Ethiopia
In 2011, responding to the nutritional crisis in the Horn of Africa, and providing people living in remote areas with access to healthcare, were the focus of Medécins Sans Frontières/Doctors Without Borders (MSF) activities in Ethiopia.
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| Somali refugees at the reception centre in Liben zone are offered health screening. Photo: Michael Tsegaye |
In the border areas close to Somalia, MSF massively scaled up its activities in response to the dire nutritional situation. Drought, a collapsed health system and violent conflict in Somalia saw more than 120,000 refugees arrive in camps in Ethiopia’s Liben zone. Services in two existing camps were expanded and three new camps were established to meet the huge needs. At the peak of the crisis in July, 3,000 refugees were crossing the border at Dolo Ado every day. MSF set up a medical screening unit at the refugee reception point. When refugees reached the camps, the team provided basic healthcare and nutritional support. For those who could not make it on their own, staff used all means, including donkey carts, to get people to medical facilities. Over the course of the year, tens of thousands of children were enrolled in nutrition programmes, which were run in partnership with the government of Ethiopia, the UN refugee agency UNHCR and other organisations.
Overall, MSF admitted more than 31,600 children to nutrition programmes in the camps, vaccinated over 53,000 people against measles and held more than 61,000 consultations. By the end of the year, the mortality rate had returned to normal levels, although tens of thousands of refugees remained in camps, requiring humanitarian assistance.
Assisting marginalised populations
In Somali region, MSF continued working with people affected by the Ogaden conflict, in places where even the most basic services are lacking.
In Degehabur, where fighting between government forces and insurgents has hindered access to healthcare, MSF has been supporting the regional hospital for four years, providing a host of services, including outpatient and inpatient care, nutrition programmes, sexual and reproductive healthcare, as well as treatment for malaria and tuberculosis (TB) and assistance for victims of violence. MSF conducted nearly 4,000 antenatal consultations and delivered 519 babies in Degehabur. Our staff also attended to over 230 wounded and carried out 270 surgical interventions.
In the town of Wardher, MSF expanded its services, creating new ‘satellite’ sites and mobile clinics, and conducting 136 field trips to 10 different locations. The team carried out more than 67,000 consultations with people living in remote communities. Over 1,250 people were admitted to the regional referral hospital, where MSF provides maternal healthcare as well as treatment for malaria and TB.
Further southwest, in East and West Imey districts, MSF conducted an average of 3,000 medical consultations per month, offering maternal healthcare, nutritional support and vaccination. More than 300 patients also received treatment for TB. In total, staff tended to more than 35,000 patients in East and West Imey.
Nutritional support in Oromia and SNNPR
In Oromia region, 300 kilometres east of the capital, where bad harvests can put a severe strain on local people, MSF supported 54 mobile feeding clinics operated by the Health Bureau – 30 in Arsi and 24 in Anchar – ensuring the appropriate medical treatment of malnourished children and women and the supply of drugs and therapeutic food. In total, more than 4,000 patients were enrolled in MSF’s therapeutic and supplementary nutrition programmes in Oromia. As levels of malnutrition decreased, MSF started handing over its programmes to the Health Bureau. This process was formally completed in February 2012.
In September, MSF started nutritional activities in Bensa and Aroressa districts, in the Sidama zone of the Southern Nations, Nationalities and People’s Region (SNNPR). As in Oromia, the teams supported mobile feeding clinics and treated severely malnourished children in intensive feeding centres.
Focus on neglected diseases
In the northern town of Abdurafi, in Amhara region, MSF focuses on treating kala azar (visceral leishmaniasis), a chronic and potentially fatal parasitic disease. Many patients in this project are co-infected with HIV. With around 600 people on antiretroviral treatment, some 1,100 in other HIV-related programmes and an average of 600 on medication for kala azar per year, MSF continued to show how treatment can effectively be implemented in resource-poor settings.
More than 11,000 people attended MSF photo exhibitions about kala azar in Gondar, Bahir Dar and Addis Ababa, which highlighted in particular migrant workers’ vulnerability to the disease. In 2012, MSF plans to continue treating kala azar patients in northwest Amhara region, while also investigating better treatment options.
An outbreak of measles, potentially deadly to people who have not been vaccinated, occurred in central Amhara region in the middle of 2011. Between September and October, MSF treated more than 5,000 patients and conducted a vaccination campaign that covered some 34,400 children aged between nine months and five years of age.
Caught between two worlds
The Nuer population of Gambella region, in the far west of Ethiopia, grew as people fled local and regional fighting across the border in South Sudan. Intercommunal feuds, which generate regular, violent cross-border cattle raids, have been increasing in intensity for the past few years. In 2011, MSF staff conducted over 35,000 consultations in the Mattar health centre and a further 17,000 through mobile clinics. Around 1,200 patients were admitted to hospital, and maternity staff assisted an average of 17 deliveries per month.
In November 2011, fighting that broke out between the Sudanese army and the SPLM-North militias in the Blue Nile state of Sudan forced a large number of people to escape to the Benishangul-Gumuz region of Ethiopia. Approximately 25,000 registered Sudanese refugees live in three camps: Sherkole, Tongo and Adamazin. Thousands more are hosted within local communities. MSF teams ran health centres and managed outreach activities as well as hospital referral at two sites. However, direct access to the camps in Benishangul remains difficult to obtain from the Administration for Refugee and Returnee Affairs. MSF developed medical programmes outside of the camps in order to assist the refugees.
MSF has been working in the country since 1984.