The conflict and insecurity in northwestern Ethiopia have significantly affected the contested area of Wolkait-Tegedie-Setit-Humera zone, leading to disrupted health services, damaged infrastructure and limited access to skilled healthcare providers. Communities face complex challenges, including shortages of trained medical staff, poor transportation, shortages or a lack of medical supplies and difficulties in accessing emergency care. These factors have contributed to high maternal and neonatal mortality in the zone.
Wolkait woreda, with a population of approximately 153,600 people, is served by Wolkait Primary Hospital, the main referral center for five local health centers—Bet Mulu, Dejena, Korarit, Shrella and Telelo—and Adisalem in Tegedie woreda.
With support from the European Union, International Medical Corps helped rehabilitate Wolkait Primary Hospital. Before our intervention, the hospital had no senior do/ctors, including surgeons and obstetricians/gynecologists, and emergency cases were often referred to distant district hospitals. Fuel shortages and limited ambulance transportation further exacerbated referral delays. Over the past nine months, the hospital recorded three maternal deaths (due to severe preeclampsia/eclampsia, antepartum hemorrhage, and severe anemia) and 20 neonatal deaths, with more than 50% linked to delayed labor management and the lack of skilled obstetric and /or surgical care. Moreover, many of the surgeries and procedures for pediatric patients—including acute appendicitis, abscess drainage, hernia repair, soft tissue mass removal and injury repair, and chest tube insertion for thoracic trauma—were not being undertaken in the hospital because there was no surgeon available
Nigus Tilahun, an 8-year-old boy from Shrella, one of the kebeles in Wolkait woreda, was referred to Wolkait Primary Hospital from Shrella Health Center on March 26, 2026, for further evaluation and management. For the past month, Nigus had been having trouble urinating, and when he did, his urine was a reddish color. He was also experiencing intermittent lower abdominal pain and severe pain during urination. He had received repeated treatment with antibiotics and analgesics at the local health center, but relief was only temporary, and his symptoms continued to worsen. This prolonged suffering not only affected his physical health but also significantly disrupted his daily life, including attending school, playing and sleeping, which are essential for his overall development.
By the time he met with Dr. Yonas Tesfaye, a general surgeon deployed to Wolkait Primary Hospital by International Medical Corps, Nigus was in severe pain, unable to sit comfortably for a proper examination. The intensity of his symptoms caused significant distress to his family, who had tried multiple remedies, including frequent medical visits and even traditional holy water treatments, without success. After quickly
stabilizing him with analgesics, the medical team prepared him for urgent evaluation and surgical management, understanding that timely intervention was critical to prevent further complications and improve his quality of life.
During this time, his mother, Yeshalem Getahun, said, “He is in pain almost every day. We were worried because he had no improvement, even with frequent medical visits and medications. We even tried taking him to holy water, but nothing helped. We are in your hands now.”
Upon evaluation, Nigus was tachycardic, with a pulse rate of 110 due to his intense pain. While other vital signs were within the normal range, examination revealed lower abdominal tenderness. Analysis of his urine sample revealed signs of infection and hematuria (blood in the urine). The surgical team suspected a bladder stone to be the cause of the recurring symptoms, which was confirmed by ultrasound imaging. Subsequently, they inserted a urinary catheter, started antibiotics and continued the analgesics.
Given the hospital’s lack of prior pediatric surgeries, the current case posed both a challenge and an opportunity for the team. The surgical team thoroughly discussed the provisional diagnosis with the child’s parents, explaining the need for surgery and the expected outcomes and potential complications. They also shared that this would be the first pediatric bladder stone surgery performed at the hospital and reassured them that the team was prepared and committed to safety. After addressing the parents’ questions, informed written consent was obtained before the procedure. Following careful planning and coordination with the anesthesia and operating room team, they successfully performed an open cystolithotomy (bladder stone removal surgery) under general anesthesia.
“My child has been suffering for such a long time. I was very concerned about his health. Seeing him recover has brought us great relief. Thank you, Wolkait Primary Hospital and International Medical Corps.”
—Yeshalem Getahun
Intraoperatively, the surgical team identified and removed a 2.2-centimeter bladder stone with sharp margins without complications. Postoperatively, Nigus was transferred to the recovery unit with stable vital signs and later to the surgical wards.
