Following a 25-day detention, Dr Mahlet Guush — a senior medical doctor who was vocal about the health professionals’ strike in Ethiopia — was finally freed from police custody on 13 June. In a social media post, her brother Eyoel said that the period she was detained had been made even more difficult as she had left behind her baby daughter. During this challenging time, however, the digital world rallied behind her. 

The pathologist — who, at the time of her arrest, was not in clinical practice — had addressed many challenges facing the Ethiopian health system on her LinkedIn account. She also gave interviews to BBC Afaan Oromo and BBC Focus on Africa. 

“The greatest asset anyone can have is the love and care of the people,” said her brother, Eyoel. “Mahlet felt that love — deeply. She felt your prayers, your messages, your quiet concern, your loud support.” 

A week after the full resumption of clinical activities across public hospitals in Ethiopia, the Ethiopian Health Professionals Movement released a statement saying: 

“We return not because justice has been fully served, but because we remain committed to our people, our oath, and the suffering communities who rely on us. Our decision comes after partial fulfilment of our basic demands, notably the release of our detained colleagues. While this does not erase the injustices we’ve faced, it marks a small step toward accountability, and we acknowledge it with cautious hope.” 

But hope has been dwindling among the medical community for some time. Dr Daniel (name changed for this article) is a 27-year-old general practitioner who studied medicine at Addis Ababa University’s Tikur Anbessa Hospital. 

“I remember my graduation ceremony; I wasn't excited at all. I didn’t even feel the ‘I made it’ moment…” he told Geeska, with a hint of disappointment on his face. Dr Daniel recalls being angry at the organisers for interrupting his sleep and rushing him to the graduation hall. “For someone who used to be excited by small things, this felt strange. I asked myself, how did I end up here? And now I’m more and more convinced that the answer is medical school.” 

After graduation, unlike many of his colleagues, he had to wait only two and a half months before securing his first job — as a general practitioner and lecturer — at one of the regional universities. 

“I had hoped that I would wait about six months to rest and discover my career path, but that wasn’t an option,” he explains. Dr Daniel found it difficult to stay at his parents’ home doing nothing at that age. He says that the pressure and mental strain he felt during that time were hard to overcome with any coping mechanism. So, he began applying for jobs immediately — and when he finally received an offer, he didn’t hesitate. 

Dr Daniel explains that before he began working, the professionals were given an orientation, during which they were introduced to System Bottleneck Focused Reform (SBFR) — the reform strategy the Ministry of Health is undertaking to improve the quality of health service delivery in hospitals. He states that the document itself was well-written and inspiring, but the problem lies in its implementation. 

The strategy has two parts: the first outlines the responsibilities of the administration, hospital, and the Ministry of Health — including providing a good working environment, refreshments for healthcare professionals, standard duty rooms, timely payment for duty and overtime, training, and performance evaluations. The second part outlines what is expected from healthcare professionals, such as providing quality care, being punctual, staying present during duty hours, and keeping their knowledge up to date. A dedicated office was set up in the hospital to monitor the implementation of this strategy. 

However, he saw problems arise quickly. “We were not getting our duty payments on time. It had been years since the hospital paid any overtime. The duty rooms were not up to standard, and general practitioners in some departments were always struggling to find a place to rest,” he said. He further explained that medications were not available. Despite these poor conditions, healthcare professionals were pushed to their limits — and when they asked for what they deserved, they were often met with threats and intimidation. 

His eyes were opened to the plight of the patients while he worked in the hospital. Most of them were very poor. Some couldn’t even afford to bring a bottle of water to give oral rehydration solution (ORS) to their sick child. “Seeing families struggle to stay in the hospital even for a few days because of financial issues affected us deeply,” he said. 

“Many assistant lecturers at our hospital couldn’t cover their monthly expenses or even support their parents after more than a decade of education and work in what was supposed to be a privileged profession. That was painful to witness,” he said. 

