A young child with his mother visits a clinic in Southern Tigray which now have no supplies of medication or intravenous hydration
For young children in Tigray the availability of health care facilities and safe transport to them, intravenous hydration, and antibiotics for treatment can make all the difference whether a child lives or dies from infection which was the leading cause of death for those under age of 5 even before the Ethiopia Tigray conflict. This adds to many children already dying everyday from starvation.
This week health officials in Addis Ababa are celebrating improved use of antibiotics in Ethiopia but remain silent on the fact that for almost a year there has been no supply of antibiotics to save the lives of innocent children in Tigray. It seems they feel no responsibility to the welfare of children in Tigray. Given the Ethiopian blockade and the resistance of international authorities to challenge the humanitarian catastrophe in Tigray it is reliably expectant without a doubt that many times more children are dying.
The leading cause of death of children in Ethiopia under age 5 has been well established to be infectious disease. A study looking at demographic data and disease statistics in 2019 before the Ethiopian Tigray conflicted indicated that male children, 0–11 months aged children, 12–23 months aged children, anemic children, husband with a lower education, mothers paid employment, non-breastfed children, regions of Amhara, Afar, Dire Dawa, Benishangul, Gambela, Oromia, SNNPR, Somali and Tigray were significantly associated with higher odds of morbidity in Ethiopia.
The general effects of the war contribute further to the medical crisis. Lack of fuel for public means of transportation means that for the mostly rural population of Tigray there is no way to seek medical consultation.
Severe budget cuts due to the need for war spending more than doubling the Ethiopian government budget has now resulted in medical supply shortages throughout Ethiopia not just Tigray. Even in discussions I had recently with some in the SNNP this is a growing situation. So it is likely death rates for young children from infection are increasing nationwide now not just in Tigray.
Abiy Ahmed has consistently shown with every action his intentions are evil even when appearing to be benevolent
Abiy Ahmed has consistently openly lied about what his real intentions are regards Tigray. At first he claimed he was doing a law enforcement operation for the good of the Tegaru people. Instead he unleased a torrent of starvation, murder, and genocide. In his latest nefarious misadventure he tries to take advantage of a peace negotiations to attempt to kill the elected leaders of the Tigray nation.
In the Biblical book of Genesis the Devil in the form of snake makes a false promise to mankind that act in defiance of God’s will and is forever damned. Many cultures have used the forked tongue of the snake to recognize evil being misrepresented by false presentation of good intentions. By this time the world should clearly recognize that Abiy Ahmed speaks with a forked tongue without any honor. He cannot be trusted and needs to be brought to justice for the evil he has sprung on the world.
Ethiopia’s Ministry of Foreign Affairs said it is “regrettable to note that the African Commission on Human and Peoples’ Rights made a unilateral announcement on the establishment of a “Commission of Inquiry” and said it was “completely outside the scope of the invitation by the government and lacks legal basis.”
The report of the African Commission on Human and People’s Rights regarding Tigray which has been underway for some time now has not yet been released but their severe concerns have been well communicated. On May 12, 2021 the whole body of the ACHPR agreed there was need to investigate potential human rights violations in Tigray.
Even though Ethiopia is a charter member of the ACHPR and its associated African Court in June 2021 it refused the jurisdiction of the ACHPR to investigate Tigray. Subsequently the ACHPR has continued investigations and updates. This body has sought out input from first hand witnesses to the events in Tigray which Ethiopian lead bodies have sought to avoid.
The government of Ethiopia has sent written statements opining that they have not committed atrocities but so far this has not convinced the ACHPR to conclude their ongoing search for the truth. They have asked all parties to cease military action and reminded the Ethiopian government of its obligations to protect human rights.
Unlike the joint United Nations and Ethiopian Human Right Commission investigations which absolutely neglected and in fact intentionally avoided certain indicated sources of investigation, the ACHPR has taken testimony for first hand witnesses in Tigray including health care providers who personally lived the war and cared for the victims. Clearly one of the reasons of the destruction of hospitals and clinics by Ethiopian and Eritrean forces was to eliminate evidence of atrocity. Additionally as I and others have discussed at Ayder Comprehensive Specialized Hospital there was intimidation of nurses and doctors to falsely write into medical records that civilian injuries were due to Tigray fighters. The AHCPR has obtained testimony from many of those involved even if they were now out of region.
