Help Refugees and People in Health Crises


On the Ground: The Day the Health Workers Returned

Ethiopia’s rural communities are bearing the brunt of a humanitarian crisis brought on by extreme drought and conflict. Read a dispatch from photographer James Buck on what he saw the day health care returned to a local community after more than a year.

By James Buck

I remembered bouncing along the dusty roads to tiny villages from my first trip to Ethiopia in 2018. This time, the desert was dotted with carcasses of animals that had died of hunger and thirst trekking alongside their owners, driven by drought from homes I had visited four years earlier. 

They had waited out one missed rainy season, they told us, and then another, and then a third. Finally, they had to leave. But it was too late for many by that point, and on the three-day hike to a government water distribution point, 10 children from the 300 households perished, along with almost all their animals. In total, 120 people lost their lives chasing water. 

mules carrying buckets of water on their back.
Devastating drought brought on by multiple missed rainy seasons has driven many rural communities across Ethiopia to desperation. All photos by James Buck for Project HOPE, 2022.

For the 80% of Ethiopia’s population that are rural subsistence farmers, animals are life. They rely on their goats and cattle for food and milk. The loss of all the animals was utterly devastating. These were people starting over. 

I met women with their first new goat in the desert, not far from the remains of the ones that had died. They were searching for food now as well as water. The government supplies were scarce. 

On top of the drought, the conflict spilling over from the nearby Tigray region had caused most health care workers to flee their posts, so the tiny local buildings providing the most vulnerable populations with their only access to care stood empty. 

Amazingly, I got to witness Project HOPE vehicles pulling up to an abandoned post some 15 miles outside of town on a bumpy, washed-out desert road, bringing the first health care workers most had seen in more than a year. As we made our way through the local militia standing guard against another invasion, the crowd urgently pressed their way in to be treated. I saw people walking toward the clinic on foot for miles in every direction. 

carcasses on road
Animal bones dot the road to a rural health post in Ethiopia. The vast majority of Ethiopia’s population are subsistence farmers, and the loss of animals has ripple effects that impact a family’s ability to find food, water, or health care.
women carrying babies on their backs
Climate emergencies like the catastrophic drought that impacted the Horn of Africa in 2022 disproportionately impact women and girls due to food insecurity, exhaustion, heat, and waterborne diseases. Photo by James Buck for Project HOPE, 2022.
man in Project HOPE truck
A Project HOPE truck at the rural health post in Ethiopia.

As a photographer for Project HOPE, I have seen this scene in so many desperate places in the world: health care workers in navy blue vests bringing life to people dying for care. Hands lifted underweight babies into makeshift scales and generously spilled abundant malnutrition supplements into waiting arms, promising to bring so many back from the brink.  

Six cases of severe child malnutrition were treated that day, giving the likelihood that 60 to 70 more could be found nearby. The Project HOPE staff who had traveled with me to this rural health post from the capital, Addis Ababa, put their heads in their hands at the magnitude of it. 

The people told us they had fled the region when the conflict erupted, and the health care workers with them. When I first approached the clinic with my camera, a serious-looking older gentleman with a rifle stood up and stepped directly into my path. Before I could worry, he reached out and embraced me in a hug. He was the village chief, greeting me. 

“We’re so thankful you’re here,” he smiled at me, melting with genuine gratitude.  

man with nutritional bar sitting with mother and baby
A health worker holds a ready-to-use therapeutic bar, which provides lifesaving nutrients for children experiencing malnutrition. Ethiopia’s combination of conflict and drought has led to increased numbers of undernourished and malnourished children in need of emergency care.

The chief told us that he had been writing letters to the local governorate, asking for health care workers. His son told us proudly how he had been taught about family planning from our clinicians, and his wife spaced her children out by three years. He wanted others to be taught the same, like the woman I met who was carrying two severely malnourished infants, and was herself malnourished, and pregnant again. 

As ever, I was impressed by the real desire of people to live healthy lives, to feed their children well, and to improve their lives through medicine. These people were lucky enough that Project HOPE was there to support that drive. As we left for the day, a dusty Land Cruiser with a Project HOPE flag took three laboring women to the nearest city to give birth where they could receive care.  

Seeing that flag flying across the dry desert, in a place so hard to reach, made my heart fill up. The work we do really reaches every corner of the globe. I’m so glad I get to see it and bring it home, and I want to help it keep reaching the many who are waiting for it. 

James Buck is a U.S.-based photojournalist who has shot for Project HOPE in Ukraine, Malawi, Indonesia, India, and multiple other countries around the world. 

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