The road to Magenta in the Afar region of Ethiopia winds through vast stretches of dry earth and is framed by distant mountains and volcanoes.
Afar, one of the hottest inhabited places on earth, is home to 2 million people who mostly rely on seasonal rainfall, shallow wells, and sometimes trucked water for their needs. The combination of intense heat, unsafe drinking water, long travel distances, and hard-to-reach health facilities creates harsh living conditions of people in Afar, significantly limiting access to timely health care.
Last year, Doctors Without Borders/Médecins Sans Frontières (MSF) began working alongside the Ministry of Health to provide lifesaving treatment for malnourished children and nutritional support for pregnant and lactating mothers, at both Dubti General Hospital and through mobile outreach activities. By combining hospital-based care with weekly visits to eight remote locations, MSF is helping ensure that even the most isolated communities can be screened and treated.
Roads in the Afar region often flood, making road transport difficult. MSF outreach teams sometimes have to push vehicles through mud or finish the journey on foot. | Ethiopia 2025 © Paula Casado Aguirregabiria/MSF
Water access and distance from care affect malnutrition
Much of the population in Afar is traditionally nomadic and pastoral, moving with herds of camels, goats, and cattle in search of grazing and water, which is a constant task. Water from the Awash river contains bacteria and high levels of minerals, and is not recommended for consumption, yet many communities depend on it. This water has been the source of cholera outbreaks in the past.
Afar has some of the lowest health indicators in Ethiopia, including high infant mortality rates, widespread child stunting, and the highest proportion of underweight children in the country. These challenges have been aggravated by a sharp reduction in mobile health and nutrition teams that usually bring medical services closer to remote and pastoralist communities.
“Distance is one of the biggest barriers to care here,” says Emmanuelle Quet, MSF project coordinator in Afar. “Families often travel for hours to reach the nearest health post and sometimes days to reach the hospital. Any disruption like flooded roads or lack of transport can mean a child doesn’t get treated in time.”
Access to certain areas within Afar is challenging not only for patients, but also for MSF teams. Recently, an MSF team spent more than six hours covering just 20 to 25 miles, and our nurses and drivers had to push the vehicles out of the mud to ensure Plumpy’Nut therapeutic food reached families in need of their weekly lifesaving nutrition. Only a few days earlier, an outreach team became stuck while transporting a child being referred to MSF’s inpatient therapeutic feeding center for urgent care, resulting in a life-threatening delay for the child. Despite the challenges, the team managed to reach the facility to provide timely lifesaving care for the patient.
Mother of Fatuma, an MSF patient
Abahefa Ari
"This year the drought was worse, and we did not get the same crops as in previous years. My baby girl got diarrhea, so we went to our closest health facility, where she was treated and discharged. After we returned home, her condition did not improve and she later developed another episode of diarrhea, which made her weaker.
A neighbor advised us to go to Dubti General Hospital, saying it was a good place for children like Fatuma. Once we arrived, we were referred to MSF’s ward. That’s when I learned my child was suffering from malnutrition."
“Two mobile teams now visit eight locations every week, screening and treating children with severe acute malnutrition and providing therapeutic food,” Quet adds. Children with severe complications are referred to the inpatient therapeutic feeding center at Dubti General Hospital when needed. “This longer-term approach helps reduce the need for repeated hospital admissions.”
Isaa, the mother of 1-year-old Fafi, has been to the ward before. “The first time we came, my daughter was only seven months old,” she explains. “We stayed for five days until she was discharged. This time, we have been here for 10 days, and I can already see how she is getting better.” Isaa and Fafi were referred to Dubti General Hospital by MSF mobile clinic teams.
Root causes of malnutrition must be confronted
Together with the Ministry of Health and the Regional Health Bureau, MSF continues to provide lifesaving treatment to local communities. By combining hospital-based care with weekly outreach visits, we are helping ensure that more remote communities can be screened and treated.
However, significant challenges remain. “We can treat severe malnutrition, but the root causes go far beyond health care alone,” emphasizes Quet. “Improving access to safe water, developing community livelihoods, and strengthening local health services and referral pathways are essential if communities are to become more resilient.”
MSF in the Afar region
MSF has been present in Afar since 2022, providing critical support for children and pregnant and lactating mothers affected by malnutrition. At the Ministry of Health’s Dubti General Hospital, we run an inpatient therapeutic feeding center with a capacity of 50 beds. The ward treats children under 5 suffering from severe acute malnutrition with medical complications. In 2025 alone, we treated 1,594 children there.
In 2025, MSF outreach teams treated 1,745 children and nearly 100 pregnant and lactating mothers across the eight locations in Afar, and referred 272 children from health posts and centers to the inpatient therapeutic feeding center (ITFC) due to medical complications.
