Health care services in Tigray are extremely limited, leaving hundreds of thousands of people, including those who are chronically ill and others who were injured during the fighting, without adequate access to essential medicines and basic services. According to the Emergency Coordination Center. Ongoing assessments by WHO indicate that 141 of the 198 assessed hospitals and health centres were either partially or fully damaged. All hospitals and centres urgently need more medical supplies, drugs and equipment, according to WHO, and partners report continued looting of health facilities, with 12 further incidents of looting by armed actors reported in the past two weeks.
Child and maternal services have been drastically disrupted. Less than 16 per cent of the health facilities are providing vaccination services, while only 17 per cent are providing maternal services, such as antenatal care and birth delivery, according to health partners. Access to drugs also remains critically low at 16 per cent of the facilities. Most Woreda health offices are not yet functional, according to the Health Cluster.
People living in overcrowded conditions in displacement centres face tremendous health challenges. The rapid assessment conducted by the Bureau of Labour and Social Affairs (BoLSA) and humanitarians in displacement centres in Mekelle Town, for example, showed a high number of diarrheal diseases and women delivering in the camps, as no emergency services are provided during the night. Although free basic attention is being provided, displaced people face challenges to access medicines due to the lack of essential drugs in the hospitals.
There has been significant increase in geographical access to more Woredas by the operational partners in the past few weeks. To date, 67 per cent (45/67) of the targeted Woredas have been accessed through 50 MHNT compared to 25 per cent (17/67) woredas that were supported in the beginning of Feb 2021. The MHNTs are run by 16 of the 18 operational partners; ten (10) of the 50 MHNTs are operated by Regional Health Bureau supported by UNICEF, WHO and UNFPA.
During the reporting period, MSF-Spain provided 431 Outpatient Department consultations (OPD), 19 admissions, 85 deliveries, conducted 17 other surgeries and provided 48 group and 75 individual consultations for mental health service. In addition, MSF-Spain conducted nutrition screening for 614 people, provided family planning services for 32 people, 250 routine vaccinations and, 17 referrals. At the Adigrat area mobile clinics, MSF-Spain provided 671 OPD Consultation, services for 5 severely malnourished children, provided family planning services for 46 people, provided 393 people with routine vaccination, and 7 referrals.
Mothers and Children Multisectoral Development Organisation (MCMDO) are supporting/ ongoing emergency health response in nine woredas through though 9 mobile health and nutrition teams (MHNTs). So far, 5,593 people have been reached through primary health care service (consultation and treatment), maternal and child health (MCH), mental health and psychosocial support (MHPSS) and nutrition screening and outpatient therapeutic (OTP) services
In Wolkayit, Tsegede and Kafta Woredas, International Medical Corps have reached 1,598 people consultation/treatment services including 1 woman who received delivery services by MHNT and Surge teams. 107 women of child-bearing age received family planning services and 74 women attended antenatal care (ANC) clinics. 32 people received MHPSS services with 2 referred for specialised care. In addition, other preventive and curative services have been provided in facility and outreach settings including nutrition screening, health promotion and awareness-creation on common communicable diseases.
World Vision International (WVI) dispatched medical kits to Mekelle which are expected to cover the health demands of 340,000 population served by 5 hospitals (Shire Hospital, Wukro Hospital, Adigrat Hospital, Saharti Samre Hospital and Mekelle Town) and 6 health centres (Enderta HC, Hagere Selam HC, Adigrat HC, Wukero HC, Shire HC, Segede HC). In addition to the kits, 20 boxes of hydralazine injection and 2 oxygen concentrators were provided. Further, one pharmacist recruited to support the SWAN/ World Vision Ethiopia Consortium visited the medical warehouse to ensure storage conditions are suitable for medical supplies.
Action Against Hunger (AAH) is providing capacity surge support through AAH health officers to Abi Adi Health Centre. AAH also provided clinical consultations for 121 children under and 195 adults in Ruba Kaza Health Centre Ageba Health Centre and Selam Biaqu Health Post through MHNTs. AAH delivered antenatal care consultations for 80 pregnant women in Ruba Kaza Health Centre, Selam and Biaqu Health Posts through MHNTs
UNFPA deployed 4 midwives in Aba'ala and Gulina hospitals including its catchment health centres in Afar Region to strengthen sexual and reproductive health (SRH) and maternal health services. Emergency reproductive health (RH) kits for 10 health centres were distributed to Afar, Oromia and Amhara regions for emergency SRH service provision. Clinical management of rape services has been strengthened in Dabat and Adiarkay health centres and Alamata and Humera hospitals.
Save the Children International (SCI) provided outpatient medical consultation service to 2,077 patients. 475 women received reproductive health services including antenatal care, postnatal care and family planning services. 657 under five children were reach through immunization services. MHNTs also screened 766 (503 children and 263 PLWs) and among which 8 children were identified with SAM and referred for therapeutic treatment services. 45 children under five and 80 PLWs who were identified as being moderately malnourished were referred for therapeutic supplementary feeding and blanket supplementary feeding services.
WHO trained 50 health facility surveillance focal persons from 50 health facilities. Conducted Severe Acute Malnutrition with Medical Complications in Children (SAM/MC) rapid assessment in 5 facilities to determine the level of support needed for full functioning of the facilities. WHO also distributed risk communication and community engagement (RCCE) materials with key health message to 7,159 displaced people in three camps. WHO deployed a team of response staff to Shire to lead Health Cluster coordination and an Information Management Officer to Mekelle to support the Health Cluster on dashboards, infographics and information management.
WHO is currently supporting the revitalization of COVID-19 interventions with joint efforts from Federal Ministry of Health (FMOH), the Ethiopian Public Health Institute (EPHI), and the Regional Health Bureau (RHB). As of this week, laboratory testing has begun in Mekelle with 8 samples tested for COVID19, including the identification of a new treatment centre and contact tracing in Mekelle.
Information generating and dissemination for prioritization of interventions and decision making is very crucial for response, and WHO has supported the implementation of numerous needs assessments, gaps analysis and recently the Health facility functionality assessment (HeRAMS). HeRAMS results shall be published this week and used to address the gaps and advocate for more support and scale up.
Persistent access constraints due to ongoing pockets of conflicts and insecurity. Mobile health and nutrition teams are yet to access and provide services for people in 22 woredas out of 88 woredas
More medical supplies required to address pipeline issues and ensure that mobile health and nutrition teams and hospitals do not run out of essential supplies.