Critical shortages of fuel, cash and relief commodities - including, medical equipment and supplies - continue to severely limit the humanitarian response in northern Ethiopia’s Tigray region. Since midDecember humanitarian supplies have not arrived in Tigray by road due to ongoing fighting in the only corridor via Afar. The UN Humanitarian Air Service (UNHAS) continues to operate twice a week to ease the movement of staff, cash, and cargo into the region although it remains insufficient to mobilize supplies for 5.2 million people in need of humanitarian assistance. In Amhara and Afar regions, reported hostilities in some areas along the border with Tigray continue to hamper the delivery of aid to accessible conflictaffected areas.
Across the three regions, more than 2.1 million8 people are estimated to be displaced as a result of conflict and 9.4 million people need humanitarian assistance. According to a new food security assessment by WFP, 40 percent of Tigrayans are suffering an extreme lack of food with more than 14 percent of children under five and almost a third of pregnant and breastfeeding women malnourished.
In Amhara and Afar regions, the conflict-driven displacement is pushing malnutrition rates up, with children and pregnant and lactating women particularly impacted by hunger.
Access to maternal and newborn care services has suffered serious setbacks in conflict-affected due to the critical shortage of skilled healthcare providers, medical supplies and damage to health infrastructure, leading to a phenomenal increase in maternal and newborn mortality and morbidity. According to an assessment of 200 health facilities conducted by the Tigray Regional Health Bureau in July 20219, 65 percent of hospitals and 87 percent of health centers were looted, damaged, and vandalized. In Amhara, regional authorities reported nearly 500 health facilities, 1,706 health posts, 30 hospitals, and 52 ambulances were damaged or looted as a result of the spillover of conflict, including the displacement of nearly 7,000 health personnel from conflict-affected areas. In Afar, regional authorities reported that only 22 percent of the 414 facilities available in the region are currently functional, including 2 hospitals and 31 health centers. Amid increasing needs, humanitarian partners continue to scale up services to the conflictaffected population in the accessible areas across Amhara and Afar. Meanwhile, bureaucratic constraints and operational challenges continue to impede the entry of medical supplies and equipment into Tigray with many health – facilities, including One-Stop Centers, reporting to be out of any medications.
Since July 2021, UNFPA sexual and reproductive health kits have not entered the Tigray region, with some emergency obstetric procedures such as, C-sections, are the edge of suspension, as reported by UNFPA-supported health partners.
Across Afar, Amhara and Tigray regions, many women and girls, men and boys have endured sexual and gender-based violence during the conflict, although women and girls have been disproportionately affected.
Health facilities have reported sexual violence-related complications, including injuries, unwanted pregnancies, while other cases were diagnosed with HIV/AIDS or endured obstetric complications, including fistula. In Tigray, among the women and girls who got tested for HIV/AIDS, 3 percent of them are HIV positive, as reported by Ayder’s One-Stop-Center (Mekelle). In Tigray, the lack of medical supplies and cash have greatly impacted the provision of services to GBV survivors with some health facilities - including One-Stop Centers - indicating, among others, a critical shortage of antiretroviral medication for people living with HIV/AIDS, for prevention of mother to child transmission of the virus, and pre-and post-exposure prophylaxis for survivors of sexual violence. Also, OSCs report the lack of Dignity Kits and Non-Food Items (NFI) to support GBV survivors. Across Amhara and Afar regions, GBV service provision continues at a normal pace although it has suffered interruptions during the spillover of conflict to these regions, particularly due to the destruction and damage of infrastructure, insecurity, and the displacement of health personnel.
Despite the operational challenges and increased humanitarian needs, UNFPA is scaling up service provision to cover health and protection needs of women and girls across Northern Ethiopia. UNFPA’s Preparedness and Response Plan for the Northern Ethiopia crisis focuses on preventing and responding to gender-based violence and bridging protection, gender equality and MHPSS, while building back capacity on sexual and reproductive health and rights in the conflict-affected regions. Currently, UNFPA has a presence in Mekelle (Tigray Region), Semera (Afar Region) and Bahir Dar (Amhara Region) with International and National Surge Capacity Specialists supporting the Northern Ethiopia Response.