Backlog of war

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LINDSAY MAST, HOST: Coming up next on The World and Everything in It: World Tour.

A devastating civil war earlier this decade left much of Ethiopia’s Tigray region in ruins. The deadly two-year conflict in the northern part of the landlocked African country left about 600,000 dead and many more with lingering wounds.

NICK EICHER, HOST: Even now, thousands of people are still in dire need of medical care . and wary of another conflict.

WORLD’s Africa reporter Onize Oduah has the story.

ONIZE ODUAH: Dr. Matthew Spreadbury began each day of his stay in the city of Mekelle last year with the same routine.

MATTHEW SPREADBURY: It was spicy, spiced eggs for breakfast in the hotel, and then I have quiet time.

He walked to the shop opposite his hotel to get a cup of coffee for about 20 cents. He chatted with people for a bit before a driver picked him up and took him to the hospital for a day of treating patients. Some had waited for help for months or even years.

Spreadbury is in his 30s, a missionary surgeon living in Norway. TESFA Foundation ... a Norwegian Christian nonprofit ... sent him to Tigray's regional capital to serve as a vascular surgeon ... filling a needed medical gap.

He says many of the patients in the hospital were amputees.

SPREADBURY: They’re like little gangs of people just, of young men and women, just with crutches and with wheelchairs, just all around the hospital, they've nowhere else to go. You know, if they go outside the hospital bounds, they'll be on the street begging, whereas in the hospital, they'll get one meal a day and they get relative shelter.

The hospital’s backlog of patients waiting for surgery added up to about 5,000. Most needed orthopedic surgeries, with others waiting for plastic, general, or neurological procedures. Spreadbury mostly operated on patients with blood vessel injuries.

SPREADBURY: A blood vessel is injured, it heals like a hose pipe, which has been injured. And it's much like a balloon on a hose pipe, and it can burst at any time. And these are very complex lesions to treat, very rarely seen in the West now, and usually exclusively seen through battlefield injuries, like bullets, drones, bombs, that kind of thing.

His youngest patient had been waiting 4 years for treatment for an injury she received at 17.

SPREADBURY: And she was actually the most complex case we operated on. It took nine hours to operate on her. So, yeah, there's very many young, young patients who have their lives put on hold, really.

Tigray is one of 10 ethnically divided semi-autonomous federal states in Ethiopia. The region’s well-armed Tigray People’s Liberation Front dominated Ethiopian politics for nearly three decades.

But after Ethiopian Prime Minister Abiy Ahmed assumed office in 2018 the group’s relationship with him frayed. Regional leaders felt marginalized under Abiy’s reforms, and the tensions eventually morphed into clashes and a subsequent military campaign.

Western nations and aid groups warned of ethnic cleansing and genocide in the region. As many as 800,000 people remain displaced.

Spreadbury took his first trip to Ethiopia’s capital city of Addis Ababa back in 2022, months before a peace agreement ended the Tigrayan war.

SPREADBURY: And it really just breaks your heart. Injustice in the world seeing this like you know, this is a war that claims 600,000 lives, which, at the time, when I was there, was more than the Ukraine war.

Poor implementation of the peace agreement has left the situation volatile.

Spreadbury acknowledges that working in the face of such need could seem hopeless. Federal aid is barely trickling into the region, and people rely heavily on aid groups like the Red Cross for medical care.

In Tigray, Spreadbury said his team operated on about 10 patients during his three-week stay.

SPREADBURY: If we had equipment and supplies, we could operate day and night, like there is no short log of patients.

He says the need for the surgeries showed in the breakdown of the equipment he used.

SPREADBURY: These should last in Europe. They would last 25 years. These instruments, they were worn out within two years.

But Spreadbury says he focuses on treating the patient in front of him. It’s a thought process he honed while working in other countries like South Sudan, Rwanda, and Myanmar, also known as Burma.

SPREADBURY: It keeps going on, and it’s in those moments you realize that it’s not in your own strength. It really isn’t, because in your own strength, you should be absolutely exhausted and sleep for two days, but He really does give grace to those who need it, and strength as the labors increase.

Earlier this week, the Tigray People’s Liberation Front party said it was taking back political control of the region, sparking concerns that Tigray may be headed for more conflict.

That’s this week’s World Tour. I’m Onize Oduah, in Abuja, Nigeria.

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