For Tigray mothers and their children running away from barbarous invasion by Eritrean, Amhara, and Ethiopian forces is just the beginning of an odious journey seeking just to survive. It is an exodus of Biblical proportions without liberation.
Life for a young mother in rural Tigray in which more than 80% of the population lives even before the eruption of war in November 2020 was a challenge. Women often traveled miles daily on foot to gather the daily water supply of 5 liters per person in the family. Added to this is helping care for farm animals, crops, the household and the children as well as an elderly parent. Studies have shown that a large percentage of women were somewhat underweight and undernourished with 25% requiring food aid.
Young mothers have often lost their spouse and other adult male family members to imprisonment or murder. They become displaced losing whatever previous food source they had for themselves or their children. Along the way they may suffer forced trafficking for labor or sex, personal violation, theft of their few possessions or cash, and isolation from their previous community. Lack of fuel and transportation means travel by foot without shelter from the elements.
Many women in Tigray are breast feeding two children as it is not unusual to see breast feeding extend to toddlers. The sudden decrease in caloric and protein intake can result in loss of breast milk production in just a few days to weeks. We know that in famine 50% of the casualties are children under 5 who cannot tolerate long periods of starvation. Especially vulnerable are infants who may sometimes live only days if mother has no breast milk.
The dominant Ethiopian Orthodox religion requires burial within a day of death. The lack of communication, transportation, and health care results in most of these not being recorded in a permanent record. The dietary laws they follow of the Old Testament prevent the eating of wild meats or other foods. During approximately 40% of the year they fast from taking meat, sugar, or milk products. Some forms of wild fruits and peas appear edible but in fact can cause chronic metabolic or neurological dysfunction and often there does not exist a community knowledge of this danger.
Even if young children or lactating mothers receive some food they may survive longer but still suffer permanent disability from poor brain and musculoskeletal development. Most often the cause of death is infection because of the loss normal immunity with starvation. Bacterial or parasitic contamination of water sources leading to diseases like cholera which under normal circumstances are treatable with antibiotics and intravenous hydration instead become killers of many affected.
When we think of what has been lost in the Tigray war or the Ukrainian war we count the dead, the injured, and the abused. I had a remembrance of a commercial that was frequently broadcast in the late 1970s while I was a medical student at Harvard titled A mind is terrible thing to wasteby the United Negro College Fund. I suddenly had the revelation that what we do not think enough about in war is that we lose our future. A recent reading for Lenten reflection, Embracing Justice, I have done about social justice and what Christ visualized as an ideal society by Isabelle Hamley opines that Jesus calls for society to allow all members to use their talents for the greater whole in accordance with God’s rules of love, forgiveness, and putting others before one’s self. In my sixth decade of life the propensity for the world to be involved in cruel wars has not abated. Jesus in the Gospel remarks that war will be always be with us. A whole generation of talented people who could save lives and contribute to societal development have seen their chance to contribute delayed if not ultimately cancelled. Societies that hold back educational development opportunities for less favored groups, blockade necessities of life, destroy hospitals and schools are actually cheating themselves not just those they discriminate against.
From 2015 to the end of 2020 I was Professor and Chief of Neurosurgery at Mekelle University Ayder Comprehensive Specialized Hospital in the Tigray state of Ethiopia. After medical school our residents would go through a five year program to become neurosurgeons. I also taught medical students, surgery residents, and PhD candidates in Neurobiology. The vast majority of students I mentored at Mekelle University in Tigray demonstrated amazing maturity, original thinking, superb problem solving, and keen interest in playing a positive role for their community. Fellows and Senior residents would effectively come up with novel surgical ideas. A young faculty member who later became a PhD candidate published research on neural tube defects that attracted world wide attention. It served as a catalyst to develop prevention strategies for all of Ethiopia.
Not just Tigray is being affected. Ethiopia is bankrupt from spending more than $6 billion in weapons while drastically cutting budgets for education and healthcare. Food shortages, fuel shortages, and sky rocketing consumer prices for essential items are crippling Ethiopia. I cannot see how anyone in Ethiopia imagines their life now is better than it was before November 2020.
Adherence to God’s teaching maximally optimizes the transformation of the community. This transformation occurs because the interaction between God and man opens up new possibilities that man alone could not ponder. Societal downfall occurred in the Bible when leaders became fixated on their own advancement in ancient Israel. This corruption spread then throughout society and was inherited in subsequent generations. War, corruption, greed, and diminished belief in faith reduces the ultimate potential of societies members.
