In 2015 MSF started a mental health project for Eritreans refugees in Hitsats and Shimelba refugee camps and the host population in the surrounding area. Hitsats and Shimelba refugee camps host around 10,000 and 6,000 people respectively (according to UNHCR figures).

Following the July 2018 peace agreement, the Ethiopian and Eritrean governments reopened crossing points on their shared border on September 11. The combination of unchanged conditions inside Eritrea and open borders has led to a stark increase in refugee numbers. According to UNHCR, the average daily arrival rate has increased more than fourfold. It brings the total number of Eritrean refugees in Ethiopia to 175 000, a large proportion of whom are unaccompanied minors. For those who stay, the ‘choice’ is not without cost: arbitrary detention, violence and intimidation are known to be used against those who do not conform to the system.

MSF services include counselling, inpatient and outpatient psychiatric care, and a wide range of therapeutic activities, including therapeutic discussions and psycho-education, where patients can discuss what they are going through and receive detailed information about their conditions and how to overcome them. Realising that other people are experiencing similar problems helps them feel less isolated. The project conducts around 2,800 individual counselling sessions and 3,600 psychiatric consultations each year.

MSF provides constant outreach activities in the camp community for the always changing refugee population. The few who stay for the long term do so because they do not have the money to move on. Some, who tried to leave and who were caught in Sudan or Libya, have seen and experienced horrible things; they return to Ethiopia even more traumatised than before.