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Afar’s silent emergency

Deadly diseases claim lives as health center struggles to cope

Shenkore Ali, a resilient woman in her early 60s, proudly embraces her role as a devoted mother to three children and doting grandmother to two grandchildren. Almost half a century ago, she and her husband made their home in the arid plains of Ziya, Amibara woreda, in the Afar regional state. It was a decision driven by her husband’s employment as a guard at the Amibara cotton farm – a position he secured 48 years ago.

When The Reporter caught up with Shenkore, she stood amidst a crowd of hundreds, over ten kilometers away from her humble dwelling. They were all patiently waiting for their turn to access a precious commodity: clean water.

In the desert of Afar, water is as scarce as hen’s teeth, making this daily struggle a harsh reality. During our recent visit to the area, the mercury soared to a scorching 35 degrees Celsius in Amibara, offering a glimpse of the challenging conditions faced by the locals. To put it into perspective, this temperature was relatively mild compared to the blistering 52 degrees Celsius experienced during the bone-dry seasons in Semera, the capital city of Afar.

For Shenkore, two options lay before her in her quest for water. The first involved embarking on a grueling journey spanning more than 20 kilometers each day to purchase piped water. However, the escalating price of 50 to 70 birr per large jerry can rendered this option unaffordable.

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 Despite the hardships of her advanced age, Shenkore found herself compelled to undertake arduous treks in search of water or risk falling victim to the unforgiving grip of thirst. Compounding the challenge, piped water was frequently unavailable, disappearing for up to six months at a time.

Afar's silent emergency | The Reporter | #1 Latest Ethiopian News Today


Unfortunately, prolonged drought and the relentless impact of climate change have conspired to make accessing water an increasingly arduous task in the Horn of Africa.

The second alternative involved a risky endeavor: relying on drilled water wells that reached deep into the earth or embarking on long and treacherous journeys to the distant Awash River. However, this choice presented a danger more menacing than the thirst itself.

Awash River, hailed as the embodiment of indigenous beauty, holds a special place in the hearts of the local population. Spanning a staggering 112,700 square kilometers with a length of 1,200 kilometers, and boasting an annual flow of 4.6 million cubic meters, Awash stands as a majestic testament to nature’s power.

Originating from the town of Ginchi, west of Addis Ababa, this mighty river traverses the eastern Ethiopian rift valley before finding its final resting place at Lake Abay, straddling the border between Ethiopia and Djibouti. En route to the Djibouti border, Awash gracefully weaves its way through various parts of the Afar regional state. In the heart of Afar’s unforgiving desert, where water is a rare gem, Awash represents a miraculous discovery akin to finding milk in the depths of hell.

“We don’t simply refer to Awash as water; it is a yogurt. It tastes like it too,” shares Shenkore, a testament to the river’s unique characteristics.

Awash has become a cherished symbol within local households, its name reverberating through generations. Poets have eloquently captured its essence in countless verses, immortalizing its significance. While songs may have been composed in praise of the grandeur of the Nile, the Nile itself is often associated with departing from its homeland, carrying away fertile soil to nourish Egypt. In a delightful twist, Awash stands as a complete reversal of this narrative.

Awash River in Ethiopia’s Afar region has long been revered by locals for its pristine, chemical-free water, earning it the endearing nickname “yogurt.” However, this natural wonder has a dark side that threatens the lives of the Afar residents, particularly when it comes to the dreaded disease of cholera.

This year alone, over 400 people in the Amibara, Awash Fantale, and Dulecha woredas have fallen victim to cholera, with a tragic death toll of four. These figures only scratch the surface of the alarming cholera cases caused by the river in Afar. In the past year, more than 1,100 cholera cases and 12 deaths have been reported in the region.

Among those affected is Emebet Agonafir, a young resident of Amibara woreda. Emebet contracted cholera from her neighbor, who sadly succumbed to the disease shortly after giving birth. Lamenting the lack of adequate healthcare services in their woreda, Emebet shared the harrowing tale, saying, “She suffered greatly and passed away after enduring days of agony. Now, the entire family is grappling with cholera.”

Despite months having passed since her own infection, Emebet has been unable to access medical treatment, leaving her in a dire state. Her weakened condition is evident as she struggles to speak, her sunken eyes reflecting her deteriorating health, and she can no longer stand without support. In moments of extreme distress, she even loses consciousness. The only lifeline available to her is glucose provided by the health center in Amibara.

