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Desperation in West Omo

A community besieged as diseases ravage remote Ethiopia

A heart-wrenching scene unfolds in Chat kebele, Bachuma woreda, and the western Omo zone, as nearly a hundred individuals, predominantly mothers with their precious babies, stand in line on a field.

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These delicate infants, frail and with traces of scabies on their faces, let out piercing cries. The mothers, their breath shallow and their strength dwindling, fix their gaze on an empty void before them. These resilient women endured a grueling five-hour trek from the remote corners of their rural communities to reach this makeshift refuge.

Tragically, Bachuma represents just a fraction of the countless kebeles grappling with a relentless onslaught of diseases. Malaria, measles, kala-azar, and other related illnesses have taken hold. The prevalence of malnutrition and nutritional deficiencies is alarmingly high, rendering mothers and children particularly susceptible to weakened immune systems and a myriad of health issues.

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In the face of government’s inability to provide adequate healthcare services amidst the recent disease outbreaks, Médecins Sans Frontières/Doctors Without Borders (MSF) stepped in to fill the void. Determined to make a tangible impact, MSF personnel launched a fleet of 21 mobile clinics in the western Omo zone over the past six weeks.

One of the mothers seeking solace in this desperate situation is Shemaita Gaizi.

She embarked on an arduous journey spanning over five hours, carrying her two ailing twins in her arms, desperately hoping to find respite under the care of MSF doctors.

Her twins, a mere year old, suffer from the relentless grasp of measles and malnutrition, leaving them alarmingly weak. Miraculously, after receiving treatment from the doctors, signs of improvement were evident on the first day.

However, the cruel hand of fate struck Shemaita when, on November 28, 2023, she received the heart-shattering news that her older child, whom she had left behind, had succumbed to malaria. Overwhelmed with grief, the grieving mother immediately abandoned caution and embarked on the somber journey to attend the funeral, taking her vulnerable twins along, oblivious to the doctors’ warning of the potential risks involved.

Language barriers compound her anguish, as Shemaita does not comprehend Amharic or English- missing the cautionary advice.

“At least three lives were lost each day until MSF’s timely intervention in the area, providing crucial vaccinations, painkillers, antibiotics, and plumpy-nuts to boost immunity,” Abebech Ketema, a health extension worker from Chat kebele in the west Omo zone, said.

The death toll, Abebech says, could have risen even higher if not for MSF’s intervention.

“Since MSF’s arrival, we have witnessed significant improvements. In the past, Chat kebele alone saw three children every day, with some households tragically losing two children. However, thanks to MSF, we have managed to put an end to these heart-wrenching deaths,” explained Abebech.

However, she says a considerable number of individuals are still arriving with severe cases of illness.

To tackle the overwhelming number of cases, MSF set up mobile clinics that remain in one location for a few days, adapting their stay based on the severity of the situation. Faced with weakened immunity, patients receive essential glucose treatments in open spaces, ensuring their recovery is prioritized.

Daniel Biru, the MSF health team’s coordinator in west Omo zone revealed that a dedicated staff was deployed to the area within 10 day of becoming aware of the outbreak through social media.

“The situation we encountered was nothing short of horrific—an epidemic on a massive scale. Over the past six weeks, our mobile clinics have treated more than 4,000 malaria cases and over 1,500 measles cases. At Bachuma primary hospital, we’ve provided critical care to over 600 patients.”

Alarming statistics reveal that the prevalence rate stood at a staggering 80 percent. Shockingly, over 70 percent of the patients seeking help at the mobile clinics are infants under two years of age.

The gravity of the outbreak surpassed the abilities of the existing health system in the newly formed South-Western Ethiopia regional state. Despite health workers diligently reporting the crisis to the Ministry of Health and Ethiopian Public Health Institute (EPHI), their pleas for assistance have gone unanswered.

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In the face of this dire situation, Bachuma primary hospital emerged as a critical lifeline, offering immediate care to serious cases. For the most severe conditions, patients are transferred to Mizan Aman hospital, located 77 kilometers away from Bachuma.

However, the reality on the ground reveals a grim truth—the public health institutions in the region lack the necessary provisions.

Sources claim that vaccination services have been absent from the area for the past two decades.

The repeated outbreaks have left the residents vulnerable, their immunity compromised. Insiders allege that corruption within Ethiopia’s health sector, involving officials at both federal and regional levels, has drained the health and vaccination budgets intended for this region.

