Reorienting and rebuilding the health system in war-torn Tigray, Ethiopia
Azeb Gebresilassie Tesema, Yohannes Kinfu
Abstract
### Summary box Armed conflict and war, directly and indirectly, affect health and health systems.1 2 Globally, conflict was responsible for over 63 000 deaths and over 2.7 million years of lives lost due to disability in 2019.3 The war in the Tigray region of Ethiopia, which started in November 2020, has already caused a considerable number of casualties, massive internal displacement and over 70 000 refugees in neighbouring Sudan.4 A recent report by World Food Program suggests that 91% of the region’s six million people require immediate emergency humanitarian assistance, and 400 000 people had crossed the ‘threshold into famine’.5 6 Evidence also revealed that women and girls were subjected to sexual abuse and gender-based violence in this war.6 In addition, the destruction, vandalisation and looting of health facilities have left millions of people without access to essential healthcare.7 The process of restoring and rebuilding Tigray’s health system will likely be shaped by many factors and take several years. In this paper, we outline three interrelated action points that we think should guide any future effort: health system adaptation; protecting, reskilling and …