Ethiopia

Bench Sheko in Southwest Ethiopia is a zone highly vulnerable to malaria. Heavy rains and limitations in accessing healthcare create conditions for recurrent outbreaks of the disease. Local health facilities have faced challenges often linked to shortages of essential malaria medicines, forcing patients to travel long distances or pay for costly private treatment if they can afford it.

In response to the rising malaria cases, Médecins Sans Frontières/Doctors Without Borders (MSF) in collaboration with the Zonal Health Bureau, the Regional Health Bureau and the Ministry of Health initiated an emergency response in Bench Sheko in mid-August 2025. Our teams established a dedicated 40-bed malaria ward at Mizan Tepi Teaching Hospital to provide treatment for severe malaria patients and launched outreach interventions across 12 hard-to-reach locations with limited access to healthcare.

Voice from the Communities

When he and his family are ill, Sokiam says, they usually turn to private clinics. "Three weeks ago, I was sick and went to one," he says. "It costs me 3,500 birr (around USD23) for two injections a day and 20 tablets. I recovered only partially. Here, I came with two of my children, and all three of us tested positive,” he explains, while getting treatment at MSF's mobile clinic in his neighborhood.

Brahane, a 30-year-old single mother of four, walked 45 minutes to reach MSF's mobile clinic. She has twin daughters who are six years old and twin boys who are just under one year. “All five of us tested positive for malaria," she says. "When my children are sick, I go to a private clinic. A month ago, one of my babies and I had malaria. I paid 1,500 birr (USD10) for myself and 1,000 (around USD6) for my baby. Then my baby was admitted to the hospital. The community helped me pay because I couldn't afford it.”

In Tatchu village, Mertalem, a 35-year-old mother of four, walked two hours to reach the Keberta Health Post to get treatment from MSF's mobile clinic. Both she and her 6-year-old daughter tested positive for malaria. “This year, my two-year-old daughter has already had malaria five times. She's been hospitalised twice for severe complications,” says Mertalem.

Shortage Struggles and Responding Rapidly

The rainy season in Southwest Ethiopia runs from June to September, with malaria cases peaking from August to November. Of the six zones that make up the region, Bench Sheko, home to over 697,400 people, has been one of the hardest hit.

Over the past three years, recurrent outbreaks have strained local health facilities, with shortages of essential malaria medications and high costs of care in private clinics limiting access to malaria treatment, especially in areas which are hard to reach.

Limited preventive measures at the community level, including low usage of insecticide-treated bed nets (ITNs), lack of environmental control of mosquito breeding sites, minimal community awareness and lack of means for early treatment have contributed to high malaria-related deaths, particularly from cerebral malaria and severe anemia.

“When we started the intervention, the malaria positivity rate was around 80 to 90%, and by the end of it, it had sunk below 50%,” says Samira Loulidi, MSF's emergency medical coordinator. “Over the 12 weeks, our team used to travel up to 75km to reach communities in remote areas and treated up to 120 patients per day in some locations via the mobile clinics.”

MSF teams screened around 13,000 suspected malaria cases across 12 sites. Of these, 8,597 people tested positive for malaria and received treatment. In addition, 772 severe malaria patients were admitted and treated in MSF's malaria ward in Mizan Tepi Teaching Hospital, where, in the first weeks of the intervention, the bed occupancy rate was around 80 to 95%.

“The level of complications and the types of patients we were treating show that malaria remains extremely severe," says MSF medical doctor Zelalem Tafese. "Many patients arrive with severe anemia, which poses serious health risks. We have also been regularly treating cerebral malaria, with around seven or eight cases per week, as well as acute kidney injury. These are serious conditions that require urgent, specialised care.”

In addition to providing treatment, community health promotion teams spread awareness on how to identify early malaria symptoms and promptly seek treatment, eliminate mosquito breeding sites, and use bed nets effectively.

At the same time, several health facilities across the area were supplied with diagnostic kits, malaria medicines, and training. This strengthened the local health system, helping reduce the dependency on private clinics and the financial burden on families. These efforts, combined with vector-control activities and bed-net distribution in high-transmission districts, led by the Ministry of Health, curbed the malaria outbreak.

By the time MSF handed over the malaria ward, the hospital had recorded a 41% decrease in daily admissions, declining from 15–25 to approximately 5–6 patients per day.

However, while new cases are declining, significant challenges remain. Timely access to malaria treatment and essential medicines is still limited, and community awareness of prevention practices needs to improve to sustain the recent progress.