Week in the Life, Tuesday: MSF in Tigray, Ethiopia

By: Joe Belliveau

Doctors Without Borders/ Médecins Sans Frontières (MSF) Executive Director Joseph Belliveau spent five weeks in March-April as a project coordinator for MSF’s mobile medical teams in Northwest Tigray, Ethiopia. This is his second journal entry over the course of one week.

Today, we’re back in a town southwest of Shire called *DM that we accessed for the first time last week. There’s generally no mobile network outside the main towns (and even then, it’s patchy), so it’s hard to get prior information about a place we haven’t been before. We talk to mini-bus drivers, merchants and anyone else who has a scrap of recent information. We also try to get at least ‘yellow lights’ from those in charge, even if it’s not always clear who they are. Last week, we were lucky. We almost literally bumped into a Colonel standing in the middle of the street in a large town about halfway to DM. His body language said, ‘you’re a nuisance,’ and his voice said, ‘why don’t you do your medical work in the bigger towns.’ That added up to a yellow light for me.

We made it without encountering any more soldiers. When we arrive, we go straight to the health centre. Six large buildings, an extensive water system, solar panels, a delivery room. None of it functional anymore, of course, but it must have been an impressive set-up three months ago. Now, every room — just like every other health centre or clinic we’ve seen — is thoroughly ransacked and looted. Medicines and needles are outside on the ground, examination beds flipped over, patient records pulled off shelves, clamps and stethoscopes here and there. We pick four rooms for consultations, clear them out and clean them up with brooms and buckets of chlorinated water. The dispensers set up their mobile pharmacy in the open-air.

Medicines and needles are outside on the ground, examination beds flipped over, patient records pulled off shelves, clamps and stethoscopes here and there.

That was last week. Because we had never been here, the patient crowd was relatively small, maybe 100 or so. Today is different. They’re expecting us.

I count roughly 350 to 400 people — all waiting or accompanying those waiting for a medical consultation. Most, maybe all of them, haven’t seen a medical practitioner since Jan. 4, when their health center was trashed and the medical staff fled. It’s a sea of people; we won’t be able to see them all. In fact, it takes the whole team over an hour just to establish the first signs of order; putting up flagging tape, a place for pregnant women here, older people there. Our triage nurse is busy all day. She has to keep shifting from place to place to shake off the mob that keeps forming around her and potentially blinding her to the people most needing medical. The drivers help, but people are crossing the tape and spilling into all the places we ask them not to. The crowd is like water, just flowing into every space.

It’s not a first-come first-serve system — we need to assist those most in need first, especially since there’s not enough time to see everyone.

After a couple of hours trying to help out with crowd control, I go to find the newly appointed town council. We sit under a tree and talk about life and healthcare. I ask for their help in explaining to people what medical services we can offer — for example, we cannot assist with most chronic non-communicable diseases like diabetes and hypertension, at least not in these early days of outreach. I explain it’s not a first-come first-serve system — we need to assist those most in need first, especially since there’s not enough time to see everyone. They agree to help out for next week’s visit.

We continue our conversation under the tree. They describe an incident that occurred in early January, shortly after an armed group arrived. On January 6, this armed group shelled the town from a short distance away, apparently to root out the militia. Everybody fled. The next day, 18 men returned and were captured. They were forced to be porters for the day and were then shot or strangled. Their bodies were left at the edge of town for four days until a group of elders lobbied to have the corpses, decaying and partially eaten by hyenas, buried. As I am hearing this from the town council, a woman comes to the health center for prenatal care. She describes the same incident to the MSF midwife. Her husband was among the 18 people killed that day. The day was just over two months ago, and she has just reached her first trimester.

*To protect communities and individuals affected by the conflict as well as MSF staff, some place and person names have been changed.

Source: MSF Canada