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War in Ethiopia: mental health should be better addressed

The effects of war on the mental wellbeing of people is given much less attention than the physical harms of conflict.

We have been researching and working on the mental health challenges faced by different sub-populations. In a recent opinion piece in The Lancet our group applied some of our earlier findings to the situation in Ethiopia.

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The country is the second most populous in Africa. It has a total population of approximately 115 million and 12 administrative regions. Conflict broke out in late 2020 between the central government and the Tigray People’s Liberation Front. The war has been ongoing ever since, with battles spreading out to the regions of Afar and Amhara.

Mental health problems are major indirect consequences of armed conflicts. They can have short-term and long-term effects on the wellbeing of individuals living in war-affected areas.

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In a new report the World Health Organization (WHO) estimates a high burden of mental health problems in conflict settings. This includes depression, anxiety, post-traumatic stress disorder, bipolar disorder and schizophrenia.

There has been limited data on the potential mental health consequences of the war in Ethiopia. To try and bridge the gap we applied the WHO’s estimates to the populations in the war-affected regions of Afar and Amhara in the country.

We argue that the burden of mental disorders and their short-term and long-term consequences in communities in the war-affected regions of Amhara and Afar should be a priority in the post-war period.

Given the large population in need of mental health interventions in northern Ethiopia, there is an urgent need to offer effective collaborative care that’s affordable and accessible.

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The impact

Over 12 months of sustained conflict has resulted in massive internal displacement, homelessness, financial and family loss, and disruption of the culture and values of millions of people living in Amhara and Afar.

Several religious institutions that have been playing a crucial role in maintaining public resilience and the mental wellbeing of the community have been destroyed. This has been in the absence of government and community-based facilities, which have been looted.

Another adversity that could increase the risk of mental health problems in the population is gender-based acts of violence and assault. This includes rape and gang rape.

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The intergenerational effects of armed conflict are also of concern. Sexual violence can lead to family breakdown, leaving children unattended, uncared for, and traumatised throughout their childhood and adulthood.

What can be done

Awareness raising, psychoeducation, skills training, rehabilitation, and psychological treatments are considered effective interventions in post-war settings. These could be provided in homes, schools, communities, and religious and health institutions.

Several UN agencies (the UN Population Fund, the UN High Commissioner for Refugees, UNICEF, WHO, and the International Organization for Migration) have been actively working to identify women affected by different types of violence, and training community-based counsellors who provide dignity kits and psychological support such as counselling in the Tigray region.

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These post-war mental health services should also be scaled up for affected populations in Amhara and Afra regions.

War in Ethiopia: addressing mental health needs to be made a priority  The Conversation Indonesia

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By Cleo

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