Tigray’s Ayder Hospital saving a 2 year old exemplifies what has been lost

The story of a two year old Tigrayan child born in Tigray’s remote countryside whose life was saved by a complex operation in 2019 illustrates how the loss of a tertiary center at Mekelle University impacts the community.

Pediatric neurosurgery at Mekelle University Ayder Hospital saved the lives of many hundreds of children suffering from birth defects, accident, tumors, and infection from Tigray, Afar, Amhara, and even some from Eritrea and distant parts of Ethiopia

The two year old was seen by health officers of the Tigray Regional Health Bureau clinic in rural Ethiopia to have difficulty breathing through his nose. The family lived in mountains hours from the highway and were poor farmers. With the help of extended family, neighbors, and church members they collected some money to be able to travel by bus to Mekelle which took all day.

A typical humble home of a farming family in Tigray
To come to Mekelle from the countryside families may walk for hours to reach the highway and then wait for a bus which will take hours to reach Mekelle in the mountainous winding roads

Pediatricians and Ear, Nose, and Throat specialists evaluated the child discovering a mass inside his nose. He was sent for a CT scan and referred to neurosurgery. This showed he had a birth abnormality where a portion of the brain which was not functional was lying in the sinuses of the nose. Without treatment he would eventually develop a fatal infection of the brain.

The child was seen in the Ayder Neurosurgery Clinic which saw in excess of 250 patients per week with neurological problems. The CT scan on the right shows the mass in the nasal cavity extending from an opening at the base of the skull (blue line)

He was taken to surgery in a joint operation with ENT and Neurosurgery where the mass was removed and the brain sealed. Here he was seen on the medical campus with his parents visiting a few weeks later. 

The 2 year old and happy parents encountered on the Ayder campus a few weeks after surgery doing well. I pray they have not suffered from the brutal invasion of Tigray.
Ayder’s neurosurgery operation theater was well equipped and staffed. Performing approximately 2000 operations a year before the Ethiopian blockade which forced a shutdown

The medical blockade of Tigray has resulted in a death sentence for thousands of children who have treatable conditions who could otherwise go on to live happy and productive lives. The advanced medical services at the Mekelle University Ayder Comprehensive and Specialized Hospital medical campus had provided specialized diagnostic, medical, surgical, and rehabilitative facilities which are now shut down. 

Memory of revelation seeing ancient Ethiopian Bible and pray for recovery of relics

For the past twenty years I have been studying Episcopal or Anglican theology and also interested in early Christianity throughout the world. Living in Ethiopia since 2012 and in Tigray since 2015 gave a wonderful opportunity to learn about the culture and history of Ethiopian Orthodox Church whose roots begin in the Axumite Empire which is now Tigray. In September 2018 I made an extended visit to the city of Axum including to the Church of Our Lady Mary of Zion. The first church site of Saba people who would become the people of Tigray( ህዝቢ ትግራይ). The original establishment of this church goes back to the 4th century when the Axumite King Ezana converted to Christianity.

As I was a visiting Professor from Mekelle University the priest in attendance allowed me to see an ancient Bible.  He carefully opened a 300+ year old Bible composed of goat skin pages and I take the photograph below. For several minutes I pondered what it was like to carefully construct and write such a treasure. How hundreds of years ago Christian followers gathered while the Ge’ez language in which it was written was spoken aloud by the priest for the congregation to hear. I was touched by the Holy Spirit by it’s presence. This reflection inspired by this document made me realize that it was not meant to be the private ownership of one person who was likely not to even be a believer in the message carried. No pious Christian would personally own such a treasure for himself. Instead it is a legacy to be shared by the Tigray.

A 300+ year old Ethiopian Orthodox Bible in the Our Lady of Zion Church in Axum, Tigray kindly shown to me in 2018

Over 90% of Tigray are Ethiopian Orthodox Christians. Even for the Muslim population in Tigray there is special relationship to the Tigray born church because it was an ancient Tigray king, Christian King Negash, who welcomed refugees, followers of the Prophet Mohammed (Peace be upon him), who were fleeing persecution from nonbelieving Saudi royalty in the 7th century.

Unfortunately now we know that Christian worshipers in Axum and Islamic worshipers in the town of Negash were attacked by Eritrean forces and religious relics stolen from both the church in Axum and the mosque in Negash. Although an investigation by Mariz Tadros , Professor of Politics and Development at the Institute of Development Studies, University of Sussex as well as director of the Coalition for Religious Equality and Inclusive Development (CREID) reported in March 2021 that the purpose of the attacks was to demoralize religious followers she wondered if relics were stolen. Ethiopian and Eritrean supporters denied these claims but now new evidence as come to light.

