In the Horn of Africa where many competing interests are exposing the region to security threats, the defense forces play crucial roles in maintaining peace and security. They have been on the frontlines in protecting the national sovereignty of the country and ensuring law and order under difficult conditions. Despite their lifetime service, soldiers in Ethiopia are not well remunerated both during their service and after retirement, lacking social security benefits. Hence, they constitute one of the less well-off groups in Ethiopian society. This calls for a special policy decision to provide retirement health care coverage for Ethiopian army members and their families as a gratitude for their heroic service to the nation. This can be particularly fitting following the recent events and their triumphant role in protecting the country despite the shocking attacks on the Northern Command.
Since 2018, as part of the new "homegrown economic reform" agenda, the government of Ethiopia has made many economic and social policy reforms. Reforms in the health sector that include social security for the army can be crucial welfare improving interventions that can enhance the quality of life for those who have been serving their country on the frontlines.
Since time immemorial, Ethiopian army has also fought several wars to maintain peace and stability both in Ethiopia and the Horn of Africa region. For instance, the legacy of Ethiopian forces during Italian invasion of Ethiopia in 1896 at the Battle of Adwa has inspired the black global and led to resistance to colonialists across Africa. Egypt's ambitions of occupying Ethiopia to have direct control of the Nile River ended in the Battle of Gura in 1876 with the sacrifice made by Ethiopian patriots. The Ethiopian army also defeated, the Sudanese Mahdist army, who invaded Ethiopia in 1889, at the Battle of Gallabat. In 1978, the gallant Ethiopian army defeated and repulsed the invading Somalian army, which controlled significant parts of eastern Ethiopia. During the Eritrean-Ethiopian war in 1998, thousands have lost their lives to defend the country. The Ethiopian army has also participated in regional and international peacekeeping missions and is praised for its courage. For instance, in 1951, more than 3,000 soldiers from Ethiopia fought in the Korea War their motto was "Never be captured in the battlefield" and contributed to the liberation of Korea. Currently, Ethiopia is a major contributor to the United Nations (UN) and African Union (AU) peacekeeping missions.
To this effect, Ethiopian soldiers have been in Darfur Sudan, Abyei South Sudan, and Somalia to strengthen cross border conflict management in the Horn of Africa together with eight other member countries of the Intergovernmental Authority on Development (IGAD). The majority of IGAD's peacekeeping force is from Ethiopia.
Ethiopian soldiers have also successfully participated in many other development activities, including maintenance and construction of public infrastructures (e.g., schools, roads, health centers), helping the people during national health and disaster emergencies (e.g., COVID-19, locust infestation, flood). However, the Ethiopian army has never been paid back for its national, regional, and international services in the form of social security benefits, they deserve more than retirement healthcare coverage. The current health reform effort in Ethiopia should consider as a similar initiative of countries that have a better healthcare program. Ensuring healthy lives and promoting well-being for all citizens is also one of the 2030 United Nations Sustainable Development Goals- SDG3. Countries that have not been investing in health services were also facing challenges during an unprecedented time like the COVID-19 that affects senior citizens more. Investing in health, education, and infrastructure are also key areas of social development.
Although the move in the direction of universal health coverage, following the World Health Organization (WHO) framework, has been slow, Ethiopia can still learn from the experience of other developing and developed countries. First, Rwanda and Ghana, provide health coverage for their population through a national health insurance scheme. The Rwanda Defense Force in its citizens outreach program which was launched in 2009 provides several socioeconomic services besides serving the community for free medical services that include dentistry, ophthalmology, orthopedics, internal medicine, gynecology, pediatric and dermatology, and minor surgeries. Second, in the United States of America, retired military personnel and their families have several incentives the TRICARE For Life program, for instance, provides a range of options for army veterans to receive healthcare coverage. The Supplemental Nutrition Assistance Program also supports over 1.3 million veterans and their families.
Ethiopia's health insurance system has remained traditional and underdeveloped. The system is dominated by community based schemes established more than 100 years ago called Idir an informal institution which provides financial help to families for emergencies like funerals. An improvement in the health sector including intervention in the care program is needed. The Idir is organized by a group of people where members pay premiums regularly as protection against unforeseen emergencies. Currently, as part of the universal health coverage, the government is trying to scale up Idir through its new initiative "Idir while alive" the plan is to pool members' premium payments into a collective fund to use for basic healthcare costs at local health centers when a member is sick. While such progress is appreciated, a modern form of health insurance like any other developing country remains weak and underdeveloped in Ethiopia.
A new form of social security in terms of healthcare insurance coverage for veterans who have honorably served the country in the frontlines is needed. Soldiers, in particular, are vulnerable groups since 1991 the Ethiopian army, which fought multiple wars to protect the country, was disbanded without any compensation but then remobilized for the war with Eritrea in 1998. Several soldiers after the Eritrea war have been unjustifiably demobilized and again invited to help the army with the current internal conflict (with the Tigray region).
It is also important to understand that frequent conflicts have economic, social, and environmental consequences including poverty and migration problems, and children, women, and the elderly are often the most affected groups. In many countries that face frequent internal conflicts, their governments are greedy for power and trap their people into poverty, transition to democracy and development can be delayed significantly the military personnel, in particular, who sacrificed their lives to protect civilians from conflicts, who have been wounded and disabled, required retirement healthcare coverage. Provision of some level of social protection and healthcare to retired military officers not only reduces the threat of endless war and conflict but it has enormous social benefits in the long run.
More particularly, providing healthcare for military veterans can offer the following types of benefits. First, it helps to maintain peace and security in a conflict-affected region. Second, it makes servicing the country in the military attractive to the educated youth as well adds dignity and honor to those who retire after their gallant service to the nation. Third, the incentive may allow the government to consider a national peacetime training and short term service in the military for the youth (this is not to fight wars) as a way of building discipline, commitment and patriotic duty as has been practiced by several developed countries which use this model for cultivating their youth after high school graduation.
Retirement healthcare coverage as a social security benefit for the army could therefore be the first of its kind in Ethiopia and provide immense social benefits. As part of the effort for extending universal healthcare in the country, it can incentivize and recognize distinguished public service for peace and security and facilitate democratization and sustainable development. As part of the healthcare reforms, intervention on retiree healthcare for the army (and their immediate family) can improve the quality of the life of soldiers who have been providing unique national service to secure peace and facing enormous risks to their lives in the conflict affected region. This can also be a good initial experience to innovate and identify other vulnerable groups in the country and explore feasible policy options to expand social protection.
Tigist Mekonnen Melesse (PhD), The views expressed in the article do not necessarily reflect the views of The Reporter.
Contributed by Tigist Mekonnen Melesse (PhD)