Ethiopia has one of the world's worst health care systems and despite efforts to improve it, it remains inadequate. The average life expectancy is only 43 years. Only 6% of deliveries are done with trained professionals (doctor, nurse or midwife), compared to a 42% average across Sub-Saharan Africa. The infant mortality remains high at 77 per 1000 live births.

Rheumatic heart valve disease (RHVD) arises when there are repeated bouts of rheumatic fever that usually go untreated. Rheumatic fever (RF) in turn arises when there are repeated bouts of strep throat that usually go untreated. These 3 entities are briefly reviewed.