A year without healthcare has cost over 200,000 lives in Tigray

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.