Last year’s harvest was marginally better than feared and coping mechanisms – such as selling off livestock, begging or cutting household spending on health or education – may have temporarily staved off the worst scenario predicted by the UN.
“We do believe that the resilience, or the coping mechanisms, of the kinds we were looking at early on was higher than what we maybe gave them credit for then,” says a US official involved in the relief effort. “But at the same time, we still assess that roughly 700,000 people in Tigray are in famine-like conditions.”
Tedros Adhanom Ghebreyesus, the head of the World Health Organization, said there was “nowhere on earth” where the health of millions of people was more under threat than in Tigray.
US officials estimate about 80% of Tigray’s population is still food insecure, up from 15% before war broke out in November 2020. Malnutrition rates have risen to 13% for children under five and more than 60% for pregnant and lactating women. Local people say food prices have doubled and in some cases have risen by 400%.
Since July, Tigray’s population of about 5.5 million has been under what the UN has described as a “de facto blockade”, imposed by the prime minister, Abiy Ahmed, as part of the government’s battle against rebels from the region led by the TPLF. Eight months since the occupying Ethiopian army withdrew from Tigray, less than 10% of the food aid needed has made it to Mekelle, capital of the region, and not one aid truck has arrived in Tigray since mid-December. A single road, which winds through the neighbouring desert of Afar region, has been cleared for humanitarian convoys. Communication and banking services have been shut down. Until last month, barely any medicines or hospital supplies had been allowed into Tigray and the Mekelle’s Ayder referral 500-bed hospital is still not receiving its monthly budget. “Almost all medical units are on the brink of total failure,” says a hospital spokesperson. “Before the war the hospital had availability of about 80% of essential drugs,” says a Mekelle doctor, who did not want to be named. “Currently it is down to 11.8%, and the state of other services is basically the same as it was in the past months. And not only that, we have a huge number of patients flooding in now because they think they will find medication here.”
A shadow economy, from fuel to finance, has filled part of the gap. More than a third of the population relies on gifts or loans for food, according to a recent World Food Programme study. For those receiving funds from outside the region, black-market lenders distribute the cash but take double-digit commissions. Others rely on smugglers crossing from the neighbouring Afar or Amhara regions, or for aid workers with permits to bring in small cash allowances. Some resort to bribing bank managers to withdraw money.
“Why can’t Abiy allow unfettered humanitarian access to Tigray?” asks a diabetic patient at the hospital. “Why is he using aid as a bargaining chip? Are we not Ethiopians?”
Foreign aid workers and diplomats who spoke with the Guardian say that the Ethiopian government made new commitments at the start of the year to ease restrictions on relief convoys entering Tigray through Afar, as well as to allow medical supplies by air. But recent fighting in Afar has hindered the implementation of those commitments.