Ethiopia

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Key medical figures:
• 120,800 outpatient consultations
• 9,900 patients treated in feeding centres
• 600 patients under treatment for TB

Ethiopia

Nomadic people, refugees, people in conflict-affected areas and those located in the remotest parts of Ethiopia lack access to health   services.

Responding to the lack of medical services for pregnant women and young children, Médecins Sans Frontières (MSF) runs a programme focused on maternal and child health in Sidama, Southern Nations, Nationalities and People’s Region (SNNPR). People are seen at Mejo and Chire health centres, and through outreach activities in 15 locations. A maternity waiting home offers  women with high risk births a place to stay for one to two weeks before delivery, so that they are close to emergency obstetric  services. In 2013, the team provided 10,460 ante- and postnatal consultations, assisted 800 deliveries and vaccinated 19,260 children. The  inpatient department saw 3,000 patients.

Visceral leishmaniasis, or kala azar, a parasitic disease transmitted by the bite of an infected sandfly, is endemic and sometimes  epidemic in Ethiopia. In Abdurafi, Amhara region, MSF provides treatment for people with kala azar and HIV/AIDS, and for those  co-infected with tuberculosis (TB). MSF completed the handover of patients with simple HIV to the Bureau of Health in 2013. The  Abdurafi programme also offers nutritional support for patients and treatment for malnourished children under five.

Filling  healthcare gaps in Somali region
Underdevelopment, a shortage of qualified senior health workers and conflict between  government forces and armed anti-government groups all pose barriers to healthcare in the Somali region. In Degehabur, MSF  supported the regional hospital with emergency obstetric services, mental healthcare, assistance for victims of violence including  sexual violence, treatment for malnutrition and TB. Basic healthcare was provided through mobile clinics in Birqod, Ararso and  Degehabur woredas. Teams carried out 3,460 antenatal consultations and enrolled 960 children in nutrition programmes. Mental  health activities, including counselling and therapy groups, were attended by 890 people, and 430 patients began TB treatment. A fully equipped 35-bed ward was built to provide better care for children requiring hospitalisation. Drugs and materials for the  management of health activities were also provided. Improvements were made in water quality and supply in MSF-supported health facilities and a team completed a measles vaccination campaign with the Bureau of Health. In the Wardher area, MSF  supported Wardher hospital, focusing on specialist care for severely ill or malnourished children, maternity services and TB treatment. Basic healthcare was offered at Yucub health post, and two health centres in Danod and Yucub received support in the  form of staff, medical supplies and training to provide quality health services to the surrounding population. Additionally, regular  mobile clinics travelled to nine outlying locations and provided antenatal care, therapeutic feeding and immunisations. A free  ambulance served another 12 villages. Teams treated 1,467 children for malnutrition, provided 2,242 women with antenatal care  and assisted 325 deliveries.

Critical refugee assistance
Teams continued to provide specialist healthcare for Somali refugees and  the host population in Dolo Ado, Liben zone, Somali region. Services include an inpatient department, emergency obstetric surgery and a therapeutic feeding centre for children. Teams vaccinated 12,180 children against measles and, in collaboration with the  Regional Bureau of Health, also carried out several rounds of polio vaccination. In the western region of Benishangul- Gumuz, a  team provided aid to South Sudanese refugees. An evaluation of the emergency nutrition programme that started in 2012 in  Bambasi camp showed that people’s nutritional status had greatly improved. MSF continued to work with local authorities to  improve healthcare and nutritional services in Bambasi, Tongo and at the new Ashura camp. Teams undertook 23,170  consultations and admitted 21,025 children to supplementary feeding programmes across all three camps. In July, following an  outbreak of violence in South Sudan, MSF started providing assistance to an estimated 3,000 refugees and 3,000 people in the  host community of Raad, Gambella region. By the end of the year, teams had carried out 5,500 consultations, and vaccinated 1,280  children against measles and 1,980 against meningitis.

Responding to drought and deportation
The worst drought recorded  in recent years in Afar region had a severe impact on people’s health and nutrition. In April, MSF responded by sending a team to  Teru Woreda, a harsh and difficult to reach area that lacks development support. Staff set up a supplementary feeding programme  and an inpatient unit, and carried out mobile treatment activities. More than 1,880 children received medical care. In November,  the government of Saudi Arabia began deporting ‘illegal’ foreign workers, resulting in the arrival of 154,837 Ethiopian men, women  and children at Bole airport by the end of December. MSF provided psychosocial support to 15,673 people. One-fifth of  those receiving individual consultations were found to have a mental illness and 40 were referred to the psychiatric hospital in  Addis Ababa for further treatment.

Programme closures
TB is the second-most common cause of death in Ethiopia after malaria,  and there are indications that drug-resistant forms of the disease are on the rise. MSF assisted the Bureau of Health in establishing  an innovative programme for TB treatment in Dire Dawa. The team handed over the project after donating diagnostic  equipment, fine-tuning medical protocols and making modifications to the TB ward and people’s homes so that they could undergo  treatment without a lengthy hospital stay. The clinic in East Imey, Somali region, was handed over to the Bureau of  Health in March, and the therapeutic feeding centre in Buramino refugee camp was closed in April. MSF also handed over the  project providing inpatient, maternity and nutrition care at a health centre in Mattar, north of Gambella city, in June. In the first  half of the year, teams carried out 33,140 health and 650 antenatal consultations, and assisted 170 birt

No. staff end 2013: 1,226 | Year MSF first worked in the country: 1984

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