With the scarcity of essential government services in Afar, the invaluable role played by NGOs and humanitarian agencies cannot be overstated. Organizations like the Action for Integrated Sustainable Development Association (AISDA) and the International Rescue Committee (IRC) have stepped in to address the pressing water supply issues and combat cholera in the region.

IRC, in particular, has introduced an innovative and life-saving intervention—water trucks equipped with large tanks—to deliver clean water directly to the most affected areas, including Amibara. These trucks traverse long distances, ensuring that households receive a sufficient supply of water right at their doorstep.

Mihret Fikadu, IRC’s communication manager, highlighted the organization’s global presence, stating, “Operating in 50 countries worldwide, our primary focus is providing critical support in post-shock situations. Typically, our interventions last up to six months, after which we move on once the situation improves. With a   EUR 335,000 in funding from the European Union, we are implementing a mobile water supply and cholera mitigation project in Afar, in partnership with AISDA.”

Amibara health center in Afar is facing an urgent crisis as the number of patients seeking treatment for cholera, malaria, and other diseases surpasses its capacity. Health workers at the center report an alarming influx of patients, with conditions becoming increasingly severe. The most vulnerable members of the community, such as the elderly, children, and recently postpartum mothers, are succumbing to these illnesses due to the inability to receive immediate medical attention.

Meles Damte, the health center administrator, expresses grave concern over the situation, stating, “So many patients are coming to the health center each day. Most of these diseases are deadly. Especially elders, children, and mothers who recently gave birth are dying because they are unable to get health services immediately.”

 Damte acknowledges the crucial support provided by NGOs such as the IRC and the AISDA, which have played a vital role in saving lives. However, he emphasizes that further assistance from the government and additional NGOs is urgently needed.

“The prevalence of these diseases is rapidly escalating. It can be contained with the provision of clean water but it necessitates a comprehensive and coordinated effort across all sectors, not limited to healthcare alone,” he said.

Health workers reveal that a significant proportion of the patients, more than 60 percent, are newcomers to Afar who are unaccustomed to the region’s unique climate. These individuals primarily consist of laborers migrating from other parts of Ethiopia to work on large-scale commercial farms in Afar. The challenging weather, combined with the lack of protective measures, has left them susceptible to falling ill.

The region is home to various agricultural investments, including expansive sugarcane farms that cater to state-owned sugarcane factories. However, health workers criticize these profitable ventures for not fulfilling their social responsibility to the community by failing to provide adequate water supply to residents or establish healthcare facilities in the area.

AISDA, recognizing the gravity of the situation, has dedicated over 20 million birr to combat cholera and other diseases in Afar. Seid Yimer says the organization has been actively providing support, including distributing water storage equipment, water treatment medicines, and essential medical supplies to health centers. They have also contributed to the salaries of healthcare workers, and “In the past three months alone, we have reached over 25,000 people at the Fege health center in Amibara and has provided assistance to more than 65,000 patients throughout Afar.

Awoke Mekonen, the director of Afar Health Bureau, acknowledges the severity of the current outbreak, which marks the fourth occurrence in the past decade. He attributes the escalating outbreaks to the region’s weak healthcare infrastructure and the recurring overflow of the Awash River, which transpires every two years.

Afar's silent emergency | The Reporter | #1 Latest Ethiopian News Today


“The aftermath of the river overflow damages critical infrastructure, including water supply lines, electricity, roads, and irrigation systems. Rebuilding these essential structures takes time, leaving the region vulnerable to disease outbreaks like cholera.” Awoke emphasizes the urgent need for improved healthcare provisions during these critical periods to prevent further health and social crises.

Abdu Ali, the administrator of Amibara woreda, highlights the inadequacy of the allocated budget for the Afar region, which falls significantly short of meeting even the needs of Amibara woreda alone.

“We are collaborating with the Ministry of Irrigation and Lowland, IRC, AISDA, and other stakeholders to dig underground water sources and secure a clean water supply. We are also working with stakeholders towards gathering comprehensive data on incoming labor forces staus before they arrive in the region,” Abdu explained.

The situation in Afar remains critical, requiring immediate attention and concerted efforts from all relevant parties to address the escalating health crisis and secure the well-being of the region’s residents. The concerted efforts of these NGOs are making a tangible difference in addressing the water and health crises faced by the people of Afar.

As the residents of Afar continue to grapple with the challenges presented by Awash River, the need for sustainable solutions and improved government services remains paramount. Access to clean water and essential healthcare services is not only crucial for combating diseases like cholera but also for ensuring the overall well-being and prosperity of the Afar community.

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