitivity for drug-resistant TB. He manages drug-sensitive TB with standard first-line DOTS protocols and MDR-TB with second-line regimens including linezolid and bedaquiline where available. He coordinates contact tracing and preventive therapy for high-risk household contacts.

Beyond TB, he manages COPD (significant burden from biomass fuel smoke exposure in Eritrea's rural population), community-acquired pneumonia including pneumococcal and Pneumocystis pneumonia (in HIV-positive patients), and asthma. He performs spirometry for COPD diagnosis and monitoring, chest X-ray interpretation, and bronchoscopy for haemoptysis investigation and diagnostic sampling. For patients with respiratory failure, he manages oxygen therapy and NIV.

Dr. Tesfamariam consults in Tigrinya, Arabic, English, and Italian — the latter two languages reflecting Eritrea's colonial history and diaspora communities in Italy and English-speaking countries. Orotta Hospital serves patients from across Eritrea and occasionally from Eritrean diaspora communities. For overseas Eritreans returning home for healthcare or Eritreans living abroad seeking second opinions on respiratory conditions, video consultations in Tigrinya and English are available.

Dr. Tesfamariam has received recognition from the Eritrean Ministry of Health for his contributions to the national TB control programme — including his role in implementing DOTS-compliant TB management protocols and MDR-TB second-line therapy at Orotta Hospital. He has been an active participant in WHO-supported TB management training initiatives in East Africa, serving as both a participant and a facilitator for national TB training workshops.

He collaborates with The Union (International Union Against Tuberculosis and Lung Disease) East African programmes on MDR-TB management and has contributed to the development and review of Eritrea's national TB treatment guidelines. His 14-year commitment to TB medicine in one of sub-Saharan Africa's more isolated healthcare environments represents a significant contribution to the country's health system.