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

Abstract

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.

Healthcare Challenges due to Global Conflict Escalation Amid the Pandemic, Climate, and Economic Dilemmas

“…Armed militants destroyed crops, killed people, looted and vandalized hospitals, clinics, health posts, and ambulances, as well as ransacked and destroyed schools (Wall, 2022). Rape, gang rape, sexual enslavement, torture, beatings and killings of friends and family, and derogatory ethnic slurs have all been reported (Teka & Berhe, 2022). According to the United Nations World Food Programme (WFP), nearly half of Tigray's six million residents are classified as "heavily food insecure," with nearly 90% lacking regular access to food.…”

Global conflict escalation during the pandemic, climate, and economic dilemmas: Healthcare sustainability challenges in conflict zones and elsewhere

“…Inadequate COVID-19 knowledge, a negative attitude toward COVID-19 management, low educational attainment, living in a rural area, and being female were all significantly associated with poor COVID-19 prevention practices (Tegegne et al, 2022). Armed conflict between the Ethiopian military and the Tigrayan Defense Force (TDF) in northern Ethiopia began on November 4, 2020 (Berhe et al, 2022) and has displaced over three million people and killed about 500,000 in the last two years (Sharif, 2022). Armed militants destroyed crops, killed people, looted and vandalized hospitals, clinics, health posts, and ambulances, as well as ransacked and destroyed schools (Wall, 2022).…”

“…Armed militants destroyed crops, killed people, looted and vandalized hospitals, clinics, health posts, and ambulances, as well as ransacked and destroyed schools (Wall, 2022). Rape, gang rape, sexual enslavement, torture, beatings and killings of friends and family, and derogatory ethnic slurs have all been reported (Berhe et al, 2022). According to the United Nations World Food Program (WFP), nearly half of Tigray's six million residents are classified as "heavily food insecure," with nearly 90% lacking regular access to food.…”

Global Health Issues With Conflict Escalation Among Pandemic, Climate, and Economic Crises

“…Inadequate COVID-19 knowledge, a negative attitude toward COVID-19 management, low educational attainment, living in a rural area, and being female were all significantly associated with poor COVID-19 prevention practices [254]. The Ethiopian military and the Tigrayan Defense Force engaged in armed conflict in northern Ethiopia on November 4, 2020 [255], displacing over 3 million people and killing approximately 500,000 in the past 2 years [256]. Armed militants destroyed crops, killed people, looted and vandalized hospitals, clinics, health posts, and ambulances, as well as ransacked and destroyed schools [257].…”

“…Armed militants destroyed crops, killed people, looted and vandalized hospitals, clinics, health posts, and ambulances, as well as ransacked and destroyed schools [257]. Rape, gang rape, sexual enslavement, torture, beatings and killings of friends and family, and derogatory ethnic slurs have all been reported [255]. According to the United Nations world food Programme (WFP), nearly half of Tigray's 6 million residents are classified as "heavily food insecure," with nearly 90% lacking regular access to food.…”