Dr Daniel then decided to quit the job. “I told myself I wouldn’t fall for the sunk cost fallacy, even if my mind and society tried to push me into it. I started learning new things and was doing fairly well — even managing to live in the capital, where the cost of living is double what it was in the previous town I lived in,” he explained. 

However, he didn’t view medicine as just a job or a skill. “It was not something you can simply walk away from,” he explained. As time passed, the thought of returning to clinical practice grew stronger, and after being away for seven months, he returned. He believed he should just help his community for one more year — and then move on. 

Coincidentally, the current strike led by the Ethiopian Health Professionals Movement (EHPM) began just a few weeks after his return. 

He was unsure whether to keep working or join his colleagues in the strike. As there was no active movement at his workplace and no one planned to strike, he remained at work. 

“Working while your colleagues are striking and paying a heavy price in the process feels strange. It brings guilt,” he said. 

When health professionals were arrested, Amnesty International released a statement demanding the immediate and unconditional release of all healthcare professionals detained in connection with the strike. “We also remind the government to engage in negotiations and end the crackdown on dissent,” the statement read. 

Amnesty acknowledged that healthcare professionals in Ethiopia had been engaged in negotiations for over five years, advocating for fair pay, improved working conditions, and better institutional support. 

Furthermore, Amnesty highlighted long-standing concerns — including the absence of a functional health insurance system, inadequate compensation for occupational hazards, and significant delays in salary payments — which have been repeatedly raised by Ethiopia’s healthcare professionals. These issues have been further exacerbated in recent years by a sharp decline in national healthcare spending, which dropped to a record low of 2.85% of GDP in 2022. This figure is far below the 15% target set by the Abuja Declaration and placed Ethiopia in the “Insufficient progress” section of a World Bank report in 2010. Data compiled by Human Rights Watch last year reported that 7% of Ethiopia’s public spending goes to health.  

One of the concerns raised by striking health professionals was the harm caused by media practitioners who, lacking adequate understanding of the matter, spread misinformation and false accusations. The professionals called on the government to take legal action against such individuals. 

Dr Daniel felt he had no choice but to continue working in his new environment, as striking alone would have made him an easy target for the authorities. 

“When the city administration tried to assign us to cover the roles of those on strike, everyone at our institution refused. We told them we fully support the striking professionals and that we don't feel morally superior for continuing to work while others are striking,” he said. 

A few days later, he and his new colleagues were invited to a meeting at the sub-city level. 

He noticed that the government’s commitment to addressing the ongoing crisis may not be as strong as required. Throughout the session, the moderators primarily focused on topics such as corridor development, student feeding programmes, and the ruling party’s achievements over the past seven years. 

Meanwhile, healthcare professionals were grappling with serious challenges — including feelings of hunger and hopelessness. When questions were raised regarding salaries, working conditions, duty payments, housing, transportation, and insurance, the responses given were largely vague assurances: “We acknowledge the issues and are actively working to address them in the medium and long term,” was the recurring phrase. 

During the strike, the Ministry of Health issued a stern warning to healthcare professionals, stating that “strikes in the health sector are legally prohibited” and promising legal consequences for those who “refuse to return to work.” 

The Ministry emphasised that it is “a well-established public fact” that the institution was “actively working” to ensure access to quality and equitable health services by developing policies and strategies that promote public ownership. The statement also underlined the government’s commitment to creating research-based solutions to ensure the long-term well-being of healthcare professionals. 

Minister Dr Mekdes Daba said that her office is committed to addressing service quality issues and the challenges faced by healthcare professionals. “To achieve lasting solutions, we will engage in constructive dialogue to respond to their demands,” she said. 

However, many professionals were not satisfied with the statements made by the Ministry and other officials. 

Normal activities have resumed — but the question remains: what’s next? 

“None of my colleagues at this institution plan to continue in the field. None of my friends, including those who used to be passionate clinicians, plan to specialise. Most of us have side hustles that pay better than our main jobs,” said Dr Daniel. 

“Who will treat the people in a few years?” That’s the question Dr Daniel and his friends always find themselves asking.