Why are we there?
- Armed conflict
- Endemic/Epidemic disease
This is an excerpt from MSF-USA's from 2013 Annual Report:
Nomadic people, refugees, people in conflict-affected areas and those located in the remotest parts of Ethiopia lack access to health services.
Responding to the lack of medical services for pregnant women and young children, MSF runs a program focused on maternal and child health in Sidama, Southern Nations, Nationalities and People’s Region (SNNPR). People are seen at Mejo and Chire health centers, and through outreach activities in 15 locations. A maternity waiting home offers women with high risk births a place to stay for one to two weeks before delivery, so that they are close to emergency obstetric services. In 2013, the team provided 10,460 ante- and postnatal consultations, assisted 800 deliveries and vaccinated 19,260 children. The inpatient department saw 3,000 patients.
Visceral leishmaniasis, or kala azar, a parasitic disease transmitted by the bite of an infected sandfly, is endemic and sometimes epidemic in Ethiopia. In Abdurafi, Amhara region, MSF provides treatment for people with kala azar and HIV/AIDS, and for those co-infected with tuberculosis (TB). MSF completed the handover of patients with simple HIV to the Bureau of Health in 2013. The Abdurafi program also offers nutritional support for patients and treatment for malnourished children under five.
Filling healthcare gaps in the Somali region
Underdevelopment, a shortage of qualified senior health workers and conflict between government forces and armed anti-government groups all pose barriers to healthcare in the Somali region. In Degehabur, MSF supported the regional hospital with emergency obstetric services, mental healthcare, assistance for victims of violence including sexual violence, treatment for malnutrition, and TB. Basic healthcare was provided through mobile clinics in Birqod, Ararso, and Degehabur woredas. Teams carried out 3,460 antenatal consultations and enrolled 960 children in nutrition programs. Mental health activities, including counseling and therapy groups, were attended by 890 people, and 430 patients began TB treatment. A fully equipped 35-bed ward was built to provide better care for children requiring hospitalization. Drugs and materials for the management of health activities were also provided. Improvements were made in water quality and supply in MSF-supported health facilities and a team completed a measles vaccination campaign with the Bureau of Health.
In the Wardher area, MSF supported Wardher hospital, focusing on specialist care for severely ill or malnourished children, maternity services, and TB treatment. Basic healthcare was offered at Yucub health post, and two health centers in Danod and Yucub received support in the form of staff, medical supplies, and training to provide quality health services to the surrounding population. Additionally, regular mobile clinics travelled to nine outlying locations and provided antenatal care, therapeutic feeding, and immunizations. A free ambulance served another 12 villages. Teams treated 1,467 children for malnutrition, provided 2,242 women with antenatal care, and assisted 325 deliveries.
Critical refugee assistance
Teams continued to provide specialist healthcare for Somali refugees and the host population in Dolo Ado, Liben zone, Somali region. Services include an inpatient department, emergency obstetric surgery, and a therapeutic feeding center for children. Teams vaccinated 12,180 children against measles and, in collaboration with the Regional Bureau of Health, also carried out several rounds of polio vaccination.
In the western region of Benishangul-Gumuz, a team provided aid to South Sudanese refugees. An evaluation of the emergency nutrition program that started in 2012 in Bambasi camp showed that people’s nutritional status had greatly improved. MSF continued to work with local authorities to improve healthcare and nutritional services in Bambasi, Tongo, and at the new Ashura camp. Teams undertook 23,170 consultations and admitted 21,025 children to supplementary feeding programs across all three camps.
In July, following an outbreak of violence in South Sudan, MSF started providing assistance to an estimated 3,000 refugees and 3,000 people in the host community of Raad, Gambella region. By the end of the year, teams had carried out 5,500 consultations, and vaccinated 1,280 children against measles and 1,980 against meningitis.
Responding to drought and deportation
The worst drought recorded in recent years in Afar region had a severe impact on people’s health and nutrition. In April, MSF responded by sending a team to Teru Woreda, a harsh and difficult to reach area that lacks development support. Staff set up a supplementary feeding program and an inpatient unit, and carried out mobile treatment activities. More than 1,880 children received medical care.
In November, the government of Saudi Arabia began deporting “illegal” foreign workers, resulting in the arrival of 154,837 Ethiopian men, women, and children at Bole airport by the end of December. MSF provided psychosocial support to 15,673 people. One-fifth of those receiving individual consultations were found to have a mental illness and 40 were referred to the psychiatric hospital in Addis Ababa for further treatment.
TB is the second-most common cause of death in Ethiopia after malaria, and there are indications that drug-resistant forms of the disease are on the rise. MSF assisted the Bureau of Health in establishing an innovative program for TB treatment in Dire Dawa. The team handed over the project after donating diagnostic equipment, fine-tuning medical protocols, and making modifications to the TB ward and people’s homes so that they could undergo treatment without a lengthy hospital stay.
The clinic in East Imey, Somali region, was handed over to the Bureau of Health in March, and the therapeutic feeding center in Buramino refugee camp was closed in April. MSF also handed over the project providing inpatient, maternity, and nutrition care at a health center in Mattar, north of Gambella city, in June. In the first half of the year, teams carried out 33,140 health and 650 antenatal consultations, and assisted 170 births.
At the end of 2013, MSF had 1,226 staff in Ethiopia. MSF has been working in the country since 1984.
Badoo, 40 years old
"I gave birth seven days ago to a baby girl. I delivered my baby in the bush where I live, as I have done with all my previous babies. I have ten children. A traditional birth attendant delivered my baby but soon after I became very sick. I had a very high fever and was shaking uncontrollably.
I felt like all the energy was leaving my body. I had been cut very badly and became infected after the birth; I found it painful to pass urine and the pain made me want to be sick and I almost fainted. I told my family that I felt very unwell and I needed help.
My family put me on a donkey cart and it took two hours to get here. The road isn’t good but it’s sandy so I was able to cope with the journey even though it was very hot and exhausting. I have been in the hospital two days and the staff check my blood pressure. They have given me medicine and have put me on an oxygen machine. The doctor says I look better now and I feel like I’m getting a little more energy in my body.
I feel like now I am here in the hospital I will be OK. I was in a lot of pain but every day that I’m here I feel a little bit better. I have to breathe with an oxygen mask because I’m still weak. If I had stayed in the bush and not come to hospital I don’t know what would have happened to me."