prevalence of HIV in adults
level of HIV infection among sex workers
The humanitarian situation in Ethiopia
The Federal Democratic Republic of Ethiopia is the second largest country in Africa. It is a country of both origin and transit for large numbers of migrants and refugees. Despite rapid economic growth in recent years, Ethiopia remains one of the poorest countries in the world. The healthcare situation in Ethiopia means the need for humanitarian assistance is substantial, particularly in relation to access to resources and to medical care.
Rural and nomad communities hit by food insecurity
Ethiopia is particularly exposed to food insecurity (8.5 million people were in need of direct food aid in October 2020, prior to the crisis in Tigré). This is due in particular to limited pasture rejuvenation, problems with access to water and rising insecurity. These factors have been aggravated by climate change and an unprecedented locust invasion. The humanitarian situation in Ethiopia is thus the result of a vicious circle of conflicts, drought, food insecurity, malnutrition, lack of access to water, vulnerability to disease, forced displacement, floods and epidemics.
A mortality rate of 94 per 1,000 for children under the age of five
For many years Afar and Somali have been the regions most affected by crises and natural disasters. Health indicators here are more concerning than in other regions of the country. These include a mortality rate of 94 per 1,000 for children under the age of five. Health problems such as malnutrition, diarrhoea, waterborne and food-borne diseases and respiratory conditions are widespread in the region.
Communities facing epidemics: the need for medical assistance in Ethiopia
The Covid-19 epidemic reached Ethiopia in March 2020. Although the virus didn’t grow exponentially in the same way as in Europe or China, the country had recorded over 25,000 cases by the end of the year. In the face of rising numbers, our teams decided to implement a medical assistance plan in Ethiopia.
The epicentre of the epidemic is the capital Addis Ababa and this is also the part of the country most at risk, owing to its population density. Areas of informal housing and places where people are living in degraded environments are most affected. Yet there was a failure to tailor communication about the virus to the customs and practices and specific needs of the people living in these areas (slum dwellers and migrants from rural areas). In the Afar region the first cases identified were among migrants who had had to return to Ethiopia due to the border closures. In 2020, around 25% of these “returnees” were minors or women, including pregnant and breastfeeding women.
In the Somali region the first Covid-19 case was identified in Jijiga in May and the “Emergency preparedness and response plan” developed by the local authorities focuses on this city. Few interventions have taken place in the Qoloji refugee camp where 80,000 people are living. However, given the level of need, the authorities decided to set up an isolation and treatment centre here for people infected with Covid-19.
Médecins du Monde’s exploratory humanitarian mission in Ethiopia
In Ethiopia, HIV disproportionately affects certain groups, especially sex workers. According to UNAIDS, 24.3% of them were HIV positive in 2019. They are among those most at risk of contracting sexually transmitted infections, being subjected to violence and being excluded from social services. Despite this, there are no reliable official data on the numbers of sex workers in Ethiopia, nor on how many of them have experienced gender-based violence (GBV).
A latent humanitarian crisis in Ethiopia
The exploratory mission undertaken by Médecins du Monde along the commercial route from Addis Ababa to Djibouti in 2017 highlighted an alarming humanitarian situation: the level of GBV perpetrated against sex workers. In addition, the lack of GBV prevention services and care and treatment for survivors means access to healthcare and rights is extremely difficult for this group. This is only serving to exacerbate the latent humanitarian crisis in Ethiopia.As a result, MdM decided to work with sex workers along the route between Addis Ababa and Djibouti, focusing on the Afar region.
Our humanitarian assistance in Ethiopia
MdM’s humanitarian assistance programme in Ethiopia has facilitated work to address health issues. The medical assistance we have provided is helping to raise awareness among local communities and to make medical care accessible for all.
Passing on our knowledge to reduce mortality in the Somali region
Médecins du Monde France has been working with communities affected by crises in the district of Gerbo, in Nogob Zone in the Somali region, since 2019. The aim of this work is to improve access for displaced people and host communities to health services (particularly sexual and reproductive healthcare), epidemic prevention and malnutrition treatment, as well as water and hygiene.
The project is delivered through two public health centres (Gerbo and Molayko) and seven health posts, in partnership with local organisation, OWDA, and the regional authorities. Our teams provide training and support health centre staff. They also help with medical supplies and equipment and support the local emergency referral system. Work on malnutrition includes screening, identification and treatment (children and pregnant or breastfeeding women). Community awareness-raising activities are also delivered in the surrounding municipalities.
Strengthening local Covid-19 prevention and response: a milestone in our medical assistance in Ethiopia
In Nefas Silk (Addis-Ababa), as part of our medical assistance work in Ethiopia, we delivered awareness-raising sessions for families in two districts and distributed soap and water purification kits. Hand-washing stations were also set up in busy public spaces (such as markets, health centres and bus stations).
In the Somali region interventions were delivered in Gerbo (a rural pastoral area), the quarantine centres on the border between Ethiopia and Somalia, the regional capital Jijiga and at the Qoloji refugee camp. In Jijiga, MdM is helping to strengthen epidemic prevention and control measures at the Kamara hospital quarantine centre and at the Dulqabow isolation centre. Four urban health centres have also received donations of personal protective equipment. Information has been disseminated and psychosocial support provided for local communities, including for healthcare staff. Protective equipment is made available and monitoring of existing measures is provided by the MdM teams.
In the Afar region we have supported two isolation and quarantine centres at the point of entry for migrants between Djibouti and Afar, as well as four healthcare facilities on the route between Addis Ababa and Djibouti.
With regard to the Covid-19 epidemic, our humanitarian work in Ethiopia includes community awareness-raising about preventative measures, providing hygiene products, psychosocial support for migrants, strengthening the referral system between the quarantine centres and healthcare facilities, and putting in place protection measures for those most at risk of GBV (women, children and young people).
Our humanitarian programme for promoting access to healthcare and rights in Ethiopia
In October 2018, Médecins du Monde started to implement a programme in partnership with Nikat Association (an Ethiopian community-based organisation of sex workers) and other institutional partners, such as the Regional Health Bureau (RHB) and the Women’s Affairs Bureau. The programme began by recruiting 18 women as peer educators and training them to lead awareness-raising sessions for sex workers on GBV, HIV prevention and condom use.
Medical activities are delivered by MdM partner, the Family Guidance Association of Ethiopia (FGAE). In line with its humanitarian assistance in Ethiopia, Médecins du Monde also support a number of health centres, as well as clinics specifically for sex workers, with the aim of improving medical, social and psychosocial care, particularly for those who have experienced violence.
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