An ancient Ethiopian Orthodox manuscript for sale on Ebay a week ago was just one of many items

For the past few months and accelerating the past week or so many precious Ethiopian Orthodox relics including ancient Bibles and Tabots (symbols of the Arch of the Covenant) have appeared for sale on Ebay. The international police Interpol and civic minded art experts are investigating the likelihood that the sales are coming from Eritrea. The meaning and value of these items is that they allow present day Tigrayans to connect with their ancient history and are a legacy to be preserved for generations to come and shared by the community. I am pleased to hear that Ebay is cooperating with requests not to sell this items and to expose the sellers.

A Tigray friend observed last week that over a 24 hour period that more than 20 precious Bibles and other relics were sold on Ebay.  Ebay has apparently promised to only accept legitimate items that are well documented. This morning I searched Ebay and found no Bibles. There were 8 antique pre-owned paintings on wood frame mostly priced below $200 shipping from Germany.  I pray international authorities and people of good will will cooperate to stop these sales and recover them so that they can be returned to their rightful owners to restore their legacy.

Eritrean refugee children supporting Isaias explained by brain postmemory formation research

The paradox of children of Eritrean refugees supporting the oppressive government their parents left is explained by brain and memory research called postmemory

The paradox of children of Eritrean refugees promoting oppressive government their parents left now explained by research of postmemory formation and chosen trauma recall manipulated by propaganda. The explanation lies in understanding how a subsequent generation of survivors respond to their parent’s trauma. The concepts of postmemory and chosen trauma have been recognized in this group and manipulated intentionally by the Eritrean government. Researcher, Nicole Hirt, of the German Institute for Global and Area Studies discusses this phenomenom .

In the aftermath of the Jewish holocaust imposed by the Nazi regime Harvard researcher, Marianne Hirsch, developed the concept of postmemory which affects the second generation of a population who has suffered a significant trauma which she published in The Generation of Postmemory: Writing and Visual Culture After the Holocaust. This memory is not a memory of primary experience but it is a perception of the first generation after trauma which is “mediated not by recall but by imaginative investment, projection, and creation”.

In Hirt’s research published in May 2021 she outlines how the intense lobbying of the Eritrean government of the first generation after the bloody Eritrean revolution have effected the development of “postmemory” which selectively chooses favorable trauma to recount and painful trauma to be forgotten which has come to be known as “chosen trauma”. The combination of frustration that things will likely never change, that one’s parents generation did not sacrifice for nothing, and the concentrated effort of savy propaganda by the Eritrean government on this generation has created this paradox.

As a medical student at Harvard I became fascinated with how the brain functions then as a neurosurgeon learning about how the brain functions to facilitate language became extremely important as we did want patients to lose speech and communication from brain operations. We know that language, communication, relationship building, and memory are all tied together. Memory is not a perfect system and is affected by the need to create reliable relationship systems. As a neurosurgeon who practiced in Ethiopia for 10 years of which seven was in Tigray I have seen hundreds of Eritrean refugees referred by the International Organization for Migration, United Nations, and the refugee camps. I can attest to their exposure of torture and deprivation.

Over the past few years as a neuroscientist an extension of my research has been understanding that language and communication evolved in humans as a part of our need to secure relationships which improve our survival. Conversely we have an innate tendency to also avoid relationships which we perceive as threatening. Working with international NGOs at Mekelle University we began a program to help business students from Tigray who had problems adapting to international culture to learn basic concepts in communication and language principles based upon these neuroscience realities applied to creating functional and useful techniques.


Tigray’s Mekelle University facing severe hardship still strives to serve community

The mission of Mekelle University :To pursue excellence in academics, research and community services and contribute to the advancement of knowledge, economic growth, and social welfare to the national and international community. This photo shows how it strives to serve the community. The MU slogan, We really care!

The world should know the story of Mekelle University which in many ways mimics the story of the people of Tigray. Her faculty and staff living without salary for 7 months and at constant risk of attack they still show a heroic commitment to continuing their long standing dedication to improving life in Tigray and beyond.  The recent publication, The impact of war on the health system of the Tigray region in Ethiopia: an assessment, in Lancet is a comprehensive landmark of public health research from ongoing collaboration of international universities and Mekelle University.

Despite war and crippling deprivation dedicated faculty and staff at Mekelle University have continued to perform essential research vital to the continued survival and their future rehabilitation. Tigray has suffered catastrophic and complex threats to civilian life for more than 7 million inhabitants including agricultural disruption, food scarcity, no health services, destruction of the electrical supply, no transportation, no phone service, and almost a complete blockade.  