The ACHPR has expressed concern over the following in it’s resolution
Deeply concerned about allegations of gross violations in the ongoing conflict in the Tigray region, including sexual violence against women and girls, gang rapes used as weapons of war, killings of civilians by belligerents and extrajudicial killings;
Also noting, and with concern, the situation of Eritrean refugees living in camps in Tigray region, and allegations of abductions, extrajudicial killings and forced repatriation to Eritrea of refugees and asylum seekers;
Deeply concerned about reports of the large-scale movement of Tigrayan refugees fleeing the conflict to Sudan and neighboring countries;
Further concerned about reports of massive and forced internal displacement of thousands of people in the Tigray region who find themselves in situations of isolation;
Expressing its deep concern at reports about the intensity of hostilities which have led to an increased number of victims and casualties in the ongoing conflict, and which have resulted in serious and gross violations of human rights, breaches of international humanitarian and human rights law, refugee rights and the provisions of the Kampala Convention;
Noting with concern the humanitarian crisis in Tigray, the challenges to the population’s access to humanitarian assistance, and reports of the use of starvation as a weapon of war;
Recalling reports with allegations of human rights violations against the civilian population, including attacks against civilian infrastructure, destruction of property, looting, destruction of refugee camps, which may constitute war crimes and crimes against humanity;
Further concerned about the threats to the safety, security, well-being and livelihood of the people of the Tigray region, as well as the loss of lives, destruction of public and private infrastructure, as the military conflict continues;
Conscious of the need to act as soon as possible to contribute to the resolution of the conflict, including the determination of accountability, in order to bring the perpetrators to justice and provide reparation and restoration to the victims, as well as bring about national reconciliation, with a view to enhancing stability, security and peace in the Federal Democratic Republic of Ethiopia;
Noting the report of the Ethiopian Human Rights Commission of 24 March 2021 confirming the killings by Eritrean troops in the town of Aksum and the statement of the Ethiopian Prime Minister acknowledging the violation of human rights in the Tigray region;
At the last sessions in August 2021 resolutions where passed to obtain opinions of experts to further investigation.
On October 23, 2021 the ACHPR issued a press statement about Ethiopian airstrikes in the Tigray region saying
The Commission has since been closely monitoring the crisis in the Federal Democratic Republic of Ethiopia (Ethiopia) and is deeply saddened by the alarming reports of the recent resurgence of military offensive between the Federal Government and the Tigray People’s Liberation Front (TPLF) in the Tigray Region of Ethiopia.
Reports indicate that Ethiopia’s Military have carried out airstrikes, the fourth in a week in the capital city of Mekele, as fighting intensified between the Federal Government and Regional Forces.
The Commission is deeply concerned about the escalation of the conflict in the Tigray Region of Ethiopia and its impact on the civilian population amidst widespread allegations of human rights abuses including, the killings of thousands of people; disruption of livelihoods; and displacement of more than two million people since the beginning of the conflict in November 2021.
The Commission is also concerned about the increasing humanitarian needs in the region where millions of people are reported to be in dire need of food and aid relief assistance, with hindered access to the necessary humanitarian aid.
The Commission would once again like to remind the Federal Government of Ethiopia of its commitments and obligations under the African Charter on Human and Peoples Rights; International Human Rights and International Humanitarian Law.
The Commission reiterates its call on all the parties to the conflict to halt all military offensive and end hostilities; prioritize the welfare of the people of Tigray; protect its civilians; and engage in a dialogue with a view to finding lasting, peaceful and mutually acceptable solutions to the crisis.
The Commission urges the Federal Government of Ethiopia to take all necessary measures to restore and facilitate the speedy and unhindered access of humanitarian aid and relief, particularity food and nutrition supplies, medicine and other assistance to the region, to avoid famine and increased hunger related deaths; as well as restore essential services including essential commercial commodities, electricity, communications and banking services in the Tigray Region.