The easy passage of Senate bill S.3199 came as no surprise today given the catastrophic suffering of Tigray which extended to Afar and Amhara from war. Whilst Ethiopia talks of peace it is clearly mobilizing for war. Now this war fixation with seeking revenge is secondarily affecting all of Ethiopia due to economic collapse and poor national concern or planning for issues which were ignored due to the primary focus of the Ethiopian government on war. Ethiopia is accelerating into ruinous chaos in a growing rage of hate. They have abandoned their religious heritage and drifted into an idolatry glorifying tribal triumph rather than universal peaceful co-existence. While talking humanitarian truce just a few days ago now Ethiopia is sending three columns of thousands of soldiers and armored vehicles to the Tigray border.
How can the leadership of Ethiopia and Eritrea be so blind to the basic moral fiber expected of what was once considered one of the most religious countries in the world. While thousands are dying daily from starvation and lack of health care, Ethiopian representatives in the government and military were talking about extermination, cannibalism, and openly recording barbaric torture on social media. Their declared primary objective was not restoring peace but instead calling for complete humiliation, denigration, and finally annihilation for the Tigray. The only issue that mattered to them was the right to uninterrupted and complete sovereignty of the current Ethiopian government which has refused any participation of representation by Tigrayan elected representatives to do whatever they wished without regard to United Nations standards and principles to which Ethiopia is a signatory. Unfortunately the lack of leadership of the African Union and the United Nations not only served to advance the suffering in Tigray but encouraged the ghastly massacre now occurring in Ukraine.
This time of year both Christians and Muslims remember the kindness and faithfulness of the John the Baptist otherwise known as Yaḥyā ibn Zakarīyā to Muslims, cousin of Jesus, and Jesus, son of God to Christians, an important messenger to Muslims. His mother holds a special place in both religions. At a meeting of John’s mother, Elizabeth, and Jesus mother, Mary, the Bible recants a song sung, Luke 1:46-55, by Mary called the Magnifcat, that reflects that God is the deliverer of justice to the oppressed and will provide for the hungry who are deprived. The high adoration of Mary in the Ethiopian Orthodox Church would surely not condone this lack of merciful intent by Ethiopia. Many theologians see Mary as a bridge between Christians and Muslims.
My prayer is that all the waring parties in Ethiopia and Eritrea will let themselves be influenced by divine intercession to look for a way to peaceful co-existence. To reflect on their faith and ask to be guided to righteousness. To search to fix the brokenness of hate and restore the wholeness of peace now missing in the Horn of Africa. It is not too late.
The United States cannot be an accessory to the cascading humanitarian crisis in Tigray and Ethiopia. Giving unrestricted aid which will support its continuance and foster a greater Tigray genocide. The pronouncements and actions of Ethiopia are a betrayal of her responsibilities recognized by being a member of the United Nations. The sanctions are morally justifiable and are intended to strongly encourage peaceful resolution with all due haste.
The veracity of promises to Tigray made by the Ethiopian government including Prime Minister Abiy Ahmed has been totally lacking towards Tigray since even before the onset of armed conflict in November 2020.
The Biblical story of Ahab and Naboth recounts a similar situation to Ethiopia and Tigray illustrating that even powerful leaders have ethical and more limits in their actions. In 1 Kings 21 the powerful Northern Kingdom King Ahab covets the vineyard of Naboth, a humble subject, who owned the property by right of inheritance. When Naboth will not accept a land trade Ahab and his wife conspire to kill Naboth. Although Ahab is a powerful king he cannot escape his duty to protect the rights of those over whom he rules. His lack of concern for the rights and even the dignity for Naboth condemn him in the eyes of God.
Like Ahab Ethiopia’s leader Abiy Ahmed has denied the Tigray the right to live in Western Tigray where they have lived for centuries. It was in Western Tigray where the revolt against the Derg Regime began almost 50 years ago. Ethiopia choose to use war as a just weapon and ignore the humanity of the Tigray people. This goes against their right of autonomy in the Ethiopian constitution. Like Ahab wanting to kill Naboth to acquire his vineyard so the Ethiopian government sought to annihilate the Tigray through war, famine, and lack of health care. God speaks through the Prophet Elijah rebuking Ahab for his sins. This message remains as true today as it did then.
Now we hear that Ethiopia is putting in place an immediate truce to facilitate humanitarian access to Tigray. At the same time the Ministry of Foreign Affairs is calling for the expulsion of U.N. officials complaining that there is no humanitarian access to Tigray provided by the Federal Ethiopian government. The world was witness to the recent videos ransacking and looting of trucks in Afar intended to deliver aid to Tigray. The fear of the imminent implementation of punitive sanctions by the United States is clearly the causation of the most recent pronouncement.
