International staff: 50
National staff: 617
The Horn of Africa was in the limelight in early 2000, with hunger tightening its grip on this region often affected by drought. Ethiopia has been badly hit by the current three-year drought. War with Eritrea to the north and civil war in the Ogaden region have also taken their toll.
In September 1999, MSF found that severe and moderate malnutrition rates in Konso Special Wereda, an area southwest of the capital, Addis Ababa, warranted immediate intervention. A supplementary feeding program for 9,000 pregnant and lactating women and children under five began in October 1999.
Further east, meanwhile, the situation became steadily worse. The people of the Ogaden region are nomadic and depend almost entirely on their livestock in an area which is naturally arid, flat, dusty and hot.
The Ogadenis have coping mechanisms to cross the "hunger gap", but this year it was not enough - there was no food, no grass and no water for the livestock, and the harvest had failed. In early February 2000 a team went into Gode, Ogaden, to review the needs and operational possibilities. However, a security incident further north, during which an MSF driver was killed and a volunteer seriously injured, led to the immediate evacuation of all staff in the region. The team was shuttled in and out of Gode afterwards, despite the security risks, to carry out measles vaccinations, vitamin A distribution and a basic nutritional study. Because of the insecurity, MSF's activities in Ogaden were delayed.
In March, the UN World Food Program and the Ethiopian authorities stated that about eight million Ethiopians were at risk of famine. Appeals to the international community went out. As media reports became more and more alarmist, MSF sent a team back into Gode to collect accurate data and look at the possibilities of intervention. MSF found that, while the threat of widespread famine wasn't high, there were pockets of severe malnutrition that posed great danger to certain nomadic people.
Soon after, MSF set up feeding centers in Denan for about 1,000 children, as well as water and hygiene facilities for the centers and a nearby camp for displaced people. Tuberculosis cases in Gode were diagnosed and treated and another team went to Gudis and Imi to examine the needs of the nomadic people there. The rains, which finally came in May, ironically caused flooding in Ogaden, making food distribution difficult and cutting off access to Gudis and Imi.
MSF eventually opened therapeutic and supplementary feeding centers and a small consultation clinic in the area. In the Arero region, the organization began a nutrition program for young children. In late spring, MSF also set up emergency feeding programs in Wag Hamra and Welayita.
Wide-ranging programs throughout the country
Aside from responding to crises, MSF has a wide range of other projects in Ethiopia. In Addis Ababa, MSF works in all 19 health centers to prevent HIV and STDs, and provides health information and services to a target group of about 15,000 women involved in prostitution.
In Somali state, MSF has a water rehabilitation program and an STD/HIV prevention project. Further north, in the Tigray region, MSF's surgery projects at Mekele and Adigrat hospitals reach a population with no other access to surgical care. The organization also works to prevent and treat HIV/AIDS and kala azar (a fatal parasitic disease transmitted by the sandfly) in northwestern Tigray.
In addition, MSF provides medical support and water and sanitation services to nearly 100,000 people displaced by war in the area. There is another long-term kala azar project in Konso Special Wereda, where the disease is endemic.
MSF also supports Dubti hospital in the Afar region, and there are plans to begin a tuberculosis (TB) program for nomads in the area in late 2000. A five-year surgery training program at Woldya hospital, in North Wollo, finished in 1999. MSF opened an intensive care unit at the hospital.
In the tiny village of Menza, near the Sudanese border, MSF had a basic care and nutrition program until insecurity forced its closure at the end of 1999; a similar program continues just over the border in the Sudanese village of Menkush. In nearby Bambudei, a health care program reaches about 5,000 Sudanese who have fled the conflict in their country. In addition, in January 2000, MSF began a water and sanitation and hygiene education program for 10,000 Sudanese refugees in Dyma.
In the southern part of the country, in the South Omo Zone, MSF has a primary care program that reaches the Mursi people. A water and sanitation project in Wag Hamra is scheduled to finish in 2000, while an assessment for a possible medical program in the same area is underway. MSF has been working in Ethiopia since 1985.