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Analysis: Tigray’s largest hospital “doomed to collapse soon” due to lack of medical supplies, doctors warn as hospital death rate surpass ten percent

One of Ayder Hospitals; operating theaters. Photo: Screenshot/Tigray TV

By Addis Standard

Addis Abeba: Ayder Referral Hospital, the largest hospital in the war-torn Tigray Region, is “doomed to collapse soon” if it is left without any support, the hospital’s CEO Dr Kibrom G/Selassie warns.

In an e-mail interview with Addis Standard, Dr Kibrom says, “we [doctors] are struggling as much as we can just not to close the hospital completely, and lose even what we could save with whatever meager resources we have.”

“In fact, if the siege is not lifted one way or another, who will remain alive?” Dr Kibrom asks.

“there was an approximately 84 percent reduction in the number of children and pregnant and lactating women (PLW) accessing primary healthcare services from August to September.”

UNICEF

The World Health Organization (WHO) officials told reporters on Friday that Tigray region is running dangerously low on medical supplies like vaccines and antibiotics, adding that only 9% of health facilities were fully functional according to report by DW.

A new report published on Saturday 29 October by UNICEF says “there was an approximately 84 percent reduction in the number of children and pregnant and lactating women (PLW) accessing primary healthcare services from August to September.”

Almost two years of fighting between the federal government of Ethiopia and the Tigrayan regional forces have left hundreds of thousands dead and millions displaced from their homes.

Hospitals among other public institutions were destroyed, much needed medical aids were hampered due to the fighting, and as a result thousands including children were left without much needed health care and medical services.

Doctors say hospitals across the entire Tigray Region are on the edge of collapse due to lack of supply of essential medications and people are dying from treatable diseases.

A recent BBC Africa Eye documentary revealed a horrific case story in Abyei-Adi hospital where a nineteen months old severely malnourished baby, who should have been on therapeutic feeding is left to suffer because there is nothing much doctors can do to help him due to lack of supply.

“We are not giving him milk because we don’t have any, he is just getting oxygen,” said a doctor standing next to the aching baby.

Screen-grab

Things are even worse at the Ayider Referral hospital, the biggest hospital in Tigray, which was managed by the federal government before the war broke out.

According to Dr Kibrom, the pharmacy run out of essential drugs, laboratory services were halted because of a lack of reagents and faulty machines that can be maintained only in Addis Abeba, and the radiology department collapsed because the equipment needs periodic connection to the internet and some of them like the (Magnetic resonance imaging) MRI requires uninterrupted electric supply.

The hospital has stopped dialysis services for kidney patients because of lack inputs needed for the treatment. “The fate of these kidney patients is nothing but painful death,” Dr Kibrom says.

The International Committee of the Red Cross (ICRC) used to help the hospital by transporting and providing donations, but since the suspension of air-flights and truck movements to and from Tigray, even ICRC couldn’t help, Dr Kibrom said.

He says that the International Diabetes Federation and Ethiopian Diabetes Association had agreed to send insulin and other DM drugs to Tigray, but “they are jammed by the government”.

“We send them to die in their houses”

Dr Kibrom says cancer has become the most dreaded disease, and physicians at the hospital are suffering a lot to tell patients that they[patients] are diagnosed with a certain kind of cancer because neither surgery nor chemotherapy is available.

“We tell them their diagnosis, we send them to die in their houses,” he says.

One such case is of that of a 56 years old woman with a chronic stomach cancer who was admitted to Ayider referral hospital and was told to go home; she died later because there was nothing that doctors could do, Dr Fasika Amdeslassie, a surgeon at the hospital told Addis Standard. “She was sent home without any treatment due to a lack of surgical materials, it was time for her to get operation,” says Dr Fasika.

“We have stopped elective cancer surgery for Two months now due to the lack of surgical materials and drugs” he added.

Patients who were taking antiretroviral drugs for HIV have interrupted their medications, and doctors say its impact on the overall national figure and the resistance that arises associated with drug interruptions will be seen in the coming years.

The lack of antibiotics has led to doctors use whatever antibiotic is available and Dr Kibrom fears that despite immediate deaths for current patients, drug resistance is all one expects in the future.

According to the information obtained from the hospital for a long period of time, the hospital death rate was below 2% while Intensive care unit (ICU) mortality rate was less than 5% in Tigray. But, after the war broke out the overall hospital mortality is greater than 10%, and the ICU mortality rate is greater than 29%.

“One should consider the number of patients who die at home because we send them home if their condition is hopeless. Some families tend to take their beloved ones home while they are still alive as the transport charge for the dead is very expensive” said Dr. Kibrom.

Ayder Referral hospital has been serving more than 300,000 patients per year, providing more than 60% of all surgeries done in Tigray. After the war, the capacity of the hospital has gone down to less than 200,000 patients per year despite the expected surge in the number of patients as the other hospitals are either destroyed or have stopped providing services as a result of lack of supplies.

Dr Kibrom says at the moment Ayder is the only hospital now in Tigray providing emergency surgical services. Cancer and other chronic disease patients who need surgery are being returned home due to lack of surgical materials and drugs.

“We wash and reuse surgical gloves, we use plastic bags as gloves to care for wounds, we dissolve table salt in the water and use as normal Saline, and cotton dresses as gauze”.

We wash and reuse surgical gloves”

According to Dr. Kibrom the top priority health service needs for patients coming to the hospital are vaccines for children, anti-rabies medications, snake ant-venom, insulin, dialysis reagents, cancer chemotherapy, antibiotics, and IV fluids among others.

The hospital has been using expired drugs for over a year, and has been operating without anesthesia, something that is “unheard in the modern era”, Dr Kibrom says.

“We wash and reuse surgical gloves, we use plastic bags as gloves to care for wounds, we dissolve table salt in the water and use as normal Saline, and cotton dresses as gauze”.

“That way we are able to save many young lives and the lives of laboring mothers,”he added.

Two weeks ago the hospital wrote an open letter to Ethiopia’s Ministry of Health and the Ethiopian Diabetes Association (EDA), asking for urgent lifesaving diabetes healthcare supply.

The hospital says there are 26,768 diabetic patients In Tigray, of which 16,420 are Type One totally insulin-dependent, and 8,224 are children under the age of 14.

The staff of the hospital hasn’t been paid since May 2021 according to Dr Kibrom. “No salary, no duty payment; in fact, they[staffs] can’t even access their previous savings in all the government banks” he says.

“They are heroically serving their people, fighting to save as many patients as they can. They are working day and night, all week,” he added.

“The world should know there is no health service whatsoever in Tigray, the entire population is doomed to die in silence, the world knows this but opted to wait and see” said Dr. Kibrom.

Efforts by Addis Standard to speak to officials of the Federal Ministry of Health were unsuccessful. AS

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