The Tigray region of Ethiopia has been under siege for two years, with at least 600,000 people killed since civil war broke out between local forces and the Ethiopian government along with its allies in Eritrea.
The dead include fighters killed in military operations, civilians targeted in deliberate attacks against them, and people who perished because of a lack of food or essential services.
The exact extent of the casualties is hard to quantify, as Ethiopia is one of the hardest places in the world to report from. Access to the region by journalists and international observers is extremely limited. But even the limited news from the region is horrifying. In July, a special UN rapporteur (link in French) found that thousands of men, women, and children were forcibly conscripted by the Ethiopian government and relocated to the Tigray’s front. Mass graves have been found in the region, and the BBC reports that people are dying so fast that hyenas have eaten corpses before they could be buried.
Even as peace talks finally begin in South Africa, the situation remains extreme. Healthcare services, in particular, have been so disrupted in the region that there is hardly any access to treatment for common conditions, including tuberculosis, diabetes, hypertension, or HIV. “Those diseases, which are treatable elsewhere, are now a death sentence in Tigray,” Tedros Adhanom Ghebreyesus, the head of the World Health Organization (WHO), said on Oct. 19.
Tedros, who is from the Tigray region and still has family there, has been speaking out about the crisis since it started, repeatedly accusing the international community of not paying attention or showing concern. “Maybe the reason is the color of the skin of the people,” he said in August.
According to Genocide Watch, Ethiopia is actively engaging in genocide of Tigrayans, committing at least three of genocide’s classic stages: organization, extermination (including by mass rape intended to “cleanse the blood line”), and denial (Ethiopia is not admitting to any atrocities in the region). Both Human Rights Watch and Médecins Sans Frontières have denounced the vandalizing of healthcare facilities and looting of medications, which have rendered the few remaining facilities unable to provide services.
About 6 million people in the region continue to face huge risks, with the destruction of healthcare infrastructure being used as a weapon of war against them. An analysis published in November 2021 in the British Medical Journal found that the region’s healthcare system had essentially been decimated. Out of close to 1,000 health centers and smaller outposts present in the region before the crisis began, only 14 remained at all functional six months after the conflict began.
Doctors operating in Tigray’s capital, Mekelle, are out of basic supplies, like intravenous fluids or common antibiotics. Even simple conditions can become deadly under such circumstances. Access to food and hygiene is also very limited.
Tigray’s healthcare crisis has become a contributing factor to the genocide underway in the region, where even people who aren’t being killed for their ethnic background are left to die because of it.