BBC Amharic - Conflict and road closures in Amhara Region have created health crisis

https://www.bbc.com/amharic/articles/c51mpnnnvkpo

Disclaimer: This is an English translation of an Amharic article taken from BBC Amharic and is intended solely for information purposes.

BBC Amharic - Conflict and road closures in Amhara Region have created health crisis

March 18, 2024 (Megabit 9, 2016 EC)

Since the last half year instability in Amhara Region has worsened towards full scale armed conflict which has lasted many months. Fighting throughout the region has had significant impacts on the daily lives of residents.

As a result regular activities have been disrupted, administrative offices, transportation services, commercial, educational and health services have also been disrupted according to residents.

The availability of health services has been cause for concern among residents in various parts of the region, being a matter of life and death. 

Among these are mothers and infants in need of regular checkups and medical care, as well as individuals suffering from chronic medical conditions which find themselves in a dire situation.

As a result of the ongoing conflict, needed medical services have been unavailable for patients in need and shortages in medicine and medical supplies have contributed to disruption in medical services.

In addition, among the areas placed under the state of emergency command post is the Central Shewa Command Post which ordered the closure of the road from Debre Birhan to Dessie for an undisclosed period which has created another source of pressure according to residents and health professionals.

Starting from February 24, 2024 (Yekatit 16, 2016 EC) the closed transportation line was a federal Highway spanning 267-km from Debre Birhan to Shewa Robit and Dessie. As a result of this closure residents told BBC they have faced numerous challenges.

New mothers have been unable to return home after childbirth

Woizero Sisay (name changed) is a resident of the small town of Majete located in Efratana Gidim Woreda of North Shewa Zone in Amhara Region which is on the Debre Birhan - Dessie line.

Woizero Sisay is a government worker and who was within hours of delivering her second child when the news of the road closure was made public.

She had delivered her first child through a C-section operation and during her medical follow up for her second child in Majete Health Center she was told she would need to go to a larger hospital to deliver her child.

On the evening of Friday, February 23, 2024 (Yekatit 15, 2016 EC) at around 7 pm she went into labor according to Woizero Sisay who said she was told, “it is not possible to deliver the baby now, it could pose a threat to your life” and she was unable to immediately travel to a hospital.

She described the situation saying, “when the labor started I was supposed to travel to the hospital but I did not go…when I should have departed that night I spent the night.”

Though the area was unsafe due to her desperate health situation she was forced to travel to the hospital and she departed towards Kombolcha Hospital at around 4 am. When they encountered security forces on the road they were told, “nobody shall pass or exit aside from you.”

Hours later the main road connecting the North Shewa and South Wollo Zones was closed for an undisclosed time.

Though Woizero Sisay delivered her baby in the hospital she has been unable to return to her home to recover. She was unable to return home for 11 days and forced to spend the weeks after delivery in a relative’s home.

Woizero Sisay describes the challenge she faced to return home saying “they were unwilling to have an ambulance come and take me”. She said she was forced to trej home in a days long journey carrying her newborn on a “bajaj transporting goods” using inner roads.

Health professionals in the Majete Medical Center would make preparations days in advance for pregnant expecting mothers to be transported to hospital and deliver their babies peacefully.

One health professional who opted for anonymity for their safety said in order to save the lives of the mothers, “we would send expecting mothers in need of operations to hospitals prior to onset of labor.”

The health professional explained in order to save the lives of mothers, unconventional roads would be used in uncomfortable circumstances, and locals would support transporting mothers and people with medical illnesses to hospitals.

Without medicine awaiting death

In the many areas of Amhara Region where fighting is ongoing, drivers have avoided operating vehicles on many occasions which has disrupted transportation services according to residents.

However the Debre Birhan-Dessie road was closed by order of the Emergency Command Post which cited “public safety”.

For this reason, residents that relied on this road for their daily affairs have been forced to go to other areas. The matter of health services is particularly urgent and individuals in need of care from higher medical institutions face life threatening circumstances according to professionals.

Ato Asalif had faced a nerve condition over two years ago which left him unable to move (paralyzed).

He was prescribed medicine from Dessie Hospital says Ato Asalif, however since the road closures “it has not been possible to undergo routine checkups or receive needed medicine.” He says, “I am now bedridden.”

Since the conflict worsened there medicine supplies were exhausted and no longer available. He has now been left without options, bedridden and unable to walk, he told BBC.

“There is war. It is impossible to move. Let alone someone like me who is sick even those with legs cannot move freely. We would face death. It would have been better to die quickly from the disease but this has not happened.” He said this explaining how he had lost hope.

Suffering of mothers and infants due to lack of medicine

Woizero Tewabech says her 18 year old son has a mental disorder and had been taking medicine since he was 15 which they would find in Dessie or Debre Birhan.

However now the road leading to both cities has been closed and this medicine which is important for her child is unattainable, “we are in a very troublesome circumstance” she told BBC.

The medicine is important for her child’s health, “without his medicine he gets out of control, he becomes restless” says the mother describing her child’s health situation, and adds both her and her child are facing “suffering”.

Residents of Majete with various health problems in need of health checkup are in search of important medical services from hospitals which they make great efforts to attain, explain local health professionals.

As a result, the costs associated with travel outside the main roads using the inner roads are significant and the journey is tiresome in order to get medicine and medical care.

The lack of security has been cause for a disruption in the medicine he had been taking for years and forced them to take these roads which Woizero Tewabech says is “not fit for the poor”.

“Up to five thousand birr is needed, it is far too much for people like me. Since it is not possible to go there and return in a day, overnight accommodations are also needed which is an additional expense. I cannot afford this whole expense” she says, explaining that it is beyond her means.

Fears that previously gone diseases could return

Following the closure of the main road connecting areas in the eastern part of the Amhara Region, health institutions face narrowing means to deal with and prevent serious health problems, according to residents and professionals.

One health professional who withheld their name said the road closures were “irresponsible” and “for those on the brink of life and death, their fate is to die before our eyes” and added that outside of pregnant mothers and the wounded, receiving medical care for other diseases is a “luxury”.

“We are not receiving vaccines, anti-HIV and TB medicines. For this reason, if we do not have the medicine all we can do is provide referrals. And taking various roads to the hospitals costs up to five thousand birr” is how he explained the medical ordeal of the public.

The medical professional expressed fears that problems related to the provision of medicine could cause spread of diseases, saying in addition to current health problems of concern other diseases which had disappeared or were on the brink of disappearing could return, which was a cause of concern for the immediate future.

The professional mentioned how diseases that had been extinguished in prior campaigns could return, specifically referring to lack of pediatric vaccination.

“The time when vaccines should have arrived has passed. If they do not arrive under these circumstances and if this issue persists for months, diseases which had once disappeared could return including measles, pneumonia and polio.”

In relation to this, war in the region has tested the healthcare system according to the Amhara Region Health Bureau, infant immunizations rates have plunged below 60% and medicine provisions for HIV, TB, Malaria and other diseases have been suspended for months which the region reported to medias.