Mekelle University had 7,500 faculty and over 2000 staff at the beginning of the Ethiopian Tigray conflict in November 2020. The Ethiopian Ministries of Science and Higher Education which also is responsible for Ayder Hospital which is a part of MU and Tigray’s tertiary referral center, as well as Health removed Tigray and Mekelle University from all budgeting. 

The first universities of Ethiopia were founded in the 1950s in the central parts of Ethiopia in Addis Ababa, Jimma, and Gondar. Historically the Tigray were discouraged from going beyond high school during the times of the monarchy and Derg regimes. A survey in the 1960s showed only 10% literacy in Tigray.  Those few fortunate ones who did attend university outside Tigray and went on to become part of the contemporary leadership of Tigray were determined to create a university dedicated to education and research to improve the life of Tigray and beyond.

Mekelle University was founded in 2000. In its twenty-two year history it had grown to have 35,000 students in seven colleges, eight institutes, and more than 90 undergraduate and 70 postgraduate programs. Recent years saw the addition of scores of PhD and post-graduate medical specialty training programs.

In the book, Universities and Sustainable Development Future, written by Peter Kohen and Juha Uitto, they compared Mekelle University with other universities in developing countries. Whereas many “become diploma mills” they found that the teaching at Mekelle University was to create a research culture whose findings were applied to and improved the local community.

Mekelle University research had the highest average citations per research publication of Ethiopian universities

Clarivate Analytics, reviewed citations of Mekelle University compared with other Ethiopian universities and found that research findings from MU where cited more than twice as often as most research findings. Even though the volume of research published was less then Addis Ababa University it had twice the impact of other universities. 

Mekelle University lead Ethiopian universities in international collaborations

Mekelle University is on record to have more collaborations with international research entities then any other university in Ethiopia. Interestingly, the Science and Higher Education Ministry of Ethiopia gave Mekelle University in 2020 the highest designation in naming it a “research university”. Now it has abandoned it.




Congress passes sanctions on Ethiopia and Eritrea to halt Tigray atrocity restore democracy

House Foreign Affairs Committee passed a bipartisan bill introduced by Representatives Tom Malinowski (D-NJ) and Young Kim (R-CA) that requires the administration to take additional measures to seek an end to the brutal civil war in Ethiopia.

While Abiy Ahmed and his supporters thought further American action against violations against humanity was not forthcoming they made a major misjudgment. Although the United States State Department, African Union, and United Nations had been meeting with Ethiopian government and Tigray leaders for months no significant progress had been made  to bring stability to the Horn of Africa. Famine threatening millions , mass killing of civilians, displacement and deprivation of human needs including medical care are worsening in Tigray.  Significant interference in Ethiopian affairs by Eritrea and other countries only seems to create chaos.  This reality  caused the United States Congress to take action against Ethiopia, Eritrea, and any others contributing to the instability.

Despite promises of the Ethiopian government under Prime Minister Abiy Ahmed made months ago to the United Nations to “allow unfettered access” of humanitarian aid, peace negotiation, and real investigation of human rights violations Congress could wait no longer such that yesterday a bipartisan bill (Ethiopia Stabilization, Peace, and Democracy Act) passed with the following key features according to Rep. Tom Malinowski of New Jersey:

    • Require the State Department to develop a plan for supporting democracy and human rights in Ethiopia, including plans to combat hate speech online, support accountability measures for atrocities and efforts to buttress a national dialogue;
    • Authorize the President to impose sanctions on individuals who undermine negotiations to end the conflict, commit human rights abuses, exacerbate corruption, or provide weapons to any hostile party;
    • Suspend all security assistance to the governments of Ethiopia until it ceases offensive operations, takes steps towards a national dialogue, improves protection of human rights, allows unfettered humanitarian access to conflict areas, and investigates allegations of war crimes;
    • Require the administration to oppose loans or other financial assistance from international agencies like the World Bank and International Monetary Fund to the governments of Ethiopia and Eritrea unless for humanitarian purposes until they take steps to end the war and restore respect for human rights; and  
    • Require a determination from the State Department concerning allegations of crimes against humanity, war crimes and genocide in Ethiopia.

This latest actions follows a United States Senate Resolution passed in May 2021 with bipartisan support stating calling for the immediate cessation of hostilities in the Tigray region of Ethiopia and condemns all violence against civilians. Further, the resolution calls on Eritrea to withdraw its military forces from Ethiopia, and it urges all parties to the conflict to cease hostilities and work to protect human rights. The resolution also calls on relevant U.S. agencies to take specified actions that encourage an end to the conflict and provide humanitarian support.

