Tigray’s health system ‘totally collapsed’, say health workers

After nearly 18 months of conflict between the federal government and Tigray rebels, the health system of the beleaguered region has “totally collapsed”, according to health officials and doctors there.

Health workers in Tigray told The New Humanitarian by phone that shortages are so acute they are using expired drugs to treat chronic conditions, while tens of thousands of patients with diabetes, cancer, and HIV haven’t been treated in months.

Patients are being asked to bring old clothes with them into the hospital for surgeons to use as gauze during operations. Test tubes, surgical gloves, and air tubes are all being reused, and there’s not enough detergent to wash soiled hospital bed linen.

A doctor at the flagship Ayder hospital, in the capital, Mekelle, likened Tigray’s health system to a “Swiss cheese” with most key components missing – from medicines to spare parts for vital equipment.

“This isn’t like the 21st century anymore; it’s more like the 16th or 17th,” said the doctor, who requested anonymity like others The New Humanitarian spoke to. “Patients just die in front of your eyes.”

Health workers are using warm salt water to wash wounds, clinics receive erratic supplies of power, and a lack of fuel is forcing pregnant women to walk – or be carried on stretchers – for days to health posts in order to deliver their babies.

Those who receive medical attention are the lucky ones: Most new mothers are delivering at home, alone, meaning thousands of women are likely dying from complications, health workers said.

Last week, Ayder hospital sent home 240 patients who were unable to buy their own food. New patients with neither food nor money are no longer being admitted.

Meanwhile, doctors haven’t been paid in months and are also struggling to feed themselves. As a result, stories of nurses and surgical residents fainting from hunger during procedures are commonplace.

More than half of Tigray’s doctors aren’t working – either because they’ve been displaced by fighting or because they’ve left their posts in search of food, said a senior regional health official, who asked not to be named so he could speak freely.

“The whole system has totally collapsed,” he added. “We are trying to do our best to serve our patients with what we have available, but things are getting worse and worse every day.”

War erupted in northern Ethiopia in November 2020, the result of long-running tensions between the federal government and the main party in Tigray, the Tigray People’s Liberation Front (TPLF). Mekelle was captured in a matter of weeks.

The conflict has seen the participation of Eritrean troops, who invaded Tigray from the north in support of federal forces. They have been accused of a deliberate campaign of looting and vandalism against health infrastructure during the early days of the war.

A survey by the regional health bureau said 90 percent of Tigray’s 40 hospitals and roughly 1,000 smaller clinics were damaged, while medics have described watching Eritrean troops cart away valuable medical equipment using trucks and even helicopters.

Access to Tigray has been restricted since the TPLF recaptured the region in June last year, with all communication links, roads, and banking services cut. This prompted the EU’s top humanitarian, Janez Lenarčič, to accuse Addis Ababa of laying “siege” to the region.


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