LocationsRebuilding after conflict
When Fentaye Misganaw fled her home in Abergele Woreda, Amhara region in northern Ethiopia, carrying her five-year-old on her back and another child in her womb, she was not just escaping conflict—she was racing against time and risk. Remaining behind would have meant giving birth without medical support, a risk she was unwilling to take.
As a health extension worker, Fentaye had long advocated for institutional deliveries and regular antenatal checkups. She visited homes, counseled expectant mothers, and ensured high-risk pregnancies were referred to health centers. She practiced what she preached—until conflict tore apart the very system she had worked to strengthen.
Fentaye is now receiving prenatal care at Nirak Health Center, and she is one of the first to benefit from the recently acquired ultrasound machine—transforming maternal care through early detection of complications. Fentaye reflects, “This time, I’m following up on my pregnancy properly. The care we receive now gives us peace of mind.”
The Nirak Health Center serves over 21,000 residents. But when conflict erupted in northern Ethiopia, the facility was destroyed. Health workers and community members fled, scattered across three IDP camps in Sekota, 65 kilometers away.
A System in Collapse
Similar devastation occurred in Tsagibji Woreda. At Mikun Health Center, eight health professionals once served the community from a modest facility with four rooms. The war destroyed everything—including the center's ambulance. Health workers like Yonas Alefe, the center's head, fled to Sekota and continued to serve from makeshift health posts inside IDP camps.
“Women were giving birth at home, exposed to life-threatening risks,” Yonas recalls. “We had to walk along the road to meet women being carried on traditional beds. I personally did this five times.”
Belaynesh Miye did not have access to professional care when her labour started. She delivered at home, losing significant amount of blood, and was only saved by an ambulance that arrived just in time from Sekota. Belyanesh sadly shares, “One of my neighbors wasn’t as lucky. Her placenta didn’t come out after birth, and she suffered severe bleeding.”
Rebuilding What Was Lost
In the aftermath of the conflict, health professionals returned to ruins. But they didn't give up. In Mikun, local authorities rehabilitated four rooms to restart operations. For six months, services were provided under the most difficult conditions—until new hope arrived.
With support from the UNDP Peace Support Facility, funded by Germany, Japan, the Netherlands, and UNDP’s core partners, a new block with four additional rooms was constructed.
“Our services expanded significantly,” Yonas explains. “We now have designated rooms for emergencies, prenatal care, child treatment, and health informants. This has improved service quality and reduced disease transmission.” - Yonas Alefe, Mikun Health Center
Today, the health center has 23 staff, including lab technicians, midwives, and health informants. New services like tuberculosis treatment, child nutrition support, and a dedicated maternity room have been introduced—none of which existed before.
Belaynesh is one of many mothers who can now access proper healthcare. “Now I come to the health center not just when my kids are sick but even when they show minor symptoms. I bring them immediately to get checked and treated. It only takes me 30 minutes to reach the health center,” she says with a smile.
Impact in Abergele
In Abergele’s Nirak Health Center, recovery also began with local efforts at initial rebuilding which brought back basic operations. However, essential diagnostic equipment was still missing. Pregnant women had to travel up to 65 kilometers to Sekota for ultrasounds—posing both physical risks and financial burdens.
This changed when an ultrasound machine was purchased for the center, and air conditioning equipment, and ambulance maintenance support provided by partners through UNDP's Peace Support Facility.
Fentaye, who has resumed her prenatal care, reflects: “This time, I’m following up on my pregnancy properly. The care we receive now gives us peace of mind.”
“Over 125 mothers have already been diagnosed using the new ultrasound.” - Mitiku Geta, head of Nirak Health Center.
Challenges Remain
Despite the progress, urgent gaps remain.
In Mikun, the facility still lacks enough rooms, basic medical equipment, and a dedicated pediatric or maternity ward. With windows covered by corrugated metal sheets and no ambulance in service, care is limited.
“Some women still prefer to give birth at home,” Yonas admits, “not because they don’t understand the risks—but because the environment lacks privacy and the journey is too difficult.”
At Nirak Health Center, medicine shortages persist, and the Maternal Health Unit is yet to be rebuilt due to budget constraints.
“Our community wants to use health services,” says Fentaye, “but roads are bad, and ambulances are too few. That’s still stopping some mothers from reaching help in time.”
A Shared Success and Responsibility
The tireless dedication of frontline workers like Yonas, Mitiku, and Fentaye—combined with the timely support of donors—has turned despair into progress. No maternal or child deaths have been reported recently due to lack of access to care in these areas.
25 health centers have been rehabilitated by local authorities in Afar, Amhara and Tigray regions with the support of partners funding UNDP's Peace Support Facility.
