Seven days of chaos in the ER: How this country's healthcare system is unraveling

"It was a mess, it was chaos, and that continued for almost seven, eight days.Without (cell) network, without electricity," recalls a surgeon in Ethiopia.On September 24, a two-year ceasefire between rebels and the Ethiopian government began to collapse.

As injured people streamed in from the countryside, this surgeon and his colleagues treated as many as they could at a hospital in Mekele, the capital city of Ethiopia's northern Tigray region.Fearing repercussions for treating rebel fighters, the surgeon asked NPR not to publish his name."The whole emergency (room) was flooded with war trauma patients," he recalls.

"The floors were all filled up, there was no place to step."For the past several weeks, the violence has continued at a steady pace, raising concerns that Ethiopia could again face a civil war.The Ethiopian military has accused Sudan, Egypt and Eritrea of backing Tigrayan militants, who have aligned themselves with seven rebel groups in Ethiopia with the goal of ousting Prime Minister Abiy Ahmed.After drone strikes in late October killed at least 15 people, including children, the director-general of the World Health Organization, Tedros Adhanom Ghebreyesus, posted on X that the violence in northern Ethiopia "is pushing an already fragile health system closer to collapse."During the initial outbreak of violence in September, the surgeon in Tigray says he spent days operating on victims of gunfire, drone attacks, and mortar shells.

Some were clearly civilians, but others were fighters in uniform.Complicating matters, he recalls, there was no way to know how many patients were coming because cell service and the internet were cut."We don't know where they're from — you just go ahead and do whatever you can, you know?" he told NPR.There had been signs that the war between Ethiopia's federal government and rebel groups could reopen.

In May, Tigrayan rebels ousted regional leaders and installed their own.In response, Ethiopia's federal government cut f...