One Health and Economic Resilience in Tigray, Ethiopia
Summary
In 2024, the One Health Alliance committed to develop an innovative consortium designed to take collective action to promote economic resilience and community health across the Tigray region of Ethiopia. Together the Alliance partners Permachive, Mekelle University, WeForest, the Center for International Health at Ludwig Maximilian University of Munich, Vivo International, and the Center for Trauma Management and Research will drive coordinated, cross-sectoral action to address the intertwined issues of trauma, disrupted livelihoods, and environmental degradation that the intense conflict in Tigray, Ethiopia has perpetuated. Over five years, the Alliance will train 3,000 entrepreneurs, providing them with the agricultural inputs to start their own smallholder farming business and access to mental health services simultaneously through a model of integrated recovery and support. The Alliance will collectively invest more than $2.5 million in support for entrepreneurs with more than 50% of that funding supporting women-owned or women-led climate enterprises.
Approach
Recognizing that mental health, livelihood, and resilience interventions in Tigray, Ethiopia, had largely been isolated, Permachive, WeForest, Mekelle University, Vivo International, the Center for International Health at Ludwig Maximilian University of Munich, and Center for Trauma Management and Research committed to develop the One Health Alliance (OHA) to drive an integrated strategy and project to address these complex challenges. OHA will provide an integrative recovery program for conflict-affected communities in Tigray, Ethiopia, focusing on mental health, economic stability, and environmental restoration.
Specifically, their strategy combines Narrative Exposure Therapy (NET) alongside income-generating activities such as apiculture, poultry farming, sheep rearing, small-scale agriculture, and business development. This approach not only prioritizes the mental well-being and economic stability of communities but also embraces environmental sustainability principles under the One Health framework, striving to optimize the health of people, animals, and ecosystems simultaneously. Through this integrated approach, the project will address the intertwined issues of trauma, disrupted livelihoods, and environmental degradation.
Targeting communities in the Eastern, Southern, and South-Eastern Zones of Tigray, the project will directly benefit 3,000 individuals and indirectly benefit 15,000 individuals from vulnerable populations. By empowering beneficiaries to choose their preferred economic activity, the initiative ensures a survivor-centered approach that maximizes long-term impact and sustainability. These efforts are pivotal in rebuilding community resilience, reducing dependence on depleted natural resources and fostering enduring socio-economic recovery amidst ongoing adversities.
Partner contributions are as follows: Permachive owns technical and data management, resource mobilization, and relationship management across stakeholders; Mekelle University owns local general administration and oversight and handles all extension research, training, monitoring, and evaluation across program activities; WeForest leads environmental programs and oversees economic activities related to bees, chickens, and sheep; the Center for International Health at Ludwig Maximilian University of Munich provides research supervision and supports the mental health cascade training model; Vivo International performs the cascade training model and supervises trauma therapy; and the Center for Trauma Management and Research provides direct mental health services and monitors patient progress.
Potential challenges include ensuring adequate funding and resources, navigating ongoing security issues in Tigray, addressing potential cultural barriers to interventions, and ensuring seamless collaboration among partners
Action Plan
This is the first instance where consortium members are uniting to address issues comprehensively under the One Health framework. Historically, each member has focused on their specific area, such as health, the environment, or research, in isolation. The formation of the One Health Alliance represents a new collaborative approach integrating multiple interventions in post-conflict Tigray, Ethiopia. Therefore, a thoughtful implementation plan outlining roles for each partner is essential for project success, and the extensive action plan has been summarized for the purposes of this commitment.
Q4 2024, OHA will secure funding, resources, and partnerships while finalizing training and partnership agreements. In Q1 2025, they will facilitate participant selection of economic activities and commence Narrative Exposure Therapy (NET) sessions. In Q2-Q3 2025, they will monitor participant progress through ongoing mental health assessments and provide support in economic activities. In Q4 2025, they will conduct a comprehensive program evaluation to assess outcomes and effectiveness for the first year and make alterations as needed for the next annual cohort. This plan for Q1 2025 to Q4 2025 will be replicated and improved upon across the remaining four years of the project, serving a cohort beneficiary model from 2026 to 2029. Replicating this project across five years will support longitudinal research initiatives and help OHA determine if these methods can be replicated in other recovering conflict zones globally.
Background
The recent conflict in Tigray, Ethiopia (November 2020 – November 2022) , has left an enduring impact characterized by widespread displacement, loss of life, and profound mental health challenges. Vulnerable groups, including survivors of Conflict-Related Sexual Violence (CRSV) , underprivileged women, demobilized war veterans, and subsistence farmers, have been disproportionately affected. Studies indicate that PTSD rates among these populations range from 48.4% to 56.28% (Tinsae, Techilo, et al., 2024) , highlighting the critical need for comprehensive support in a region where access to mental health services is severely limited.
There has been some work to address these complex challenges in Tigray. For example, Narrative Exposure Therapy (NET) , a treatment that is often used in community settings when individuals are suffering from multiple and complex traumas, has been used by certain organizations to help individuals develop a narrative to contextualize their traumatic experiences in a manner that has been shown to reduce posttraumatic impacts on their lives effectively. Yet despite certain mental health interventions and responses, collective work that seeks to address trauma and rebuild livelihoods simultaneously remains limited.
Progress Update
Partnership Opportunities
The One Health Alliance team is seeking the following resources and services to fulfill their commitment:
Financial Resources: They are particularly interested in grants and public-private partnerships, especially those focused on the income-generating aspects of this project.
Topic Expertise: OHA is looking to partner with other research institutions that have expertise in psychiatry, public health, and/or reconstructive economics to support them in maximizing the impact of their work and capturing it in a way that is replicable for other post-conflict zones.
Best Practices: OHA is eager to learn from organizations that have successfully implemented One Health and Mental Health and Psychosocial Support programs in post-conflict zones in the Global South over the past decade.
Media Support: They need support from media outlets to raise awareness about the new alliance and generate new partnerships. Visual assets are particularly important as they provide a glimpse into the remote areas of Tigray, Ethiopia, where the alliance is actively working and where visual resources are limited., Best Practices: OHA provides localized and culturally competent expertise in mental health interventions, economic resilience strategies, and environmental sustainability practices. These practices are based on rigorous, evidence-based research conducted by academics and professionals specializing in agroforestry, rural development, and mental health. Their approach is aligned with the principles of the One Health framework.
Implementing Partners: These partners include non-partisan NGOs, civil society organizations, academic research institutions, and healthcare centers, forming a robust network to support their initiatives effectively.
Subject Matter Expertise: The OHA team has deep knowledge and expertise across the environmental, health, and economic conditions in Tigray, Ethiopia, spanning the pre-conflict, conflict, and post-conflict phases. Further, each organizational lead in the consortium holds a PhD in their respective field and brings extensive field experience, ensuring their interventions are grounded in cutting-edge research and practical insights.