TIGRAY, Ethiopia – On 22 November, Wahid Hadush, 40, became the first mother to deliver a healthy baby via Caesarean section at Adi Daero Primary Hospital in Tigray, Ethiopia. It was more than a year after the conflict, and surgeons were starting to bring life into the world again – yet nothing would be straightforward.
Ms. Hadush had been transported by ambulance from Adi-Abagi and upon her arrival, doctors realized that her child had a non-reassuring fetal heartbeat pattern, meaning the child’s heart rate was abnormal. The doctors immediately admitted her to the OR to conduct an emergency C-Section, where they were able to save her baby's life – something that would have been impossible just weeks earlier.
For nearly three years, Adi Daero Primary Hospital, located 30 kilometres from Shire Endassilasie, had been operating at minimum capacity as the facility struggled to recover from a devastating two-year conflict. The once-bustling primary hospital, serving a catchment area of more than 130,000 people, stood as a grim testament to the conflict's devastation.
We had no equipment, barely any staff, but we used the open ground and unfinished structures to offer whatever services we could.
With a team of 11 doctors, 11 midwives and 6 ambulances, it was the area's sole primary hospital for a catchment of health centres and other small health posts depending on its referral capacity. In November 2022, amid the conflict, the hospital was burned to the ground, making it just one of the many health facilities lost in the devastation.
The Health Resources and Services Availability Monitoring System (HeRAMS), published in October 2023 by the World Health Organization, showed that of the accessible health facilities in the Tigray region, more than 90 per cent were partially or completely damaged, with 98 per cent lacking essential family planning supplies, and 93 per cent of referral facilities lacking the basic supplies necessary for providing key obstetric services or signal functions for pregnant women and newborns.
"We tried to provide emergency care," said Yemane Tesfa, the hospital's Chief Executive Officer. "We had no equipment, barely any staff, but we used the open ground and unfinished structures to offer whatever services we could.”
In March 2023, UNFPA and partner Medical Teams International (MTI) stepped in. Two of the unfinished wards at the hospital were refurbished and provided with vital medical equipment. This allowed for the revival of first the maternity wards and soon after, the OR services. Deliveries, once just 10 per month, have now surged to 70. Major and minor surgeries have resumed, offering a critical lifeline to the community. The referral system has been revitalized, with ambulances fuelled by UNFPA’s partner ensuring timely transfers for critical cases.
This was made possible with the support of Canada, a vital partner in supporting sexual and reproductive health care for women and girls all over Ethiopia. The Government of Canada has provided almost $16 million to enable UNFPA to scale up essential health services across the conflict-affected regions. This will assist in reviving health systems devastated by conflict, including the provision of contraception, skilled health workers and essential reproductive health medicines.
The health workers here are exhausted. They need psychosocial support.
However, the hospital has yet to resume normal operations, and much more is needed to revive the hospital's infrastructure. Of the six ambulances the hospital used to have, only one remains. It is also struggling to regain its human resources, and now operates with just four doctors. “The health workers here are exhausted. They need psychosocial support,” said Mr. Tesfa.
Before the conflict, the hospital was undertaking an expansion plan to upgrade its facilities to provide general hospital-level care, which would have made more specialized care available for residents who would otherwise have been required to travel to Shire Endasilassie to receive this. “ I don’t know when we will be able to meet that promise now,” Mr. Tesfa said.
Communities like Adi Daero, where Wahdi comes from, continue to need the support of UNFPA to help revitalize infrastructure devastated by the conflict. The UNFPA Humanitarian Response Appeal 2023 is calling for nearly $48 million to respond to the protection and health needs of women and girls across crisis-affected regions in Ethiopia. To date, 38 per cent of the appeal remains unfunded.
