Traumatic Stress During Armed Conflict and Associated Siege: Experiences of Healthcare Workers and Teachers in Tigray, Ethiopia

Abstract

Abstract Background Healthcare and education professionals living and working in conflict settings develop psychological injuries that can significantly impact their life and work. However, little is known about the potential impact of armed conflict and related siege on the psychological injuries of healthcare workers and schoolteachers in Tigray, Ethiopia. This study examined the impact of war and related siege on psychological, mental, and physical trauma among healthcare workers and schoolteachers from conflict-affected communities in Tigray, Ethiopia. Method This study was conducted in four purposively selected zones of Tigray. A cross-sectional study design was employed to determine the level of burnout, compassion fatigue, vicarious trauma and mental health status among health professionals and teachers during the war and related siege in Tigray. A multistage sampling procedure was used to select the study units. The proportional allocation technique was used to distribute the total sample size of each sector (health and education). Similar approaches were used to allocate the sample size to the health facilities and schools from each zone. A total of 67 health facilities, including 14 health posts, 25 health centers, 16 primary hospitals, 9 secondary hospitals and 3 tertiary hospitals, were included. Similarly, a random sample of 832 healthcare professionals and 840 schoolteachers was used. Descriptive statistics were used to summarize the frequencies and percentages, and bivariate and multivariate analyses were conducted to assess the associations between the variables. Results Healthcare workers and schoolteachers had high levels of anxiety (64.8% and 77.5%, respectively), depression (74.2% and 84.8%, respectively), burnout (44.3% and 42.9%, respectively), compassion fatigue (56.3% and 47.7%, respectively) and vicarious trauma (88.4% and 90.8%, respectively). Compared with healthcare workers, education workers (61.8%) had a remarkably greater prevalence of trauma-associated sleep disorders (42.2%). The experience of providing services to ill or injured clients is believed to have led to serious mental health outcomes. Conclusion The healthcare and education sectors need to institute trauma-informed care and provide training as part of continuous professional development and integrated refresher training to alleviate mental health challenges and enhance service quality.