Obstetrics and gynaecology in an Ethiopian war zone

Yemane, Awol; Tesfay, Frewoini; Gidey, Hagos; Tekle, Ashenafi; Tadesse, Ytbarek; Yahiya, Mohammedtahir; Tadesse, Habtom; Amare, Birhane; Gebru, Fanos; G/her, Mulugeta; Hailay, Selam; GMariam, Tesga; Berhe, Yibrah; Wall, L. Lewis

doi:10.1111/1471-0528.17238

Cited by 9 publications

(25 citation statements)

References 9 publications

(17 reference statements)

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“…Before the war, the average water supply coverage in the region (rural and urban water supply) was approximately 58%, (Debeb, 2022). The hospitals and clinics in Tigray can neither process blood for transfusion nor store it for later use due to the lack of water and power, as a result of the damage to the infrastructures due to the war (Yemane et al, 2022). The people of Tigray are also exposed to waterborne diseases such as cholera because the damage to the water supply infrastructure has exposed the public to fetch water from open and untreated water sources like rivers and lakes (Zwizwai, 2022).…”

Section: Overall Damages To the Water Supply Systems Of Tigraymentioning

confidence: 99%

Assessing the impact of war on the water supply infrastructure in Tigray, Ethiopia

Shishaye¹,

Gebremicael²,

Meresa³

et al. 2023

Preprint

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Armed conflicts throughout the world can have substantial impacts on private and public infrastructure and its people. Over the last two decades, the regional government of Tigray in Ethiopia has invested extensively in developing surface and groundwater resources for water supply leading to 61% of rural and 57% of urban populations having access to safe drinking water by 2020. However, the Ethiopian Government and its allies&rsquor; invasion of Tigray in the early November 2020 led to considerable damage and devastation of Tigray's water infrastructure. This study assessed the damage to Tigray's water supply systems and determined the impact on its people. The study, conducted between late 2021 and early 2022, found that the destruction reduced the rural and urban water supply coverage of the region by over 50% (i.e., reduced to 28% and 25%, respectively). The war exposed more than 3.7 million people in Tigray to a shortage of drinking water supply and water-related risks, such as disease and food insecurity. Over the past 15 months of the war, the damage to the water supply infrastructures in Tigray was considerably higher than in other regional conflicts, with the damage in Tigray being 15% higher than the damage to Syria's drinking water supply infrastructures over 10 years of conflict and 6% higher than the damage to Yemen's water supply infrastructures over seven years of conflict. This study shows the significant and long-term impacts armed conflict can have on a developing country's water infrastructure and people. In future conflicts, monitors and aid agencies must assess this more adequately to limit the impact on civilian populations.

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Section: Overall Damages To the Water Supply Systems Of Tigraymentioning

confidence: 99%

Assessing the impact of war on the water supply infrastructure in Tigray, Ethiopia

Shishaye¹,

Gebremicael²,

Meresa³

et al. 2023

Preprint

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“…Except for trickles of some medications from international donors, almost no medical supply has made it to the region adding strain to the already fragmented healthcare system [ 3 ]. This has no equivalency other than the denial of the fundamental human right to access healthcare services [ 4 ]. The burden of healthcare disintegration is mainly carried by patients with chronic medical illnesses including patients on hemodialysis (HD).…”

Section: Introductionmentioning

confidence: 99%

Vicarious trauma on the hemodialysis healthcare workers in the besieged Ethiopia’s Tigray region: a call to action

Berhe

Tesfay

2022

BMC Med

Self Cite

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Background The war on Ethiopia’s Tigray broke out on November 4, 2020. Amid the armed conflict, governmental institutions were destroyed, people were displaced, and thousands of civilians were killed. The region was experiencing an on-and-off type of blockade since the war broke out until June 28, 2021, at which time the federal government of Ethiopia imposed a siege cutting off the region from the rest of the world. Due to the shortage of medicines and medical supplies, witnessing deaths that otherwise were preventable under normal conditions has become the daily predicament of healthcare workers. The burden of healthcare disintegration is particularly carried by patients with chronic medical illnesses including patients on dialysis. Main body Ayder hospital, Tigray’s flagship healthcare institution, hosts the only hemodialysis center in the entire region. This center is currently unable to give appropriate care to kidney failure patients for a lack of access to dialysis supplies and consumables due to the ongoing war and siege. This has resulted in vicarious trauma manifested with compassion fatigue, irritability, a feeling of bystander guilt; sadness about the patient’s victimization, and hopelessness among healthcare workers caring for dialysis patients. Conclusion The suffering of veteran patients and witnessing preventable deaths have continued to haunt and torment healthcare workers in the dialysis unit leading to vicarious trauma. Cognizant of the fact that vicarious trauma has serious health ramifications on healthcare workers; we call up the international community to advocate for a full resumption of access to healthcare and the provision of mental health support and educate and train healthcare workers dealing with end-stage kidney disease patients on hemodialysis.

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“…Focusing on the impacts on human beings, thousands of civilians have died due to direct killings and lack of medicine and food [ 1 , 3 ]; the incidences and prevalence of morbidities from existing and new illnesses are increasing [ 4 ]; and people are suffering due to the near-total collapse of the health-care system [ 4 , 5 ]. Coupled with the imposed siege of the entire region by the Ethiopian and Eritrean governments and Amhara regional forces, women and children living amongst the ongoing conflict in war-torn Tigray are the ones paying the highest price [ 6 ]. In particular, women who have developed fistula experience excruciating pain as a result of isolation, shame, and rejection by families and communities [ 7 ], partly due to fecal/urinary incontinence.…”

Section: Introductionmentioning

confidence: 99%

“…As of May 2022, Tigray Regional Health Bureau [ 10 ] revealed that 36/40 hospitals had been fully destroyed or partially damaged, 208/232 health centers had been fully destroyed or partially damaged, and 670/741 health posts had been fully destroyed or partially damaged; moreover 274/308 ambulances had been burned or looted. Such targeted attacks on the health infrastructure have severely affected the maternal health services [ 4 , 6 , 10 ]. For example, antenatal care (ANC) decreased from 94% in 2019 to 16% in 2022 and skilled delivery from 81% to 21%, leading to obstructed labor during childbirth [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Fistula in War-Torn Tigray: A Call to Action

Gesesew

Berhe

Gebretsadik³

et al. 2022

IJERPH

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Fistula is roaring in the ongoing war on Tigray. The potential risk factors for fistula in the conflict zone include obstructed labour due to limited or absent maternal care services, a correlation between malnutrition-stunted growth and birth difficulties and trauma, and sexually transmitted infections (STIs) due to conflict-related sexual violence. As a call to action to mitigate the unimaginable suffering that women and girls are facing in the region, concerted international effort is needed to provide treatment, rehabilitation, and re-integration; secure peace and stability; rebuild the health-care system; and ensure perpetrators are held accountable.

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Obstetrics and gynaecology in an Ethiopian war zone

Cited by 9 publications

References 9 publications

Assessing the impact of war on the water supply infrastructure in Tigray, Ethiopia

Assessing the impact of war on the water supply infrastructure in Tigray, Ethiopia

Vicarious trauma on the hemodialysis healthcare workers in the besieged Ethiopia’s Tigray region: a call to action

Fistula in War-Torn Tigray: A Call to Action

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