Tigray babies die at 4 times pre-war levels, study finds, Health News, ET HealthWorld

Nairobi: Babies in Ethiopia’s beleaguered Tigray region are dying in their first month of life at four times the rate before war cut off access to most medical care for more than 5 million people, according to the most in-depth study to date on how mothers and children are suffering.

Women are dying during pregnancy or within 42 days of childbirth at five times the pre-war rate, and children under 5 are dying at twice the pre-war rate, often for easily preventable, according to the yet unpublished study shared by its authors with The Associated Press.

Almost two years have passed since the start of the war and the Ethiopian government has isolated the Tigray region from the rest of the world, cutting off basic services such as electricity, telephone, internet and banking services.

While UN-backed investigators last month said all sides, including Tigray forces, had committed abuses, they said the Ethiopian government was using “civilian starvation” as a weapon of war.

The two sides have been invited to peace talks mediated by the African Union this weekend in South Africa.

A lull in the war earlier this year allowed thousands of humanitarian aid trucks to enter Tigray, but renewed fighting in August again halted deliveries to an area where essential medical supplies like insulin and children’s vaccines have run out.

There is an “extreme shortage” of medicines and equipment, UN-backed investigators have found.

Pregnant women and young children, the least responsible for the fighting, are among the most vulnerable.

The new study was conducted in May and June by local health authorities with financial support from two UN agencies and surveyed more than 189,000 households in six of the region’s seven zones via cluster sampling.

With limited fuel for transportation, researchers sometimes walked for hours to reach rural areas.

Maternal mortality was 840 deaths per 100,000 live births, down from a pre-war low of 186, with obstetric haemorrhage and hypertension being the most common causes.

“This level is unacceptably high and is comparable to the level that was 22 years ago,” the study said.

More than 80% of mothers died outside of a health facility, another stark contrast, according to the study.

More than 90% of mothers in pre-war Tigray received antenatal care and more than 70% received skilled delivery, according to an analysis published in the BMJ Global Health journal last year.

The rise in maternal mortality in Tigray has been “phenomenal”, the UN Population Fund said this year.

Neonatal mortality, or children who die within the first 28 days of life, was 36 out of 1,000 live births, according to the new study. That’s a four-fold increase over pre-war levels, and more than half of deaths have occurred at home without medical intervention.

The most common causes were prematurity, infections, and perinatal asphyxia, or the inability to establish respiration at birth.

Under-5 mortality was 59 per 1,000 live births, double the pre-war rate.

“Vaccine-preventable diseases like diarrheal disease, pneumonia and whooping cough account for the majority of cases,” the study says.

In footage shared this week with the AP from Tigray’s flagship hospital in the capital, Mekele, a health worker pinched the thin stomach of a small child, 2-year-old Selam Mulu. The skin remained pinched after the hand was removed, a sign of dehydration if malnourished.

The study calls for more medical supplies, including painkillers, antibiotics, anticonvulsants, vaccines, IV fluid and drugs to induce labor after the fetus dies.

“For the women here, it’s hell,” a gynecologist from Mekele who was part of the research team told the AP. He spoke on condition of anonymity for fear of reprisals.

“They get pregnant and don’t have access to care,” he said. “I am talking about rural women. And if she is giving birth and if she lives in the mountains, which is the case for most pregnant women in the periphery, they cannot move.

They can’t call an ambulance. There is no money to pay for private transportation. Even if they arrive at a health facility, there is nothing.”

Before the war, a woman’s pregnancy was a joyful affair, says the gynecologist. Now that’s a bad omen, people feel sorry for her.

“I haven’t heard of such things in other parts of the world,” he said.

It comes as UN-backed investigators have found that some Tigrayans are resorting to transactional sex to survive.

It remains difficult to estimate the number of war dead due to widespread constraints, the gynecologist added. Thousands of people died. Independent journalists have been barred from the region.

The researchers plan to share their findings with the international community and Ethiopian Minister of Health Lia Tadesse, who is also a gynecologist.

The minister shared the findings and asked for comment, but did not respond to the AP.

The war has devastated Tigray’s once well-funded health system, the gynecologist said. “People would ask you, are you going to help us? What’s after the data collection? Are you going to solve our problems?” It was haunting.”