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Ethiopia: Latest MSF Updates

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This is an excerpt from MSF's 2014 International Activity Report:

Some 200,000 refugees from the civil war in South Sudan arrived in Gambella region, western Ethiopia, between December 2013 and October 2014.

The long journey on foot, with inadequate food and water, had taken a toll on people’s health and many arrived in Ethiopia sick and malnourished. From February, Doctors Without Borders/Médecins Sans Frontières (MSF) provided medical consultations and care at entry points close to the border. Teams worked at a health post in Pagak and Tiergol, ran mobile clinics in Pamdong and Burbiey, and conducted outpatient consultations at a health post in the Matar transit camps.

MSF also started a program in Leitchuor camp. The 100-bed hospital offered outpatient consultations, emergency services, maternal health care, and treatment for malnutrition. Outreach workers engaged in health promotion activities and identified people needing medical attention. The camp is located in an area prone to flooding and was inundated during the rainy season, causing the eventual relocation of the refugees to other camps in nearby villages and on higher ground.

MSF ran inpatient and outpatient services for refugees and the host population at a 118-bed health center in Itang, close to Kule and Tierkidi camps, where more than 100,000 people had settled by April. When the Itang health center flooded in August, MSF moved activities to the staff compound and had to reduce the number of beds. MSF provided decentralized medical care through two health posts in Tierkidi camp and three in Kule, and ran a 120-bed hospital in Kule. The hospital has an isolation unit for hepatitis E patients and between July and the end of the year, 541 people with suspected hepatitis E received medical care.

To address the lack of clean water and sanitation facilities in Kule and Tierkidi camps, MSF set up a water treatment plant that produced 14.6 million gallons of safe water before it was handed over to Oxfam in July. Teams also constructed more than 2,500 showers, 1,200 latrines, and 180 hand-washing points in the camps.

MSF launched a preventive vaccination campaign against cholera in Gambella region in July, targeting 155,000 refugees and members of the host community who each received two doses of the vaccine. In November, some 23,000 children aged six weeks to five years were immunized against pneumococcus and common childhood diseases.

Southern Nations, Nationalities, and People’s Region (SNNPR)

A program focused on health services for mothers and children under five continued in the Aroressa and Chire woredas (districts) of Sidama, SNNPR. Teams worked in health centers in Mejo and Chire and conducted outreach activities in 13 locations. During the course of the project, which was handed over to the Ministry of Health in October, two maternity waiting houses were constructed to enable women with high-risk pregnancies who lived far from health facilities to deliver safely. MSF also supported referrals of pediatric emergencies and women presenting with complications during labor to hospitals in Hawassa, Yirga Alem, or Addis Ababa.

MSF started a new project in SNNPR in October, together with the Regional Health Bureau. Its purpose is to strengthen the emergency preparedness, surveillance system, and response capacity of the public health management team in six selected zones of the SNNPR. These zones are Sidama, Wollayta, Gamogofa, Segen, South Omo, and Bench Maji.

Somali Region

Underdevelopment and conflict between the government and armed opposition groups pose barriers to health care in Somali region, and 200–500 refugees from Somalia arrive in the Liben zone each month. The population of Buramino and Hiloweyn refugee camps, Liben zone, has reached 77,000. MSF continued to assist with the provision of basic health care at the reception center and in the camps. A team also provided medical care for Somali refugees and the host community in Dolo Ado, Liben zone. In the hospital, MSF supported the pediatric inpatient department, stabilization center, emergency room, and laboratory, as well as emergency obstetric surgery and maternity services. Between January and March teams vaccinated 12,100 children against measles and carried out several rounds of polio vaccinations in collaboration with the Regional Bureau of Health.


South Sudan refugees fleeing to Gambela, Ethiopia

MSF supported the regional hospital in Degehabur, providing inpatient care for children under five, tuberculosis (TB) treatment, nutritional support, and emergency room and intensive care services. It also supported three health centers and nine health posts in Degehabur, Ararso, and Birqod woredas, and conducted outreach activities. The focus in 2014 was on mother and infant health—there were 2,578 antenatal consultations—as well as nutrition and vaccination activities.

In September, MSF started supporting Fiq Hospital, Nogob zone, and provided an emergency referral system, outpatient services, nutritional support, pediatric inpatient care, obstetrics and gynecology, and pharmacy and laboratory services. A network of community health workers was also established.

In Danod, MSF offered basic health care in the 24-hour health center and ran weekly mobile clinics in four villages in the district. The team conducted more than 12,000 consultations in 2014. In addition, MSF helped build local health care capacity by donating medical supplies, and coaching and supervising staff. Maternity services and treatment for malnutrition are a focus of this program. MSF continued to address gaps in health care provision around Wardher, running mobile clinics in five villages in the district, and visiting Yucub health center three times a week to support and supervise the staff and to donate medical supplies. An ambulance service also operated, covering 18 villages in Wardher and Danod districts, transferring patients with life-threatening conditions to Wardher Hospital. MSF supported the hospital’s pediatric, TB, and maternity departments, as well as a stabilization unit for severely malnourished children, and was involved in the set-up of an operating theater run by the Ministry of Health, which provides emergency obstetric surgery. A measles vaccination campaign was carried out in collaboration with local health authorities in March, reaching 4,300 children, and eight rounds of polio vaccinations were completed in Wardher and the surrounding area. In September, MSF handed over routine vaccinations, care for chronic conditions, and triage to national health authorities.

Kala Azar and Malnutrition in Amhara

The parasitic disease kala azar (visceral leishmaniasis), endemic in this area, is usually fatal if left untreated. MSF continued its program for patients with kala azar in Abdurafi, Amhara region, including those co-infected with HIV/AIDS or TB. Nutritional support is available to patients in the program. More than 1,200 people were screened for kala azar in 2014. MSF also filled gaps in emergency services, provided inpatient care for children under five with malnutrition, and transported patients to hospitals in Humera and Gondar.

Project Closures

In Raad, Gambella region, an emergency project that started in July 2013 came to an end in January following the closure of the transit camp for South Sudanese refugees. Another project providing assistance to refugees in the western region of Benishangul-Gumuz, also came to an end in May.

At the end of 2014, MSF had 1,416 staff in Ethiopia. MSF has been working in the country since 1984.

Patient Story

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."

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