Additionally many are noting the request by Somaliland to be identified as an independent country which is offering use of the Berbera port and establishment of US military base to solidify protection of United States strategic interests in the Horn of Africa. 

Joint American and Pan-African lawyers filing to AU court to stop genocide

A Pan-African coalition of lawyers and Americans filed the complaint to get the African Union to stop the atrocities committed by Ethiopia and Eritrea. They discussed it in a video posted by Human Rights Watch.

A coalition of African and American lawyers has filed a complaint of mass killings, violations of women, and military targeting of civilians in Tigray with the African Court on Human and People’s Rights. While the previous joint report by the Ethiopian Human Rights Commission and the UN has been widely criticized as biased and limited many are hoping for a just outcome and action to stop the Tigray genocide. Debevoise & Plimpton LLP has partnered with Legal Action Worldwide (LAW), as well as the Pan-African Lawyers Union (PALU), to submit a landmark complaint against Ethiopia.

The ACHPR investigation has been different in that many interviews have been done via live internet with first hand witnesses and medical providers including members of Mekelle University and others from Tigray who were able to evacuate outside the country. Although initially there was robust discussions including a statement asking for the cessation of air attacks affecting civilians the ACHPR investigation seemed to have quieted down in the past few months after a recommendation was made to have “experts sent to Ethiopia” to further investigate. This same discussion of experts was done at the recent African Union summit but in regards to peace negotiations without discussion of investigation.

The African Commission on Human Rights and Peoples Rights was created in 1987 and has a mandate to perform review and investigation of human rights violations with treaty members which include Ethiopia and Eritrea which are charter members. While Ethiopia is not signatory to the International Criminal Court it is subject to the African Court on Human and People’s Rights to provide legal opinions regarding complaints filed of it’s charter members.

Since the first reports of human rights abuses in the invasion of Tigray by Eritrean, Ethiopian nationals, mercenaries, and Amhara militia forces the Ethiopian government has sought to minimize their impact. In February 2021 when the former  Minister of Women, Children, and Youth for Ethiopia, Filsan Abdullahi Ahmed, went to occupied Mekelle  to review early findings. Although she said violations of women “occurred conclusively and without a doubt” this view was not shared by the Ethiopian government. 

Subsequently, a joint report from the Ethiopian Human Rights Commission and the African Union which was very limited in the scope of where and with whom it conducted investigation. No interviews of health care providers in Tigray who provided treatment to victims were done. Much of the investigation was done by phone calls only to “witnesses” arranged by the occupying force who could be reasonably assumed to be under duress. Many areas such as Axum were not included in the joint report.

Ethiopia impeding study of Tigray public health issues is unjustifiable

At the recent Africa Union Summit Ethiopian Prime Minister called for an African News organization which would control all information about Africa killing free press and objective scientific inquiry. 

Historically international public health discussions were apolitical but now the Ethiopian government has chosen to see access to public health information as a political tool. Local research assets of Mekelle University in Tigray are continuing collecting data on famine, disease, climate, and agriculture in international collaborative working bodies which is necessary to formulate strategy to prevent potentially the death of millions. The Ethiopian government has made no efforts to collect such vital data. Instead it is mounting a hostile response to block any such endeavors and forbid any publication by any means. Ethiopia and some other like minded authoritarian regimes want to control all information of any kind that comes out of Ethiopia as noted in the recent African Union summit this week. High impact scientific journals in the United States and Europe have received severe warnings and threats. This new censorship by Ethiopian authorities was brought to light in discussions at a symposium Health Crisis of War: Making  War a Priority Health Agenda at the Medical University of South Carolina this week.

Formalized international cooperation between the nations of the world first started in 1922 with the League of Nations Health Organization leading to current World Health Organization in 1948 with formation of the United Nations. With this new agreement to international cooperation the world hoped epidemics and disease outbreaks could be reduced. The field of public health was defined as the science of protecting the safety and improving the health of communities through education, policy making and research for disease and injury prevention.  One of the driving principles is that public health is ideally evidence-based and driven by medical knowledge without attention to international relations and avoiding political discussions. 

Within the public health community there has always been some controversy about how to separate discussions of public policy regarding health and politics. International cooperation has always been present because of the reality that developed countries have advanced and sophisticated resources lacking in developing countries.  A basic tenant of providing objective information freely available to all was always present. Hiding the realities of suffering in war ravaged Tigray and other areas of Ethiopia is unjustifiable by any moral standard.

The world must hear the bell tolling for every victim of the Ethiopian war

Tsigereda Girmay a twenty year old ethnic Tigrayan was stabbed to death at Arbaminch University in Southern Ethiopia where she was a college student on January 31, 2022.

