A mother watches on as her son takes a nap in the inpatient therapeutic feeding centre tent. Ethiopia, 2022. © Njiiri Karago/MSF
Clearly, many people in Afar cannot access the very minimum levels of healthcare, food and water necessary to sustain human life due to a combination of recent conflict, displacement, lack of access to healthcare, food and water scarcity, combined with an insufficient humanitarian response,” said Veicht. “To even begin to get control of this, a major scale of humanitarian assistance is urgently needed for displaced people and vulnerable host communities, with food security, primary healthcare, nutrition and water as key points of focus.”Raphael Veicht, Emergency Coordinator
Damaged, destroyed, abandoned or under-resourced, it is reported that only 20 percent of health structures in Afar region are functional. At Dupti Hospital, where more than 80 percent of malnourished children admitted for care have had no previous access to healthcare before arriving to the referral hospital. Patients tell Doctors Without Borders they struggle to access healthcare, food, clean water or other basic needs, leading to increased levels of malnutrition and life-threatening illnesses.
“The site where we are staying is extremely harsh and uninhabitable,” said Asiya Salih Mohammed, who says many people from her community died in the conflict and that she was forced to travel by foot for over a month in search of safety. Now, she has arrived in a displaced persons site which lacks even the most basic provisions, including no medical centre, which is why she’s brought her one-year-old daughter to Dupti Hospital. “There is not enough food to eat, there is no drinking water, the house in which we are staying has no roof, so we have no shade and we’re exposed to the sun.”
MOH staff at the hospital measuring the mid-upper arm circumference of a child during a malnutrition screening at the inpatient therapeutic feeding centre in (ITFC) in Dupti hospital, Afar region. Ethiopia, 2022. © Njiiri Karago/MSF
The impact of those conditions is apparent among the patients in Dupti Hospital, where nearly two third of malnourished children requiring hospitalization come from displaced families, driving up admission rates. After Doctors Without Borders started its support for the 14-bed in-patient therapeutic feeding centre in Dupti Hospital this April, the ward was quickly overwhelmed with two or more patients per bed. Teams opened 14 additional beds in temporary structures, but these are also fully occupied and medical staff struggle to provide the level of care children need in this overcrowded facility. And recently, even the regular paediatric ward has become overwhelmed, with the number of patients exceeding beds by a factor of two or more.
Doctors Without Borders has recently agreed with the Ethiopian Ministry of Health to increase the hospital’s paediatric, in-patient feeding and emergency department capacity, including with the rapid construction of new buildings and to support sanitation and the establishment of a reliable water source. In parallel, Doctors Without Borders plans to open five out-patient feeding programs in the most critically needed areas, but far more is needed to stave off a looming crisis.
Hundreds of thousands of people are struggling to survive not only in Afar but also other parts of Ethiopia. In Wardher, Somali region, rains have finally started, but people are still experiencing compounded challenges of food and water insecurity linked to an extended period of drought. Doctors Without Borders recently completed a measles vaccination campaign reaching more than 7,000 children in 50 different locations and has implemented medical surveillance to quickly react to emergency medical needs. Communities across the region warn of catastrophic drought, which is killing off livestock and other vital lifelines for survival, while water, food and access to healthcare are often out of reach.
There are currently thousands of people suffering from the dire consequences of the ongoing nutritional crisis and in desperate serge for food and assistance not only in Afar but also other parts of Ethiopia. Of course, the only response to a nutritional crisis is to make sure that people have access to food. But large parts of the population in Afar and other parts of Ethiopia, especially those displaced by conflict, also don’t have access to other essential means to sustain life such as medical care and safe drinking water. Without an urgent upscale of the humanitarian response in Afar, many people already living through the horrors of conflict, displacement and drought will be further pushed towards the brink of survival. In order to avoid further excess morbidity and mortality as a consequence of the ongoing nutritional crisis in Afar and other parts of Ethiopia, the humanitarian community must act with urgency