Ethiopia: Aid Cuts Threten Refugee Lives in Gambella, Ethiopia

Aid Reductions Trigger Immediate Humanitarian Impact

The reduction in humanitarian funding has led to the suspension of nutrition services in four of the seven refugee camps in Gambella, putting approximately 80,000 children under five at risk of life-threatening malnutrition. Refugees now report receiving food rations that run out well before the end of the monthly cycle, with many families surviving on drastically reduced caloric intake. In Kule camp, where MSF runs a therapeutic feeding centre, refugees have received as little as 600 calories per day since October 2024—less than 30% of the recommended 2,100 calories. This severe shortfall has directly contributed to a 55% year-on-year increase in child admissions for therapeutic feeding in 2025, with half of these children referred from other camps where services have collapsed.

Personal accounts from refugees illustrate the human toll of these cuts. Nyauahial Puoch, a mother from Tierkidi camp, described travelling eight kilometres to reach MSF's facility in Kule after her 17-month-old daughter was diagnosed with malnutrition. She noted that food items once regularly provided are no longer distributed, forcing families to stretch inadequate rations. Similarly, Kuoth walked three hours from Akula camp to seek treatment for her one-year-old child suffering from cough, diarrhoea, and severe malnutrition, requiring a 15-day hospital stay for recovery. These testimonies highlight how funding gaps translate into real-world suffering and increased pressure on remaining aid providers.

Healthcare System Overwhelmed by Rising Demand

MSF's outpatient department in Gambella has recorded a 58% increase in patient visits compared to the same period in 2024, with many patients arriving from surrounding camps where local health services have ceased due to NGO withdrawals. Antenatal care attendance has risen by 72%, reflecting growing maternal healthcare needs amid declining support. Armand Dirks, MSF Project Coordinator in Gambella, explained that the influx stems from the absence of alternative services: 'We're receiving more patients from other camps… because these services are no longer available locally due to many NGOs withdrawing from the region due to funding cuts.' MSF is now operating at full capacity but struggles to meet demand, raising concerns about long-term sustainability.

The strain extends to disease prevention, particularly malaria control. With bed net distribution, indoor and outdoor spraying, and timely healthcare access scaled back, MSF anticipates a sharp rise in malaria cases during the rainy season (May to October). In July 2025 alone, malaria patients treated at MSF facilities increased by approximately 125% compared to June 2025. Since January 2025, over 23,800 malaria cases have been treated, with more than half originating from neighbouring camps. Birhanu Sahile, MSF deputy medical coordinator, warned that overcrowded living conditions and limited sanitation heighten exposure to malaria-infected mosquitoes, posing a serious threat to an already vulnerable population.

Compounding these challenges, the breakdown in water, sanitation, and hygiene (WASH) services has increased the risk of waterborne diseases such as cholera and diarrheal illnesses, particularly among children. Latrines are overflowing or non-functional in many camps, and access to clean water has become intermittent, undermining basic disease prevention efforts. MSF has responded by scaling up oral rehydration point distributions and cholera preparedness measures, but warns that without restoration of core WASH infrastructure, preventive gains remain fragile and reversible.

Urgent Calls for Local Integration and Sustained Support

Beyond immediate relief, aid workers are advocating for structural changes to reduce dependency on volatile international funding. Dirks pointed to the visible legacy of withdrawal: 'Walking through the camp, you'll see many empty buildings—spaces once used by NGOs that have now withdrawn. Their absence is deeply felt.' MSF is responding by enhancing malaria treatment services and planning a dedicated malaria health post in Tierkidi camp, which hosts over 74,000 refugees. Bed net distribution and vector control efforts are being intensified in Kule camp to mitigate outbreak risks.

However, MSF stresses that its efforts alone are insufficient. 'MSF is working at full capacity, but the scale of needs in Kule far exceeds what we can address alone,' said a spokesperson. The organisation urges the Government of Ethiopia to take decisive steps toward integrating refugee services into local systems, including strengthening regional healthcare infrastructure to withstand future funding shocks. Such integration would not only improve resilience but also promote dignity and self-reliance among refugee populations, aligning with broader humanitarian principles of local ownership and sustainability.

Long-term solutions require coordinated action between donors, host governments, and humanitarian actors to build systems that can endure funding fluctuations. This includes investing in the capacity of regional health bureaus, training refugee and host community health workers, and ensuring supply chains for essential medicines and nutrition commodities are resilient to disruption. Pilot programs showing promise in other regions demonstrate that gradual integration, when properly resourced, can improve service continuity while reducing parallel system costs. Without such forward-looking investment, the cycle of crisis and temporary response will continue to undermine years of progress in protection and assistance.

What this means

The crisis in Gambella’s refugee camps underscores the profound consequences of retreating global humanitarian commitment. As food rations dwindle, preventable diseases rise, and overwhelmed clinics struggle to cope, the lives of hundreds of thousands of refugees hang in the balance. While organisations like MSF continue to deliver critical care under extreme strain, their warnings are clear: without renewed donor investment and proactive steps by host governments to absorb and sustain essential services, the gains of years of humanitarian work risk being erased. For businesses, policymakers, and global citizens alike, this situation serves as a stark reminder that aid is not charity—it is an investment in stability, health, and human dignity. Sustained engagement, innovative financing, and local capacity-building are not optional; they are essential to preventing further suffering and upholding the promise of protection for those forced to flee.