Frustrated with the current situation, Jemal Nassir (MD), the emergency case team coordinator at Bachuma Hospital, emphasizes that the health facility is ill-equipped to handle not only normal cases but also deadly outbreaks like malaria and measles. The hospital receives a staggering influx of at least 30 patients daily, while many others are unable to reach healthcare centers due to the long distances and lack of transportation options, he explained.

“In this area, public health institutions suffer from a severe budgetary shortfall,” laments Jemal. “The limited funds we have are primarily allocated to staff salaries, which frequently face months of delays. We are unable to procure essential medical equipment due to the lack of budget.”

Consequently, he says, the public health system is incapable of effectively responding to the current health crisis. “The government’s existing structure is ill-equipped to handle this problem, particularly considering the recent establishment of the region.”

He continues, “Our health budget faces a substantial deficit. The allocation has remained unchanged for years, failing to keep pace with the increasing demands. Currently, we can barely manage day-to-day operations, let alone tackle outbreaks. The prices of medicines have skyrocketed, while our budget remains stagnant. Unless the budget aligns with rising inflation, we cannot continue providing public services.”

According to the Ministry of Health’s standards, a primary hospital should ideally have between 50 and 300 beds. However, the Bachuma primary hospital, established in 2017, is equipped with a mere 33 beds.

The government relies on the outdated 2007 census data to allocate health budgets in this area. For instance, funding decisions is based on the assumption that there are 350,000 people residing in the West Omo zone. However, local authorities argue that the actual population exceeds one million.

The high fertility rate in the region has outpaced per capita land ownership, exacerbating the challenges faced. Moreover, the lack of healthcare facilities, infrastructure, and a cold chain system hampers vaccine effectiveness in this area.

In an effort to draw attention to the dire situation in the West Omo zone, local authorities invited Members of Parliament to witness the unfortunate conditions firsthand.

“They came, they saw, but no change is forthcoming,” expresses Demise Sapi, the general manager of Bachuma primary hospital. “We have submitted our requests in writing to the Parliament, emphasizing the urgent need for support in this newly established region. The outbreak situation has reached alarming levels, surpassing the capacity of our hospital. Malaria, measles, and malnutrition outbreaks have overwhelmed the regional administration, surpassing the government’s capacity.”

The General Manager says that the population is surviving solely with the assistance of divine providence and MSF. “Since their arrival last month, MSF has saved countless lives. We are facing a fundamental problem—a crisis in both health and society.”

According to the local authorities, the government must reassess its healthcare capacity or allow more non-governmental organizations (NGOs) to operate in the area.

Since August 2023, 11 individuals have died from measles after arriving at Bachuma hospital. Over 40 people lost their lives due to malaria last year. These figures exclude those who perished without ever reaching the hospital, as per Demise’s account.

These statistics have been corroborated by assessments conducted by the Ministry of Health (MoH) and the World Health Organization (WHO).

The general manager also highlights that the MoH and WHO have failed to respond adequately to the evolving malaria strain in the area.

“We have reported the issue to the MoH and WHO, but to no avail,” laments Demise. “The problem lies in the fact that existing medicines no longer effectively treat malaria in this area. None of the current medications can cure malaria due to the changing nature of the malaria strain. So, we have reached an agreement with the WHO and MoH to conduct further investigations and develop new medicines.”

Demise says it is crucial to update our understanding of such diseases at least every five years. Unfortunately, this has not been done, leading to variations in diseases within this area.

“So, the development of new medicines and treatments is of utmost importance. Malaria, measles, and malnutrition cases, as well as death rates, have been steadily rising year after year, with a significant surge this year. Furthermore, there is no malaria vaccine available in this area.”

In the case of measles, vaccination could have prevented 85 percent of the cases, according to the Manager. “We fear the occurrence of additional epidemic outbreaks, so the strengthening of vaccination efforts is imperative.”

While local authorities attribute the health crisis to various factors such as inadequate infrastructure, inaccurate census data, budget deficits, and a lack of health awareness among the population, insiders suggest that the health crisis in the West and South Omo zones is merely a symptom of a larger issue—grand corruption within the healthcare sector.

According to sources, funds allocated to these areas have been misappropriated by corrupt officials, particularly at the federal and regional government levels. While these corruption allegations are widely accepted as factual, officials at the Ministry, Institute, and Ethiopian Pharmaceutical Supply Service (EPSS) have refrained from commenting on the matter.

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