The Commission also associates itself with the various condemnations concerning the situation in the Ethiopia, and calls on all stakeholders within the International Community to combine their efforts in order to take appropriate measures needed to restore peace and security in Ethiopia.
The detainment of Tigrayans in Addis Ababa increased with the retreat of Ethiopian forces from Tigray
The intentional escalation of hate of the Tigray demonstrated by Abiy Ahmed and his supporters beginning well before the onset of the Ethiopia Tigray conflict closely mirrors how the Nazi movement in Germany labeled and then persecuted the European Jews. The Nazi movement lead by Adolf Hitler began its rise to power in part by naming European Jews as the cause of Germany’s economic woes in the post World War I period. Although initially seen as radicals the failure of German democratic movement to effect jobs and economic growth in the face of a punishing treaty that called for punitive payments eventually found the Nazi’s gaining popular support. Abiy Ahmed intimated by naming his new political party, Prosperity Party, like the Nazis could bring economic success by attacking a minority just as Hitler had done.
The Nazi’s capitalized on this idea that they had majority support in the same way as Abiy Ahmed supporters currently proclaim to begin a gradually escalating policies toward the Jews and other non-Aryans who became the strawmen for all of Germany’s woes. First they were labeled as different then the majority and seen to have evil motives to the general population. Public badges of Jews were then legislated into place to point them out. Then in 1941 and increasing rapidly through 1942 the concept was put in place to detain all Jews and place them in concentration camps leading to millions becoming slave labor and executed. This progression from labeling to genocide seen again in the Ethiopia Tigray conflict to be coming true.
Although he once praised the Tigray People Liberation Front as an ideal regional government to his Parliament after agreeing to a cooperation pact with Isaias Afwerki the praise turned to condemnation. At first the scenario painted was that the Tigray population was a victim of a despotic TPLF leadership. During the initial takeover of most of Tigray, Abiy Ahmed placed many TPLF Tigrayan critics in key interim administration positions. However these appointees began to complain almost immediately about the conduct and policies of the Ethiopian and Eritrean forces. This included destruction of factories, high rates of violations against women, and blocking of farmers planting a harvest.
The resurgence of the Tigray Defense Force following the occupation of Mekelle leading to the Ethiopian Defense Forces forced withdrawal and defeat marks an important change in the Ethiopian rhetoric towards the Tigray. Now Abiy Ahmed was saying that the strong support of the Tigray fighters by all Tigray justified actions against Tigray civilians. This was the beginning of a spiraling decline from the recognition of Tigrayans as Ethiopian citizens with rights to conversely all be enemy combatants so evil that even the elderly, small children, and mothers must be urgently confined as necessary for “national security”.
At this moment nobody knows the exact number of detainees but estimates now exceed 70,000 throughout Ethiopia. No clear definition of what constitutes a dangerous person requiring detainment has been given. Under terrorism law and the emergency state there are no clear cut rights to legal representation or due process. Many are being held in warehouses without provisions for bathrooms, feeding, or medical care. Family members have no rights to know where their loved ones or in what condition they are in. We know by way of a statement of a member of the Federal prosecutors office that some extrajudicial killings have already occurred. FANO leaders and others in the Prosperity Party have already posted on the internet that these Tigray and other detainees should be executed automatically to force the Tigray Defense Force and their alliance to surrender.
A brain tumor in a young farmer from the countryside of Tigray treated in 2018. Today someone like him has no chance for treatment due to the Ethiopian blockade
The following is a story of a single patient written in 2018 before the Ethiopia Tigray conflict. It was a time of hope. That we could bring something new to Tigray and help the farmers. I pray these days will come again
As the family said goodbye to him he left the ICU for the operating room. He had been intubated and resuscitated in the emergency room where he presented with coma. A young uneducated farmer from a remote primitive area who had been deteriorating for a year and half. Tumors in this part of the world are large and angry because they present so late. The MRI of the brain showed a 10 centimeter tumor in the fourth ventricle which was highly vascularized. This is the type of case neurosurgeons dream of, a mix of danger and hope.
