Widespread destruction of health facilities in Ethiopia's Tigray region

Hospitals occupied by soldiers

One-fifth of the health facilities visited by MSF teams were occupied by soldiers. In some instances this was temporary; in others, the armed occupation continues. In Mugulat, in eastern Tigray, Eritrean soldiers are still using the health facility as their base. The hospital in Abiy Addi in central Tigray, which serves a population of half a million people, was occupied by Ethiopian forces until early March.

"The army used Abiy Addi hospital as a military base and to stabilize their injured soldiers," said MSF emergency coordinator Kate Nolan. "During that time it was not accessible to the general population. They had to go the town's health center, which was not equipped to provide secondary medical care—they can't do blood transfusions, for example, or treat gunshot wounds."

Ambulances seized

Devastating impact on the population

Before the conflict began in November 2020, Tigray had one of the best health systems in Ethiopia, with health posts in villages, health centers and hospitals in towns, and a functioning referral system with ambulances transporting sick patients to hospitals. This health system has almost completely collapsed.

MSF staff conducting mobile clinics in rural areas of Tigray hear of women who have died in childbirth because they were unable to get to a hospital due to the lack of ambulances, rampant insecurity on the roads and a nighttime curfew. Meanwhile many women are giving birth in unhygienic conditions in informal displacement camps.

In the past four months, few pregnant women have received antenatal or postnatal care, and children have gone unvaccinated, raising the risk of future outbreaks of infectious diseases. Patients with chronic diseases such as diabetes, hypertension and HIV, as well as psychiatric patients, are going without lifesaving drugs. Survivors of sexual violence are often unable to receive medical and psychological care.

"The health system needs to be restored as soon as possible," Behn said. "Health facilities need to be rehabilitated and receive more supplies and ambulances, and staff need to receive salaries and the opportunity to work in a safe environment. Most importantly, all armed groups in this conflict need to respect and protect health facilities and medical staff."

MSF teams are rehabilitating a number of health facilities across the region and providing them with drugs and other medical supplies, as well as providing hands-on medical support in emergency rooms, maternity wards and outpatient departments. MSF teams are also running mobile clinics in rural towns and villages where the health system is not functioning, and in informal sites where displaced people are staying. However, there are still rural areas in Tigray that neither MSF, nor any other organization, has been able to reach; MSF can only assume that people living in these areas are also without access to health care.