Mereja Forum

[sarcasm]

Children are dying of malnutrition at increasing rates in Tigray due to a man-made humanitarian catastrophe, writes the head of Tigray’s health bureau.


Since the war on Tigray began in November 2020, the Ethiopian military, its Amhara allies, and Eritrean troops have committed countless atrocities.

Most significantly, the war has resulted in the near-total collapse of the region’s health care system. Before the conflict, the region’s health system was based on a sturdy foundation with enhanced community engagement, in addition to an Early Warning, Alert, and Response System.

With the looting and destruction of facilities across Tigray, the family health system has collapsed. A damage assessment study conducted by Mekelle University revealed that 78 percent of health posts, 72 percent of health centers, and 80 percent of hospitals have been destroyed.

On account of the persistent denial of critical medical supplies, health facilities—including the regional flagship hospital, Ayder Comprehensive Specialized Referral Hospital—have run out of medication for chronic illnesses and other basic life-saving medicines.

Patients at Ayder have succumbed to otherwise non-life-threatening wounds because the hospital has run out of gauze. Post-surgery patients have died of septic shock due to the shortage of antibiotics.

The destruction has wiped out 20 years of progress, returning Tigray’s health system to a time when there were no decentralized essential health services.

Emergency conditions

One of the aspects of the siege imposed on Tigray is a communications blackout that has prevented the timely detection of emergency health conditions. Given this and the presence of numerous hard-to-reach areas, the extent of the crisis in Tigray is underreported.

While thousands in Tigray have already perished unnecessarily, many more are still perishing each week without the international community or even the regional government being aware of it.

In addition to the blackout, the fuel shortage has made it virtually impossible for health professionals to travel to remote areas and assess conditions. The federal government has denied the entry of fuel into Tigray since early July.

According to World Food Programme (WFP) estimates, the number of people in need of humanitarian support in Tigray has risen to 5.2 million, a figure that includes 3.9 million people in need of health assistance.

The WFP has said that 100 aid trucks are needed each day but only 1,355 have arrived since July. By severely limiting the number of convoys, the federal government has created a dire situation. It has produced an acute shortage of medical equipment, supplies, medicines, and vaccines, resulting in a large number of easily preventable deaths.

According to a report by the Tigray branch of the Ethiopian Pharmaceutical Supply Agency, all immunization antigens, health program medicines for TB/HIV and malaria, family planning supplies, and other essential health commodities have been out of stock for the past six months.

Rising malnutrition

The nutrition situation across Tigray has also been steadily getting worse.

The malnutrition rate among pregnant and lactating women is above 60 percent. Over 1.6 million children under-five and pregnant or lactating women need nutrition intervention.

Acute malnutrition in children under five has hit 29.1 percent, of which 7.1 percent have been diagnosed with severe acute malnutrition (SAM). This figure is well above the global emergency threshold of 2 percent, and 22 percent have been diagnosed with moderate acute malnutrition (MAM).

Across Tigray, 54 percent of water points are not functional, affecting water access to 3.5 million people. As a result of this humanitarian catastrophe, the famine classification is expected to reach the highest level, IPC 5, in the coming few months.

Mortality survey

A recent initial mortality assessment looked at priority health needs and associated intervention in terms of mortality for the first time since the outbreak of the war.

Data was collected from 333 tabias/sub-districts (40 percent of the total) of 53 districts in the Mekelle, Southern, Southeastern, Eastern, Central, and Northwestern Zones of Tigray.

The entire Western Zone is inaccessible since it is under occupation by Amhara forces and the Eritrean military. Parts of Northwestern, Eastern, and Southern Zones are also inaccessible for the same reason.

Since the magnitude of the destruction and health crisis in the inaccessible areas is undoubtedly high, the survey is bound to underreport the real extent of the crisis.

Data was collected by NGOs from their project sites in collaboration with the regional health bureau. Representatives of health facilities, wereda health and/or social affairs offices, and community/religious leaders were contacted using a template. The questionnaire asks for the deceased’s name, sex, age, area of residence, and cause of death, as clinically confirmed or as perceived by the respondent.

Death patterns

Out of 5,421 deceased recorded, 56.4 percent were male and 43.3 percent were female. The majority of deaths occurred in the age group 15 years and above.


Table 1: Socio-demographic characteristics of deceased persons; Tigray, 2021.

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