Ayder Comprehensive Specialized Hospital, College of Health Sciences, Mekelle University, Mek'ele, Tigray, Ethiopia.
Ayder Comprehensive Specialized Hospital, Department of Internal Medicine, Nephrology Unit, Mekelle, Ethiopia.
BMC Med. 2022 Nov 8;20(1):431. doi: 10.1186/s12916-022-02637-1.
The war on Ethiopia's Tigray broke out on November 4, 2020. Amid the armed conflict, governmental institutions were destroyed, people were displaced, and thousands of civilians were killed. The region was experiencing an on-and-off type of blockade since the war broke out until June 28, 2021, at which time the federal government of Ethiopia imposed a siege cutting off the region from the rest of the world. Due to the shortage of medicines and medical supplies, witnessing deaths that otherwise were preventable under normal conditions has become the daily predicament of healthcare workers. The burden of healthcare disintegration is particularly carried by patients with chronic medical illnesses including patients on dialysis.
Ayder hospital, Tigray's flagship healthcare institution, hosts the only hemodialysis center in the entire region. This center is currently unable to give appropriate care to kidney failure patients for a lack of access to dialysis supplies and consumables due to the ongoing war and siege. This has resulted in vicarious trauma manifested with compassion fatigue, irritability, a feeling of bystander guilt; sadness about the patient's victimization, and hopelessness among healthcare workers caring for dialysis patients.
The suffering of veteran patients and witnessing preventable deaths have continued to haunt and torment healthcare workers in the dialysis unit leading to vicarious trauma. Cognizant of the fact that vicarious trauma has serious health ramifications on healthcare workers; we call up the international community to advocate for a full resumption of access to healthcare and the provision of mental health support and educate and train healthcare workers dealing with end-stage kidney disease patients on hemodialysis.
埃塞俄比亚提格雷地区的战争于 2020 年 11 月 4 日爆发。在武装冲突中，政府机构被摧毁，人民流离失所，数千平民丧生。自战争爆发以来，该地区一直处于断断续续的封锁状态，直到 2021 年 6 月 28 日，埃塞俄比亚联邦政府对该地区实施了封锁，切断了该地区与世界其他地区的联系。由于药品和医疗用品短缺，在正常情况下本可避免的死亡事件，如今已成了医护人员的日常困境。医疗体系瓦解的重担尤其落在了包括透析患者在内的慢性病患者身上。
阿德尔医院是提格雷地区的旗舰医疗机构，拥有该地区唯一的血液透析中心。由于持续的战争和封锁，该中心目前由于缺乏透析用品和耗材，无法为肾衰竭患者提供适当的护理，导致创伤后应激障碍。这导致同理心疲劳、易怒、旁观者内疚感、对患者受害的悲伤以及照顾透析患者的医护人员的绝望等替代性创伤表现。
资深患者的痛苦和目睹可预防的死亡继续困扰和折磨着透析病房的医护人员，导致替代性创伤。鉴于替代性创伤对医护人员的健康有严重影响，我们呼吁国际社会倡导全面恢复医疗服务，并提供心理健康支持，并对处理终末期肾病患者血液透析的医护人员进行教育和培训。
