Restoring health services in conflict-torn communities in northern Ethiopia

March 31, 2025 by Saba Ermyas

In the conflict-ravaged Afar Region, a partnership between PATH and Gavi, the Vaccine Alliance, is restoring vital health care access for 70,000 people, bringing lifesaving vaccinations back to communities where health care workers once hid medical equipment to preserve essential services.

For Derbew Abebaw, the morning ritual at the Lihada Health Post in Ethiopia's Afar Region became a heartbreaking inventory of loss: shattered windows, missing doors, stolen equipment, damaged medicines, and destroyed patient records. As the health post’s leader, he has faced these devastating scenes daily since conflict erupted across northern Ethiopia in 2020.

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Derbew Abebaw, health post leader in Lihada, Afar Region, indicates damage to the facility's windows following conflict-related destruction that has forced health care workers to hide essential equipment throughout the community. Photo: PATH/Saba Ermyas

When health centers become casualties of war

The violence didn’t discriminate between personal and professional boundaries. When looters ransacked his home—housed in the same modest building as the health post—Derbew was forced to seek refuge within the community. Despite the danger, his commitment to his patients never wavered. He carefully relocated vital equipment like blood pressure monitors and patient registers to locations throughout the community.

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A dilapidated health post in Afar Region before renovation, where conflict destroyed critical infrastructure that left approximately 70,000 people without access to routine immunization and essential health care. Photo: PATH/Saba Ermyas

Six kilometers to care: The price of destruction

“We had to beg for help from community members to carry a sick family member all the way to Mesgid Health Center for treatment,” recalls Hawa Ali, a 30-year-old mother of three. The destruction left her and thousands of others with no choice but to walk six kilometers to reach the nearest functioning health center—an impossible journey for many, especially those already weakened by illness.

The devastation stretched across multiple communities until PATH, with funding from Gavi, launched a critical intervention. This partnership has restored services in 14 health posts across four districts in Afar: Ewa, Tellalak, Ada’ar, and Chifra.

Rebuilding health infrastructure, one post at a time

In conflict zones, maintaining vaccination services is critical to preventing outbreaks of preventable diseases that can devastate already affected populations. The facility renovations address more than infrastructure—they restore a vital link in Ethiopia's immunization system that protects thousands of children from diseases like measles, polio, and pneumonia, which can spread rapidly in displacement settings.

According to the Ethiopian Federal Ministry of Health’s Optimizing the Health Service Extension Program Optimization Roadmap (2020–2035), each health post should serve 5,000 people. Thus, the restoration of these 14 facilities means approximately 70,000 people in need of services in Afar now have access to essential care—bringing health services back within reach for these communities.

“Restoring these health posts ensures children receive their vaccinations and that lifesaving medicines reach those who need them most,” explains Fatuma Teshome, vaccine program coordinator for Chifra District.

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The renovated health post during its August 2024 handover ceremony, part of PATH and Gavi's strategic initiative to restore vaccination services in conflict-affected regions. Photo: PATH/Saba Ermyas

When a community rallies to protect its lifeline

The impact goes beyond infrastructure. Ahmed Ibrahim, Chifra’s health promotion and disease prevention team leader, expressed profound gratitude for PATH's support, which he emphasized would have been impossible for the local health office to achieve alone. “The quality of the renovations and PATH's dedication have been extraordinary,” he noted, urging other partners to follow PATH's example.

The restoration has sparked a remarkable community response. Local officials encouraged residents to protect the health posts as their own, and community members have organized voluntary rotation shifts to safeguard these lifelines of health care.

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Mothers and children gather at a newly renovated health post in Afar Region, where essential vaccination services have resumed. Photo: PATH/Saba Ermyas

A return to routine: Vaccinations resume

For people like Derbew and Hawa, these restored health posts represent more than buildings—they symbolize healing, resilience, and the return of hope to communities that have endured unimaginable hardship.

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Fatuma Teshome, vaccine program coordinator for Chifra District, welcomes visitors to a renovated health post, where PATH and Gavi's partnership enables continuous vaccination services. Photo: PATH/Saba Ermyas