The history of communication from Ethiopia on Tigray has been an unbroken stream of nefarious declarations intended to fool the international community. Although he won the Nobel Peace Prize over what is now known to be false pretenses by September 202o Abiy Ahmed had already lost credibility with many Western democracies. It is to be remembered that Abiy Ahmed in a speech before the Ethiopian Parliament said he would never go to war with Tigray. Once the war was started he called it a “law enforcement operation” done with the intention of “protecting Tigray civilians” which of course we now know suffered and continue to suffer atrocity, deprivation, and violation on a massive scale. Then in June 2021 he claimed a unilateral ceasefire to allow planting of crops in Tigray however his own appointees to the Tigray Interim Administration occupying Tigray told international media including France’s News24 that they were blocking planting.
It is well past due for Ethiopia to recognize the human dignity and rights of the Tigrayan people. To reaffirm their ancestral right to live in Tigray. To repent from the sins of nefarious greed and finally to seek peace.
There is no greater betrayal of professional duty then the case of Lia Tadesse’s treachery to Tigray. Throughout 2021 Lia Tadessa, Minister of Health for Ethiopia, falsely promised in press announcements that medical supplies and medical facilities would be provided to Tigray while off-camera giving the message to Tigray medical leaders that she would do nothing. In March of 2021 she visited Mekelle, the capital of the Tigray region, when it was already known that the vast majority of health care facilities where out of supplies, nonfunctional, or even destroyed. I have had personal discussions with most of the local Tigray health attendees at the meeting who described how armed security forces were there to carefully monitor topics and threatened immediate arrest of any words critical of Ethiopian policy or the situation at hand. Even many of the Abiy Ahmed Tigray Interim Administrators complained of her inaction.
Even though she had trained at Mekelle University’s Ayder Comprehensive Specialized Hospital she avoided visiting this tertiary facility. Instead she focused on the small city hospital in Mekelle. In a bizarre statement, she claimed that Tigray had been behind in health care and she would make sure rapid rehabilitation and improvement would be done. In a bold outrageous lie she stated that “seventy percent of health care facilities were fully functioning” in that March 2021 visit. In continuance of a cruel joke the statement “The Ministry of Health would like to take this opportunity to thanks Partners, various sections of the community locally and abroad for supporting the government’s efforts to ensure all people have access to essential health services, and calls for strengthened support and coordination between all sectors.”.
Meanwhile we know that Ethiopian Defense Force commanders had ordered to kill Doctors Without Borders doctors as well as in coordination with Eritrean forces gave carte blanche to ransack, loot, and destroy medical facilities in Tigray.
In February 2022 she hypocritically celebrated the Government of Ethiopia being committed to the African Union Year of Nutrition and Food Security 2022 while condoning the starvation killing innocent women and children at a staggering 1000 lives per day.
She coordinated international fund drives to collect medical supplies for Ethiopia which specifically excluded Tigray and parts of Oromo. Her time of service has seen a reduction of spending per capita for health care from a high of $23 per capita to estimates as low as $10 for Ethiopia reversing a decade of progress. She has traded being a physician to being an expert propagandist. As a Christian I must pray she will one day repent for being an active participant in Tigray genocide.
Five hundred days and five hundred thousand dead in Tigray which means 1000 dead a day have and will continue to die. Although the Ethiopian government using weapons of war supplied by other countries continues to kill civilians including innocent women and children daily now the greatest threat to the population are the sanctions of Ethiopia on Tigray. The most powerful sanctions currently going on anywhere in the world is the complete blockade of food, water, electricity, communication, fuel, and medicines from Ethiopia or Eritrea to Tigray.
In a bizarre example of hypocrisy, supporters of Abiy Ahmed’s Ethiopian government have made the statement “Sanctions are a form of warfare that kill more people than bombs & guns” referencing H.R. 6600 which seeks to stop Tigray holocaust. The bill contains specific exemptions to humanitarian aid to any part of Ethiopia. It should be remembered that the United States still gave over $ 1 billion in aid to Ethiopia the past year.
Except for a few carefully pre-screened medical aid flights which are like giving a man dying from hunger a single grain of rice this situation is now extending into its second year. International experts say that 83% of Tigrayans are at risk of death eventually from hunger or otherwise treatable medical conditions.
During the occupation of the capital of Tigray, Mekelle, by Ethiopian and Eritrean forces between November 2020 and July 2021 unsung heroes were the daily and nightly volunteer unarmed foot patrols coordinated by youth groups. Although armed fighters were outside the city in surrounding mountains these youth groups played a key role in intelligence gathering, spreading and informing news to the kebeles (neighborhoods), and finally at great personal risk acting as safety escorts for women traveling in the streets.
A few days after the initial military occupation by regular military forces we saw a change in the composition of the enemy soldiers. A greater number of Eritreans and Amhara appeared on the streets. Everyday they would be “patrolling the street” in squad size groups carrying out looting of local businesses and even worse whisking away women off the street to terrible fates including sexual violence.