The 16th Century English cleric and poet, John Donne, wrote in his famous Meditation 17 that when the Church buries a person it is a chapter out of all of mankind’s existence. That when the bell tolls for one who has passed it is ringing for all of us to hear. In this terrible war between Ethiopia, Tigray, Oromia and others as in previous wars it is all to easy to become numb to death. We need to see the true horror and loss of this young woman and remember it has been multiplied more than hundreds of thousands if not a million times. 

The Biblical story of our creation in Genesis reminds us we are all a creation of God and priceless in our worth. John Donne declared that the death of any person should concern us because we must be involved in all mankind. Deranged calls for extermination, starvation, violence against once fellow countrymen are not actions of glory but endeavors in blasphemy against the ways of God espoused by the Christian and Islamic faiths. Government leaders and all good people of faith must come together now to find a just peace for the suffering in Tigray and Northern Ethiopia. 

The Ethiopian propaganda machine is saying she was Amhara but this is a lie. She is from Adi Remets. Here is video on Twitter where she is singing she is Tigrinya and TPLF which cannot be taken away.

Tsigereda Girmay singing she is Tigrinya and TPLF and it cannot be taken away


Public health research efforts may provide proof of human rights abuses in Tigray

I do not believe that organized government efforts to hide the truth of punitive injury to civilians in Tigray, Myanmar, Syria, and other places in the world to which we do not now pay enough attention will continue to succeed forever. Public health research may be a vital tool to document the injustice of tyrants who deprive dissenters of basic human needs. The beloved American President, Abraham Lincoln, once said in a famous political debate in 1858 one “cannot fool the people: you may fool people for a time; you can fool a part of the people all the time; but you can’t fool all the people all the time”. The emergence of starvation and denial of health care as weapons of war must countered by collection of reliable data so that those responsible can be brought to justice and this practice abandoned as a viable threat.

Today I was very fortunate to play a small part in symposium called The Health Crisis of War: Making War a Health Agenda organized by Dr. Mulugeta Gebregziabher of The Global Center for Health at the Medical College of South Carolina. It is patently clear that public health care research multidisciplinary teams from around the world are studying the effects of conflict on the noncombatant populations immersed in war in Syria, Yemen, Myanmar, and now Ethiopia. Many tools are now available from remote types such as satellite imaging and radar scanning to physiological and biochemical analysis of victims as well as their environments which are without prejudice.  No amount of government censorship, press persecution, or political bartering will stop this process from continuing to develop.

Are the Tigrayans another Rohingya betrayed by the Nobel Peace Prize?

Nobel Peace Prize winners, Aby Ahmed and Aung San Suu Kyi, dealings with genocide are following a similar course

Will the world’s attention and will to act fall away from the injustice in Tigray just has happened in Myanmar to the Rohingya? After intentional famine imposed on millions of Tigrayans, unjustified imprisonment of innocents, as well as hundreds of civilian deaths by drone attacks Nobel Prize winner Abiy Ahmed’s leadership in Ethiopia seems to be following in a similar pattern to that of a previous winner, Aung San Suu Kyi. Esteemed leaders who bought time doing little until the world eventually lost interest.

In 1991 Aung San Suu Kyi was hailed as “bringing power to the powerless” winning the Nobel Peace Prize then in 2015 she was elected in the “first democratic election of Myanmar” to lead the country. However in 2017 Myanmar security forces carried out genocidal violence as described by the United Nations displacing several hundred thousand Rohingya within Myanmar and another 740,000 people fleeing to neighboring Bangladesh. At the time  Kyi remained silent on issue and was criticized by many of the world’s leaders. Since the early 2000s her status has been shaky in Myanmar as her power has been continually challenged by the military whom she has been adverse to criticize calling them “sweet”. She and the military leaders have imprisoned the press and limited free speech.

Despite intense world-wide attention for a few years Myanmar has made no significant progress in resolving the crisis, or providing accountability and justice for the victims. The court-martial conviction of three military personnel for crimes against Rohingya reflects ongoing government efforts to evade meaningful accountability, scapegoating a few low-level soldiers rather than seriously investigating the military leadership who directed and oversaw the atrocity crimes.  Today almost one million Rohingya refugees live in the world’s largest refugee camps in Bangledesh’s Cox Bazar Region. Meanwhile Rohingya remain without rights of citizenship such as voting, owning a business, or even to work in Myanmar. 

A brief inquiry was officially made by the United Nations to see how the UN could have better responded to the crisis but placed no blame. The International Criminal Court found that changes in election procedures, law enforcement, and civil rights were needed but nothing substantial has happened.