The residents and fellows do the initial opening until the back of the brain is exposed which takes the first hour of surgery. I can see the tumor erupting to surface with very swollen blood vessels around it. Instead of the ependymoma (an easier tumor to remove) this was going to be hard. I begin working a millimeter at a time. Gently dissecting tumor from brain, isolating and separating scar bands and blood vessels. Using directed light and magnification for the next 8 hours I cannot take even a 5 minute break. Removing the tumor means there is constant blood loss. The brain receives more blood than any other organ. Tumors cause extra blood vessels to grow into them. As you control one bleeder another 2 start.
By the fourth hour into surgery he has lost 5 liters of blood and his blood pressure is fragile. By the sixth hours there is still about 20% of the tumor left which is covering the cerebral aqueduct. This must be removed to allow flow of cerebrospinal fluid. We are millimeters away from vital areas that cannot be damaged.
Another 2 hours goes by and there are times when the blood loss starts again and pressure gets low even with another 2 units. After 8 hours from the beginning of my part of the surgery the tumor is completely removed. The patients blood pressure is holding thanks to high dose epinephrine (a drug to raise blood pressure in critical patient). Now comes the hardest time. Will the patient wake up? He goes to the intensive care unit and we wait. After a few hours he begins to move in a way that suggest he will emerge from coma. This is the life of neurosurgeon. Fighting to stay on the brink of life for hours at a time.
He left the hospital fully functional and returned to his farm. I pray he has survived the war.
The growing paradox between what Abiy Ahmed promised and what reality has emerged under his leadership
The glow of hope was replaced by the tarnish of despair in just three years after Abiy Ahmed came to power in April 2018 as the Prime Minister of Ethiopia. The world watched initially with awe as the new leader freed political prisoners, took up the plight of Oromo interests being ignored in the growth of Addis Ababa, promised democratic elections, and a dialogue with all of Ethiopia’s varied and many ethnic groups. But this new wave of democracy would not last.
A major part of his rise in political popularity was the civil actions of the Qeerro demonstrators and support of Oromo activists including Jawar Mohammed who accompanied the new Prime Minister on his tour meeting diaspora in the United States. Today Jawar Mohammed and others sit in jail without a real due process. The Oromo whose cause was once championed by the Prime Minister suffer extrajudicial killings without restriction.
Early in his new role, Abiy Ahmed complimented the Tigray as an example of a good regional government in discussing with the Ethiopian parliament what should be expected of elected officials.
Now Ethiopia is involved in a civil war with an ever growing number of participants from almost all regions of Ethiopia joining the Tigray and Oromo fighters who clearly see that the Prime Minister has violated his supreme duty to follow the Ethiopian constitution and act in the best interests of Ethiopia.
The Tigray regional state had only 9000 armed forces in its service in November 2020 not the 250,000 claimed. Build ups in Eritrea and Amhara as well as severe cutting of budgets normally allotted by population and most importantly the characterization of the Tigray leadership as “terrorists” even after they had left power peacefully created an intolerable environment. It is literally a miracle that they were able to survive the initial onslaught of the combined forces of Ethiopia and Tigray estimated to be over 150,000. No doubt that a part of this revival was due to the will to overcome the intentional and massive genocide being acted upon the innocent Tigray population.
As someone who has lived and worked in Tigray for the past 7 years until I was forced to evacuate I have spent time in many regions talking to farmers, city dwellers, and thousands of patients and their families. The representation that the Tigray were subjugated to an unpopular despotic regional government is nonsense. What ever differences existed have been dismissed as the vast majority of Tigrayans, the Tegaru, are united in the purpose of avoiding an intended complete genocide. No doubt this is why Abiy Ahmed and his followers have such a fear of children, the elderly, and mothers of the Tigray that they want to arrest all of them immediately.
