Dismantling the Institution: The Migration of Professionals Amid Insecurity

By Wendemagegn Enbiale

Insecurity is dismantling institutions, forcing professionals to abandon their roles, and eroding the very foundations of the services they built. The recent loss of Dr. Andualem has only accelerated this trend, pushing an increasing number of highly trained experts to leave their positions, either migrating within the country or seeking opportunities abroad. The story of Tabebe Gion Hospital and Bahir Dar University College of Medicine illustrates the growing crisis.

For nearly two decades, Bahir Dar University College of Medicine has played a vital role in Ethiopia’s healthcare and medical education system. It grew to house more than three hundred and fifty specialists and sub-specialists, making it the third-largest institution for medical training after Black Lion and Paul’s Hospital. However, in the past 18 months, even entering and exiting the hospital has become a challenge due to escalating insecurity in the region.

The departure of a mentor, colleague, and leader who once laid the foundation for the institution leaves a painful void. The former Vice Dean and later the Academic and Research Director of Bahir Dar University College of Medicine, who dedicated years to developing the Tabebe Gion Hospital, has left the hospital he helped build and nurture. His departure marks not just a personal loss but a devastating blow to the region, which lost its only sub-specialist.

For those of us who remained, the unraveling of stability and safety made it impossible to continue our work. When I left the college and hospital in May, it was not a decision made lightly. The conflict that erupted in the region, particularly in July 2015, disrupted my ability to conduct medical and research work. The fear of becoming a prisoner of war was a reality I could no longer ignore. Even after my formal contract ended, I continued to teach and research remotely, hoping for a return to stability. But with time, it became clear that peace was slipping further away. The administration of the college was in disarray, theft was rampant, and my remaining research projects had to be relocated to a safer region.

The situation at Tabebe Gion Hospital has become increasingly dire. The hospital, located next to a heavily guarded regional prison, should have been among the safest institutions in the region. Instead, government efforts to protect staff and infrastructure were inadequate. Repeated robberies on the premises, gunmen entering the hospital during working hours, and even the killing of staff turned the once-thriving medical center into a place of fear. Hospital vehicles were hijacked multiple times, and when one of the main access roads to the city was closed, patients were cut off from care. Despite these challenges, the remaining staff struggled to keep services operational.

The situation is not unique to Bahir Dar. Three months ago, I visited Ayder Hospital in Mekele, an institution I once admired for its excellence. What I found was disheartening: a hospital that had lost not only its professionals but also its functionality. It was not just about the buildings or the infrastructure—morale had collapsed, and the hospital reeked of decay. When the conflict in Tigray began, Ayder Hospital’s department had six doctors and nurses; by the time relative peace had returned, all six had left. This exodus of professionals is a clear indication that institutions are not just being weakened; they are being dismantled.

For Tabebe Gion Hospital, the death of Dr. Andualem was the final straw. It accelerated the mass departure of professionals, leaving a void that may never be filled. Those who had the means to leave fled, abandoning the college, the hospital, and the region. The local community, once reliant on these experts, now faces an uncertain future. The elderly and the sick, who once had access to quality care, now pray for their children’s safety instead of worrying about where their next treatment will come from.

It takes years to build an institution, but it can be dismantled overnight. The loss of professionals—whether due to insecurity, conflict, or fear—is an irreversible tragedy. The migration of expertise leaves a region without healthcare, education, and innovation. It is not just individuals who are leaving; it is the collective knowledge, experience, and hope for the future that is being erased.

Who will remain to rebuild when everything has been destroyed?