My prospective as a long time researcher, teacher, and physician at Mekelle University on the effect of the Tigray war and subsequent siege on women’s health
Just prior to the invasion of Tigray by Ethiopian and Eritrean forces we know that Tigray had one of the highest rates of medically assisted childbirth in Ethiopia likely to be close to 20%. This low number reflected that it also included a high number of women who were recognized in screening by local health authorities as at risk for a problem pregnancy which lead them to seek closer follow up and care.
Now the health care extension worker network and local clinic systems staffed by public health officers, nurse, and general practitioners have been eliminated. There is no communication system or reliable transportation system even if there was functioning health facilities to visit.
Tigray already had high levels of birth defects including neural tube defects which require close pre-natal care and surgery immediately after birth to improve the health of mothers and children not only for their survival but to promote prevention. The medical and prevention services for these defects in which Tigray was a leader in Africa recognized for the leading research work done by Mekelle University by the World Health Organization and Ministry of Health which has abandoned Tigray now have essentially ceased.
Vaginal bladder and rectal fistulas which are preventable by pre-natal and appropriate birth care management have already skyrocketed. Additional many horrendous mutilations by invading armed forces further added to this burden. Women with these preventable and treatable conditions require sophisticated counseling and specialized surgical care units to avoid a life of social rejection and isolation. These services minimally exist now.
Female reproductive system, breast, thyroid and other malignancies affecting not just the elderly but often women as young as the second decade were in the pre-war era being addressed by preventive screening and the development of comprehensive cancer treatment at Ayder Hospital in Mekelle. A three hundred bed cancer center which included surgical suites and a radiation therapy installation remains unfinished and somewhat vandalized by the occupation of Mekelle.
Before the war about 25% of Tigrayans required food aid. Most of the rural population of women have to carry out the duties of contributing to farming and raising animals, caring for elderly relatives, collecting daily water, and child care. Poor health compromises their abilities to function in society causing higher levels of birth defects, maternal and child perinatal mortality, and retards the goals of elevating women’s status in society.