Today, Ethiopia is a failed state due to the chameleon nature of the Prime Minister and his followers which have now revoked all their promises. Many of his former supporters are now in prison. There is no free speech, no free press, no growing economy, and now Ethiopia is becoming identified most closely with outlaw nations like North Korea, Iran, and yes especially Eritrea. Ethiopia has allied itself with the enemies of all the values it once promised to hold most dear.
Mayor Adanech Abebe of Addis Ababa seems to have escaped embezzlement controversy by becoming staunch Abiy Ahmed supporter
The controversial mayor of Addis Ababa, Adanech Abebe, made some comments during a recent interview including that rape of Tigrayan women did not occur, that the number of Tigrayans to be placed in concentration camps will be increased, and finally that Tigray has a right to become independent following rules in the Ethiopian constitution.
Whereas before many Amhara and other Abiy Ahmed loyalists had contended they were on some kind of mercy mission to save the Tigray from the leaders of the Tigray Peoples Liberation Front as well as the idea that the rest of Ethiopia had complete say on the future of the Tigray this new statement is an important retreat. One wonders if this new viewpoint is of convenience to be able to lock up all Tigray as “enemy aliens” and permanently confiscate all their assets. No doubt they plan to permanently expel Tigray from Addis Ababa and perhaps all of Ethiopia.
The mayor has been the subject of controversy since coming to power in August of 2020. Allegations arose that she had over 40 million birr in a bank account. Prior to her current post she had served as the Minister of Revenue and Customs Authority as well as Federal Attorney General. Previously Abiy Ahmed had promised a new election when questions arose about potential embezzlement but now she appears to have been forgiven in return for staunch support of Abiy Ahmed and his Prosperity Party.
In speech made at Addis Ababa University in 2019 she had promised to “perform her duty” in collecting taxes from those avoiding it. However the initiatives to collect back taxes from wealthy merchants and others in Addis Ababa seem to have diminished soon after her speech.
The government of Ethiopia has blocked all food and medical aid to Tigray
Why Ethiopia and Eritrea want to hold Mille and why TDF (Tigray Defense Force) and the OLA (Oromo Liberation Army) wants to gain control of it tells the truth about the real motivations for the ongoing conflict. In the absence of any international attempt to save the millions of Tigrayans from starvation, death from lack of health care, imprisonment for ethnicity, and even just the simple right to make a living the TDF and OLA have no choice but to seize control of the roads connecting ultimately to the seaport of Djibouti. This will allow a high flow of food, medicines, medical supplies, and fuel to Tigray and the Oromo regions. Meanwhile the Ethiopian Eritrean forces want to continue to starve, deprive, imprison, and kill Tigrayans as Abiy Ahmed as well as his supporters put it into an oblivion of dust as if they never existed.
Despite the fact that the Bible and Quran outlaw the use of starvation as a weapons the clerico-fascists of Abiy Ahmed persistent and loudening claims that God has specifically given him the right to use any means necessary to exterminate the Tigray people and subjugate the Oromo similarly continue unabated. Numerous persons and entities supporting Abiy Ahmed claim to be for an all inclusive Ethiopian identity that would not exclude Tigrayans with the only intent to carry out a law enforcement action against the leaders of the Tigray Peoples Liberation Front and the Oromo. Yet they keep persistently silent when asked why deprive the innocents of food, medicine, and personhood. Why destroy hospitals, schools and factories?
Once a highly specialized tertiary hospital Ayder has now been rendered a place where the sick and their families wait for death
A year has passed since the onset of the Ethiopian and Eritrean war on Tigray including its subtotal blockade beginning even before November 2021 and the complete closing of all but a trickle of food aid since July 2021.
In August 2021 I wrote the concept of the crude death rate which relates to expected deaths per thousand population in Tigray. We knew that in 1950 for Ethiopia as a whole which was without any significant medical care the crude death rate was 32 per 1000 population. By 1971 it had fallen to 21.1 and then by 2020 before the war was only 6.4 per 1000.
