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Ethiopia: Update on the humanitarian situation and MSF response in Tigray
March 1st 2021: Hundreds of thousands of people have been forced to leave their homes in the Tigray region of northern Ethiopia after fighting broke out in early November, 2020, according to UN agency OCHA.
Limited access to food, clean water, shelter and healthcare
As of mid-February 2021, more than 60,000 people have crossed to Sudan as refugees, while many others are displaced within the Tigray region, staying in towns, remote areas or trapped between localised outbreaks of fighting.
For those areas MSF teams could access, tens of thousands of displaced people are living in abandoned buildings and on construction sites in northwestern and western areas around Shire, Dansha and Humera towns, while others have found refuge in host communities in the east and south of the region.
Both host communities and displaced people have very limited access to food, clean water, shelter and healthcare. In several areas our teams visited, health centres have been destroyed and looted and there is a severe lack of staff and medical supply.
MSF teams have also heard reports that many people are still hiding in the mountains and in rural areas across the region. Although access has now been granted to some humanitarian organisations, there is still only a marginal scale up of humanitarian aid.
In some of the places visited by MSF, power lines are cut, water supplies are not functional, telecommunications networks are down, banks are closed, and many people are afraid to return to their places of origin because of the ongoing insecurity. Even when services like electricity return to some places they fail again recurrently.
Often, they have no way to contact their relatives or to buy essential items for their households. Some people are also hosting family members displaced from elsewhere in the region, creating an additional burden on them.
The fighting also broke out at harvest time in a region where crops were already badly damaged by desert locusts, leaving food in short supply.
Before the fighting started, nearly one million of people were already dependent on food assistance. Although aid agencies and local authorities are distributing food in some areas, there are concerns about the current targeting of aid and that supplies are not reaching the most vulnerable.
MSF remains concerned about the ability of people in need to receive lifesaving medical care and humanitarian assistance. WHO estimates that only 22 per cent of health facilities are functional and that 78 per cent of the hospitals in the region are not accessible.
Prior to the crisis, Tigray had some of the best health indicators in the country. The population in Tigray was around 5.5 million before the fighting, including more than 100,000 internally displaced people and 96,000 refugees who were already dependent on food assistance, according to the UN.
Since mid-December 2020, MSF teams have been providing medical care to some of the most affected people in need in the areas we’ve been able to access inside Tigray:
- In southern Tigray, MSF teams ran mobile clinics and restarted some services at health centres in the towns of Hiwane and Adi Keyih, alongside staff from the Ministry of Health, until mid-January. Between 18 December and 17 January, MSF teams in Hiwane and Adi Keyih provided 1,498 medical consultations.
- In eastern Tigray, MSF is supporting the hospital in Adigrat, the region’s second city. When an MSF team arrived in the city on 19 December, they found the hospital, which served a population of more than one million, had partially stopped functioning. Since 23 December, MSF medical teams have been running the hospital’s emergency room, as well as the medical, surgical, pediatric and maternity wards. They are also providing outpatient care for children under five.
In total, MSF received 2,212 patients in the emergency room of Adigrat’s hospital, assisted 486 deliveries (including 56 caesarean sections), and admitted 119 patients in the surgical ward, 86 in the paediatric ward from 24 December to mid-February.
We have recently started a mental health programme and are also supporting seven health centers in the area, where we run mobile clinics, and trying to reach more health centers in rural areas.
At least 1,907 medical consultations have been carried out through mobile clinics in the peripheral areas of Adigrat until mid-February.
- In central Tigray, in the towns of Adwa, Axum, MSF teams are providing some of the displaced people and local population with basic healthcare and supporting health facilities which lack essential supplies such as medications, oxygen and food for patients. In Adwa, we are supporting Don Bosco hospital and four health centers. In Axum, we are supporting the hospital and four health centers. In both places we are trying to increase outreach activities to other areas. Since the beginning of the year and until mid-February, our teams have treated 240 people in the Emergency Room and assisted 90 deliveries (including 19 c-sections) in Axum, among other activities. In the same period we carried out 1,061 medical consultations through mobile clinics in the peripheral areas of Adwa and Axum.
In the town of Abyi Addi, west of Mekele a team is supporting the health centre. The emergency room, outpatient departments and other basic services have been restored and are back to being fully functional.
In the past weeks intense combats and bombardments in the areas near the town. The team received, treated and referred some patients with injuries from the fighting to Mekele Hospital. A team first went in early January and since beginning of February we have a team fully based in town.
- In northwest and western Tigray, in Shire, we are supporting the hospital and have given donations to several health centres in Shire and surrounding areas. We are also conducting mobile clinics in three IDP sites in Shire, where IDPs live in a university and two school buildings and to the population in surrounding villages. In Shire, we conducted 3,814 consultations in January. In the town of Sheraro, we are providing support to Sheraro Health Center in terms of technical medical assistance and hands-on-coaching through our staff, facilitating transport of medical supplies to the HC, ensuring proper facility set-up including waste management and IPC, and facilitating emergency referrals to Shire hospital.
In the towns of Mai Kadra, and Humera, as well as in Abdurafi in Amhara region on the border with Tigray, MSF provided support to some health centres and has been assisting around 2,000 internally displaced people by providing medical services, supplying water, sanitation and hygiene products, and constructing emergency latrines after the fighting started. Most of the internally displaced people are no longer there.
We continue supporting the remaining IDPs in Abdurafi and other places and are conducting mobile clinics, water and sanitation activities, as well as giving donations to health centers in the triangle between Humera, Dansha and Abdurafi.