Eighteen-month-old Haftom Hailay is too weak to cry. All the boy, weighing three kilogrammes, can do is sigh in pain. His mother, malnourished herself, has no milk to breastfeed him.
Where they came from in Aragure, a village east of Mekelle, the capital Ethiopia’s embattled Tigray region, the need for food is desperate.
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“One month ago, everything ran out,” Haftom’s mother, Girmanesh Meles, 30 told Al Jazeera.
More than 10 months into the conflict, the famine-like conditions, which up until early July were limited to rural areas of Tigray, have now reached the outskirts of Mekelle.
“It became normal to spend four days eating nothing,” said Girmanesh, who like others tried to survive by eating sparingly whatever crops her relatives from Mekelle could donate.
“I waited for two weeks in the village … hoping someone would help,” she added. “But no one was able to help. Everyone was like us.”
Parents of severely malnourished children in Tigray have shared images with Al Jazeera of the worsening situation in Ethiopia’s war-hit region, where communications have been cut and little aid is getting through.
— Al Jazeera English (@AJEnglish) September 24, 2021
Worried about her son’s wellbeing, Girmanesh on September 11 embarked on foot from Aragure to bring Haftom to Tigray’s flagship Ayder Referral Hospital in Mekelle.
“My relatives told me to stay in the village, that there is nothing the hospital can do,” said Girmanesh. “[But] watching my boy getting weaker each day, I could not sit and wait until he dies in my hands.”
During the past two months, the main hospital in Mekelle has received 60 children with severe acute malnutrition. Of those 60, six have died, according to Dr Abrha Gebregzabher, a paediatrician supervising the treatment of malnourished children at Ayder hospital.
‘De facto humanitarian blockade’
Ethiopia’s Prime Minister Abiy Ahmed in November 2020 launched a military offensive to remove the governing party of Tigray, the Tigray People’s Liberation Front, accusing it of attacking federal forces. The continuing conflict has killed thousands of people and displaced more than two million – and more recently, has expanded to the neighbouring regions of Amhara and Afar.
Communications have been cut off across Tigray since June 29, when Tigrayan fighters retook most of the region. However, Al Jazeera managed to contact people in Mekelle and gather exclusive footage showing the extent of the humanitarian crisis. Interviews with 12 people in the city – including first-hand testimonies of parents currently caring for severely malnourished children, doctors, nurses, internally displaced people (IDPs) and residents trying to survive by begging for food – as well as videos and images taken from inside Ayder hospital suggest the dire humanitarian conditions are worsening.
In one image, a small emaciated boy is crying, a feeding tube going into his nose, his skeletal feet covered in wounds. The others show similar scenes.
According to the United Nations, more than 400,000 people are facing famine-like conditions and 1.8 million are on the brink of famine across Tigray. The region of some six million people remains under a “de facto humanitarian blockade”, the UN said earlier this month, warning of a “looming catastrophe” and urging all warring sides to allow and facilitate the unimpeded passage of aid.
The September 2 statement by Grant Leaity, the UN’s acting humanitarian coordinator for Ethiopia, said a minimum of 100 trucks of food, non-food items and fuel must enter the region every day – but access has been extremely difficult. “Stocks of relief aid, cash and fuel are running very low or are completely depleted. Food stocks already ran out on 20 August,” it added.
Separately, the World Food Programme said last week that, since July 12, 445 contracted non-agency trucks have entered Tigray, but only 38 have returned, calling their disappearance “the primary impediment” to stepping up humanitarian response.
Ethiopian authorities and Tigrayan officials have traded the blame for the blocking of aid convoys attempting to enter Tigray. According to the United States officials, less than 10 percent of needed humanitarian supplies reached Tigray over the past month due to obstruction of aid access.
In Mekelle, people interviewed by Al Jazeera said the deteriorating humanitarian situation was due to the blockade following the withdrawal of federal troops from the city in late June.
“Up until the siege, we were in a relatively better condition because the residents of Mekelle used to bring us food,” said Tesfay Gebretsadik, who fled to the capital from Humera, in western Tigray. “After the siege, all donations stopped. The inflation, and everything gets heavy. Residents are focused on saving their own life.”
Al Jazeera reached out to the spokesperson of the Ethiopian prime minister’s office, Billene Seyoum, for a comment but did not receive a response by the time of publication.
Begging for food
While aid corridors and telecommunications remain shut, Tigray’s banks have also been cut off from the federal system. This means that it is impossible to send remittances into the region, where cash is running out.
“Economic activities are stuck,” Micheal Gebreyesus, 35 a resident in Mekelle told Al Jazeera. “Since early September, we are only allowed to withdraw 1,000 birr (approximately $22; previously 2,000-birr withdrawals were permitted) per month,” he added, lamenting that the sum cannot cover the skyrocketing prices of basic food items.
“Teff (essential grain to bake injera) is 6,000 birr ($130.43) per quintal (220 pounds). Cooking oil is 700 ($15) birr and that is if you are lucky to get it in the market. Essential vegetables like tomato and onion are 100 birr ($2.17) per kilo.”
The crisis is driving residents to beg for food, including those like Worknesh Welday who were better off a few months ago.
The 25-year-old mother-of-two said she was ashamed she had to go from house to house, knocking on strangers’ doors to ask for a loaf of bread or a small portion of injera.
“I am used to spending two days eating nothing. But my children cannot spend more than one day. They cry; I beg so that they stop crying,” said Worknesh.
Since the fighting erupted, thousands of people from across Tigray have fled to Mekelle in search of safety. Sheltered in schools, these IDPs people are waiting for food aid. During the past two weeks, four people in Mai’woyni secondary school have died, residents said.
“They died … after weeks of starvation. Two of them were elderly and the remaining [were] children,” said Tesfay, the IDP from Humera who spends his days begging outside the school.
‘He cries non-stop’
Meanwhile, in Ayder hospital basic medical supplies and medicines are also running out. Doctors and nurses who spoke to Al Jazeera called on regional authorities and international aid group to support them, warning that most services have been suspended and the food stock for patients has finished.
“We are struggling to continue with extremely limited resources. We are struggling to provide food to patients,” said Dr Sentayhu Mesgana, the hospital’s deputy medical head.
“We have suspended further diagnosis due to electric interruptions and lack of spare parts. By now, the hospital is only providing basic services.”
According to Dr Sentayhu, health centres across Tigray are unable to send patients to the referral hospital due to a lack of fuel affecting ambulance services.
“We don’t know how many people are dying across the region from malnutrition. We are disconnected with the health centres due to the telecommunications blackout. We could only know about patients who managed to arrive here. Only a few can make it,” said Dr Sentayhu. “We cannot do adult nutritional support to the general public which is very costly and ineffective given the dire situation we are in.”
Inside the hospital, another boy, 13-month-old Gebreanannya Tesfay, cries relentlessly. Doctors weighted him four kilogrammes (8.8 pounds) when he was brought there on August 22. His father, Tesfaye Hiluf, who used to make a decent living as a farmer in Mai’alem, a village on the outskirts of Mekelle, could no longer feed his family.
“We ran out of food two months ago. We tried to survive by asking friends for help. There was nothing to eat for three weeks. I could not afford to buy milk for my son when the mother failed to breastfeed him. He cries non-stop,” Tesfaye said.
“Listening to his cries, there are days when I contemplate killing myself.”
With medical supplies running out, Dr Abrha, the paediatrician looking after malnourished children, feared the worst is yet to come.
“The stock of therapeutic milk will run out in three weeks given there are no new cases,” Dr Abrha said. “That means we will suspend the treatments after three weeks.”
For now, Haftom and Gebreanannya are still getting the therapeutic milk.