“Words fail to describe what has been done”: understanding the lived experiences of health professionals during war and siege

BACKGROUND: The surge in armed conflicts since the mid-2000s has significantly disrupted healthcare systems, leading to humanitarian crises and profound economic and infrastructure damage. This study explores the experiences of healthcare professionals to examine the impact of the war in Tigray on the healthcare system, professionals' livelihoods, community health, and healthcare services. METHODS: A qualitative study using a phenomenological approach was conducted in Tigray Regional State, Ethiopia, involving in-depth interviews with health professionals. Participants were selected through purposive sampling, focusing on those with clinical and administrative roles during the war. Data collection occurred between February and March 2022, with interviews conducted in Tigrigna. RESULTS: The war has devastated Tigray's healthcare infrastructure, leading to a collapse of health services and a significant decrease in healthcare professionals' quality of life. The community's health has deteriorated due to reduced healthcare access and increased disease prevalence. Key themes identified include the perils of war on a thriving health system, a community hanging by a thread, and resilience and hopes for recovery. The study highlights the urgent need for focused interventions to mitigate the conflict's impacts and foster long-term recovery in the region. CONCLUSIONS: The Tigray war had a profound impact on the healthcare system, professionals, and community health. The findings underscore the necessity of urgent, coordinated efforts to rebuild the health sector, support affected professionals, and enhance community health resilience. This study provides crucial insights into the challenges faced by healthcare systems in conflict zones and the importance of safeguarding these systems against the ravages of war.