Tigray before the war was leading not only Ethiopia but much of Africa in increasing percentages of medically attended births, lowering maternal and child deaths, providing tertiary care for adults and children including surgical specialty services for not only Tigray but Afar, upper Amhara, and even Eritrea. We served a total catchment area of over 10 million population. Mekelle University’s Ayder Comprehensive Specialized Hospital where I was Head of Neurosurgery working closely with the Tigray Regional Health Bureau was a model of developing health care for Africa.
Now 80% of hospitals and clinics in Tigray are basically nonfunctional because of intentional destruction and ransacking by Amhara militia, Ethiopian National Defense Forces, and Eritrean forces. Medical equipment not wrecked was taken to Eritrea. Many doctors, nurses, and other health care workers such as health extension workers and health officers are displaced, have been abused or even killed. Although Ayder Hospital through a nonviolent civil action of the cities residents avoided gross destruction it has received no supplies in over a year. All health care workers have not been paid for essentially a year yet many remain trying to help without resources.
Now that a year has gone by with the medical resources of Tigray regressed to the standards of 1950 there is absolutely no doubt that the prediction that out of 7, 070,260 population of Tigray measured in the last census the Ethiopian blockade has brought about at least 226,248.32 deaths since the onset of the war in Tigray. This of course does not include deaths from intentional civilian mass genocide and execution.
To replenish the supplies, replace the lost and broken equipment, re-station the workforce, and re-establish the working society of transportation as well communication to stop this increasing death spiral will take months at best. It will take more than sending a few aid trucks. The absolute security of the Tigray Nation State functioning in an environment of growth and freedom not destruction is the only way of recovery.
Ethiopia’s story about Eritrean troop involvement changes every day. Currently they say they have left but if they were there it would be reasonable to assist their allies in Ethiopia claims Ethiopian MFA.
Why has Eritrea not left Ethiopia? No one believes the Ethiopian Ministry of Foreign Affairs notice this week stating this lie. Multiple sources report that Isaias Afwerki is controlling Ethiopian intelligence services as well placing commanders with Amhara militia and the Ethiopian National Defense Force. Why has Afwerki not left the basically defeated Ethiopian state?
Going back to 1991 it has been well documented that Afwerki wanted to unite Eritrea and Ethiopia into a confederation. This would give him access to the Ethiopian economy, a more stable currency, hosting the African Union, and legitimacy on the world scene. Being the second worst nation in terms of human rights violations and lack of any election since he came to power would be placed aside by a new confederation with the naïve Abiy Ahmed.
Although political integration under the larger Ethiopian state had been discussed since 1952 the rise to power of Afwerki made it more of an realizable idea. His stalemate with the Tigray Peoples Liberation Front in the 1990s over the Eritrea Tigray border and subsequent hostility that remained rendered this idea mute until the Abiy Ahmed became Prime Minister of Ethiopia causing the TPLF to recede from national power.
Here was the perfect situation. The master schemer manipulated the young inexperienced Abiy Ahmed into a secret pact ostensibly as far as the world was concerned creating peace between Ethiopia and Eritrea but in reality a war plan to dominate Tigray once and for all. This would pave the way for Isaias Afwerki to become the de facto leader of the new Ethiopia Eritrean state.
Even though the military confrontation with Tigray has failed there is still hope that international heavy weights and the United Nations concerned with severe famine, refugees potentially streaming to Europe, and a failed Ethiopian state leading to chaos in the Horn of Africa will push hard for some immediate ceasefire. With this ceasefire a promise of food and medical aid will be allowed into Tigray but Tigray will have to withdraw into its borders. Both Esaias and Abiy Ahmed are counting on the international call to be strong to end any further fighting thus preventing capture of Addis Ababa or Asmara.
No doubt this pause will give Isaias time to strengthen his armed forces and those of Ethiopia as well with a plan to reinvade Tigray. Of course the leaders of the Tigray National State realize this is exactly what will happen. They know Ethiopia will only let a trickle of aid come in while complaining all the while that everyone bringing aid is really plotting to help the Tigray. Many more months will go by until Ethiopia and Eritrea can once again attack in force. This is why the Tigray Defense Force and the Oromo Liberation Army must continue to march on.
