A humanitarian crisis is unfolding in Ethiopia's Tigray region, where hundreds of thousands of people have been displaced by conflict. Health facilities across Ethiopia's Tigray region have been looted, vandalized, and destroyed in a deliberate and widespread attack on health care. "The health system needs to be restored as soon as possible," said MSF general director Oliver Behn. "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." Learn more.
In Gambella region, in Kule and Tierkidi camps for South Sudanese refugees, MSF has set up one 20-bed COVID-19 isolation center and another with a capacity of 10 beds. A team also provides support to the COVID-19 triage and temporary isolation center in Gambella hospital.
Since May, a team in Addis Ababa has been providing mental health support in three COVID-19 quarantine centers for some 5,000 migrants who have returned mainly from Saudi Arabia, Kuwait, and Lebanon. MSF is supporting the Ministry of Health medical and non-medical staff who work in the quarantine centers by training them on migrants’ mental health needs.
Our teams support the regional health authorities in different project locations in Amhara and Somali Region in their isolation and treatment centers and with health education. We have also been working on preparedness in all our projects putting in place preventive and hygiene measures.
In Ethiopia, Doctors Without Borders/Médecins Sans Frontières (MSF) fills critical gaps in health care, responds to disease outbreaks, and assists internally displaced people and refugees.
By the end of 2019, Ethiopia was hosting 750,000 refugees, most of whom were from neighboring South Sudan, Eritrea, and Somalia. The country with the second-biggest population in Africa witnessed episodes of intercommunal violence, which led to waves of displacement. Mainly for economic reasons, Ethiopia was also the origin of a fluid migration route towards Saudi Arabia.
On November 4, Ethiopia’s prime minister ordered military action against the Tigray People’s Liberation Front (TPLF) in the Tigray region, following an attack on an Ethiopian military base. The escalating conflict could affect millions of people and runs the risk of destabilizing other parts of the country and the region, with potentially catastrophic humanitarian consequences.
MSF continued to work with the Ethiopian authorities to respond to emergencies such as cholera and measles outbreaks, and deliver health care to remote communities, refugees, and displaced people, and providing treatment for snakebites, kala azar (visceral leishmaniasis), and other neglected diseases.
In the first quarter of the year, teams were still working in some woredas (administrative areas) in western Ethiopia, with a focus on emergency health care and water and sanitation for people displaced by violence on the border between Benishangul-Gumuz and Oromia. We concluded these activities in April.
In the same month, we launched another emergency intervention in Gedeo, in the southern part of the country, only three months after closing one in the same place. This was in response to a huge deterioration in the humanitarian situation of the uprooted populations and assessments that showed alarming malnutrition levels among children and lactating women.
In five months, MSF teams treated 5,100 patients, 3,820 of them severely malnourished children under the age of five, in inpatient and outpatient therapeutic feeding programs. In August, we ended these activities due to a sharp decrease in admissions following the government’s relocation of most of the internally displaced people to neighboring West Guji.
These two displacement crises, both linked to ethnic tensions and conflict, were the worst to take place in Ethiopia in 2018 and 2019, with a total of around 1.2 million people displaced during peak periods.
MSF teams responded to outbreaks of violence elsewhere in the country with smaller, short-term interventions, for example in Moyale in Somali region, and Gondar and Metekel in Amhara and Benishangul-Gumuz regions respectively.
Ethiopians continued to migrate from rural areas with the aim of reaching Saudi Arabia and other Gulf countries and finding better paid jobs. According to the International Organization for Migration, 138,000 people—mostly Ethiopians, but also people from other African countries—set off from the Horn of Africa across the Gulf of Aden towards Yemen in 2019; this exceeds the number who crossed the Mediterranean seeking safety in Europe.
At the same time, an average of 10,000 Ethiopians per month arrived in the capital, Addis Ababa, on flights from Jeddah, as part of a deportation drive that the Saudi authorities initiated in 2017.
Our teams maintained a medical screening project at the airport and mental health support at a counseling center in the city. The migrants undergo an extremely perilous journey, during which most witness or experience traumatic violent incidents either at the hands of traffickers while crossing war-torn Yemen or in detention in Saudi prisons.
In Doolo zone, we expanded our work to reach the most vulnerable pastoral communities. By the end of the year, we were operating in 18 flexible mobile clinic sites, offering comprehensive general health care, including maternal health services. We also strengthened a dynamic health surveillance system via ‘tea teams’ to engage the community over tea, as per local tradition.
In September, we handed over to the local health authorities our last medical activities in Dolo town, in Liben zone, after a continued presence of nearly a decade. Over the previous years, health indicators stabilized and there were no significant arrivals of refugees from Somalia.
We maintained our support to Gambella hospital, the only facility in the region offering specialized medical care for around 800,000 people, half of them refugees from South Sudan. Each month, MSF teams admitted between 60 and 70 newborns to the intensive care unit and assisted around 250 births. We also carried out surgeries and treated dozens of people in the emergency room every day including wounded people from the conflict in South Sudan and intercommunal violence conflict
While the number of South Sudanese refugees decreased during the year there were 309,000 in Gambella as of December 2019, according to the UN refugee agency, UNHCR. We continued our interventions in Kule, Tierkidi, and Nguenyyiel refugee camps and Pamdong reception center, conducting around 264,000 outpatient consultations, assisting some 2,230 births and providing care for 2,950 patients admitted in the health center.
At the end of the year, we closed our activities in Nguenyyiel camp and reduced our operations in Tierkidi camp to be able to focus more on quality health care delivery in areas where no other health care provider is present. Learn how you can best help in Ethiopia and other countries.
More than 70,000 Eritrean asylum seekers sought refuge in Ethiopia in 2019, adding pressure on registration and reception facilities and exacerbating the already dire conditions in the camps. In Hitsats camp in Tigray region, our teams conducted over 3,000 psychiatric outpatient consultations and 1,160 individual mental health consultations, with both refugees and the host community.
In and around Abdurafi, in Amhara region, we continued to focus on visceral leishmaniasis, also known as kala azar, and on the management of snakebites. It is mostly seasonal migrant workers who are affected by both neglected diseases, as they have not built up an immunity to kala azar, live in poor living conditions, and work unprotected in the agricultural sector making them an easy target for snake bites.
We screened over 2,100 suspected cases of kala azar and treated 320 patients with the disease. We also continued with clinical research to develop safer treatment and better diagnostics.
Our teams treating snakebites witnessed an exponential increase in cases, from 647 in 2018 to 1,431 in 2019, which reflects the extent of the problem and the need to invest more in snakebite treatment research. Please donate to support our work in Ethiopia and other countries around the world now.