Some 200,000 refugees from the civil war in South Sudan arrived in Gambella region, western Ethiopia, between December 2013 and October 2014.
The long journey on foot, with inadequate food and water, had taken a toll on people’s health and many arrived in Ethiopia sick and malnourished. From February, Médecins Sans Frontières (MSF) provided medical consultations and care at entry points close to the border. Teams worked at a health post in Pagak and Tiergol, ran mobile clinics in Pamdong and Burbiey, and conducted outpatient consultations at a health post in the Matar transit camps.
MSF also started a programme in Leitchuor camp. The 100-bed hospital offered outpatient consultations, emergency services, maternal healthcare and treatment for malnutrition. Outreach workers engaged in health promotion activities and identified people needing medical attention. The camp is located in an area prone to flooding and was inundated during the rainy season, causing the eventual relocation of the refugees to other camps in nearby villages and on higher ground.
MSF ran inpatient and outpatient services for refugees and the host population at a 118-bed health centre in Itang, close to Kule and Tierkidi camps, where more than 100,000 people had settled by April. When the Itang health centre flooded in August, MSF moved activities to the staff compound and had to reduce the number of beds. MSF provided decentralised medical care through two health posts in Tierkidi camp and three in Kule, and ran a 120-bed hospital in Kule. The hospital has an isolation unit for hepatitis E patients and between July and the end of the year, 541 people with suspected hepatitis E received medical care.
To address the lack of clean water and sanitation facilities in Kule and Tierkidi camps, MSF set up a water treatment plant that produced 56.4 million litres of safe water before it was handed over to Oxfam in July. Teams also constructed more than 2,500 showers, 1,200 latrines and 180 hand-washing points in the camps.
MSF launched a preventative vaccination campaign against cholera in Gambella region in July, targeting 155,000 refugees and members of the host community who each received two doses of the vaccine. In November, some 23,000 children aged six weeks to five years were immunised against pneumococcus and common childhood diseases.
Southern Nations, Nationalities and People’s Region (SNNPR)
A programme focused on health services for mothers and children under five continued in the Aroressa and Chire woredas (districts) of Sidama, SNNPR. Teams worked in health centres in Mejo and Chire and conducted outreach activities in 13 locations. During the course of the project, which was handed over to the Ministry of Health in October, two maternity waiting houses were constructed to enable women with high-risk pregnancies who lived far from health facilities to deliver safely. MSF also supported referrals of paediatric emergencies and women presenting with complications during labour to hospitals in Hawassa, Yirga Alem or Addis Ababa.
MSF started a new project in SNNPR in October, together with the Regional Health Bureau. Its purpose is to strengthen the emergency preparedness, surveillance system and response capacity of the public health management team in six selected zones of the SNNPR. These zones are Sidama, Wollayta, Gamogofa, Segen, South Omo and Bench Maji.
Underdevelopment and conflict between the government and armed opposition groups pose barriers to healthcare in Somali region, and 200–500 refugees from Somalia arrive in the Liben zone each month. The population of Buramino and Hiloweyn refugee camps, Liben zone, has reached 77,000. MSF continued to assist with the provision of basic healthcare at the reception centre and in the camps. A team also provided medical care for Somali refugees and the host community in Dolo Ado, Liben zone. In the hospital, MSF supported the paediatric inpatient department, stabilisation centre, emergency room and laboratory, as well as emergency obstetric surgery and maternity services. Between January and March teams vaccinated 12,100 children against measles and carried out several rounds of polio vaccinations in collaboration with the Regional Bureau of Health.
MSF supported the regional hospital in Degehabur, providing inpatient care for children under five, tuberculosis (TB) treatment, nutritional support, and emergency room and intensive care services. It also supported three health centres and nine health posts in Degehabur, Ararso and Birqod woredas, and conducted outreach activities. The focus in 2014 was on mother and infant health – there were 2,578 antenatal consultations – as well as nutrition and vaccination activities.
In September, MSF started supporting Fiq hospital, Nogob zone, and provided an emergency referral system, outpatient services, nutritional support, paediatric inpatient care, obstetrics and gynaecology, and pharmacy and laboratory services. A network of community health workers was also established.
In Danod, MSF offered basic healthcare in the 24-hour health centre and ran weekly mobile clinics in four villages in the district. The team conducted more than 12,000 consultations in 2014. In addition, MSF helped build local healthcare capacity by donating medical supplies, and coaching and supervising staff. Maternity services and treatment for malnutrition are a focus of this programme. MSF continued to address gaps in healthcare provision around Wardher, running mobile clinics in five villages in the district, and visiting Yucub health centre three times a week to support and supervise the staff and to donate medical supplies. An ambulance service also operated, covering 18 villages in Wardher and Danod districts, transferring patients with life-threatening conditions to Wardher hospital. MSF supported the hospital’s paediatric, TB and maternity departments, as well as a stabilisation unit for severely malnourished children and was involved in the set-up of an operating theatre run by the Ministry of Health, which provides emergency obstetric surgery. A measles vaccination campaign was carried out in collaboration with local health authorities in March, reaching 4,300 children, and eight rounds of polio vaccinations were completed in Wardher and the surrounding area. In September, MSF handed over routine vaccinations, care for chronic conditions and triage to national health authorities.
Kala azar and malnutrition in Amhara
The parasitic disease kala azar (visceral leishmaniasis), endemic in this area, is usually fatal if left untreated. MSF continued its programme for patients with kala azar in Abdurafi, Amhara region, including those co-infected with HIV/AIDS or TB. Nutritional support is available to patients in the programme. More than 1,200 people were screened for kala azar in 2014. MSF also filled gaps in emergency services, provided inpatient care for children under five with malnutrition and transported patients to hospitals in Humera and Gondar.
In Raad, Gambella region, an emergency project that started in July 2013 came to an end in January following the closure of the transit camp for South Sudanese refugees. Another project providing assistance to refugees in the western region of Benishangul-Gumuz, also came to an end in May.
No. staff in 2014: 1,416 | Expenditure: €21.3 million | Year MSF first worked in the country: 1984 | msf.org/ethiopia