Conflict and health
Surgery under fire: war injuries and the consequences of delayed care in Ethiopia's Tigray region
By Klausing A, Bruchhausen W and Wynands J.
Abstract
Background
The armed conflict in Ethiopia, particularly in the Tigray region, has caused a substantial burden of war-related injuries in the context of a fragile and disrupted health system. Restricted access to timely surgical care has resulted in delayed presentation and may contribute to secondary complications, contractures, peripheral nerve dysfunction, and long-term disability. However, the consequences of delayed surgical treatment for conflict-related extremity trauma in active war settings remain insufficiently described. This study aimed to characterize conflict-related injuries in Mek'ele, Ethiopia, with a particular focus on delayed surgical care, peripheral nerve injuries, and reconstructive needs.
Methods
This retrospective observational study was conducted between September and December 2023 at Ayder Comprehensive Specialized Hospital in Mek'ele, the capital city of Ethiopia's Tigray region. Patients presenting with conflict-related injuries were identified through routine clinical documentation. Epidemiological characteristics, prior surgical interventions, presenting complaints, clinical findings, and diagnoses were recorded. Peripheral nerve injuries and reconstructive challenges were analyzed in detail. Surgical treatment plans were categorized into reconstructive, corrective and functional, tendon and muscle, nerve, scar and contracture, limb or tissue removal, and supportive procedures. Group comparisons were performed using chi-square and Fisher's exact tests, and logistic regression models were used to estimate relative likelihoods. Statistical significance was set at p < 0.05.