Local neighborhood groups of Mekelle residents organized unarmed foot patrols usually of just one person to function during daylight hours and also covertly at night when there was a curfew. Many times these guardians saved ladies walking from work, church, visiting relatives, or obtaining household needs by warning them of approaching enemy patrols or distracting the patrols while the women got away or found a hiding place.
From November 2020 through the beginning of January 2021 I know of at least seven young men who were shot by occupying forces. Those that were lucky enough to be brought to hospital by relatives or neighbors were often taken out of the hospital by enemy forces in the morning and never seen again. An evil fate for the remains of those killed at scene copied a practice used by the Derg regime. I first learned about this from a friend, Rev. Douglas, whose mission was near the Desta Hotel near the Business School Campus. I went there and saw the decaying body lying on side of the busy street. Bodies would be ordered to lay where they died on the street for days. You could see the locations from a long distance because within a few hours scavenging birds would circle over them.
The lack of response or even concern for the terrible suffering in Tigray for millions of innocent civilians, mothers, and children by the non-Tigrayan medical establishment in Ethiopia’s capital including at universities, medical schools, and government health organizations is shocking. For many years cordial relationships existed with cross training of medical students and post-graduate resident occurring frequently between Mekelle University’s Ayder Hospital and Addis Ababa’s teaching programs.
TGHAT Tigray News reported today about receiving a letter from a doctor who wished to remain anonymous complaining of the “blatant double standard and hypocrisy the leadership of the medical society has exhibited on issues related to Tigray”. This doctor felt the silence of suffering violated his sacred duty and oath as a physician to society. The head of the Ethiopian Pediatric Society, Professor Bogale Worku, threatened any physician who wanted to discuss help for Tigray during academic meetings.
Even the current Ethiopian Minister of Health, Lia Tadesse, a trained obstetrician gynecologist who spent time in training at Ayder, has acted as if Tigray does not exist any more. During the occupation of Mekelle several phone calls with Lia Tadesse by Ayder leadership were met with the response of “there is nothing I can do”. Subsequently all funding for the University and Ayder Hospital which were federal not Tigray institutions primarily were completely ended. Medical supplies intended for delivery to Ayder were sent to Eritrea. USAID officially complained to Lia Tadesse about her lack of regard for the welfare of the Tigray population and refusal to cooperate with aid to the region.
The fundraising effort, Doctors 4Ethiopia, claims to be raising funds to rehabilitate and restore medical services for “all of Ethiopia”. However in small text they have a disclaimer that they will only help hospitals designated by the Ministry of Health which apparently has decided not fund any Tigray hospital. They are intentionally misleading donors wanting to help Tigray.
In long history of mankind it was not unusual for the healing professions of opposing sides to show mercy to enemy combatants and innocents. Notable exceptions occurred in World War II where some Nazi German doctors used Jewish civilians for immoral experimentation. More recently during the Rwanda genocide of 1994 the Hutu regime punished doctors who treated Tutsi victims. There was at least one doctor, Sosthene Munyemana , who has been called the “Butcher of Tumba” for his atrocities to the Tutsi. The prevailing sentiment in the organized medical establishment of Ethiopia appears to have abandoned their morals and duties in favor of seeking political favoritism.
The immoral global disparity in recognition of the humanitarian crisis in Ukraine versus Tigray occurring in press coverage has also now been seen in scientific publications. Noted researcher, Dr. Mulugeta Gebregziabher PhD, Professor at the Medical University of South Carolina had put together an international collaborative team including on site researchers from Mekelle University to assess the destruction of health care facilities in the war on Tigray. The research findings were published in the prestigious British medical journal Lancet however so far the journal has refused to publish a commentary on the morality and urgency of this potential form of genocide while it quickly published a similar comment regarding attacks on health care facilities in Ukraine.
Whilst no one is denying the urgency and gravitas of the Russian invasion on Ukraine many are asking the question as to why Western democracies are so silent and barely involved in seeking solutions to the conflict where at least half a million people have died due to war, starvation, lack of health care, and blockade of food, fuel, communication, electricity, clean water, and other necessities of life?
Medical research has the most fundamental tenet that it is committed to improving human life. We teach young researchers that as well as developing sound scientific principles of investigation there is an absolute need when completed to communicate the research to the public otherwise the effort is meritless.
A part of this reporting a priori requires an analysis of the morality of the issue. This substantiates the need of response and level of response to identified problems. Talking about unnecessary death, suffering, and deprivation to millions of people cannot be done with a total disregard to the moral values which define the lessons we are supposed to have learned from catastrophic world wars.
The Ethiopian Prime Minister is talking to the United States after a period of defiant silence because Ethiopia’s economic survival is threatened. Ethiopia cannot survive economically and continue the Tigray war indefinitely. Take a class in basic economics about nations and you quickly learn about “gun vs butter”. All nations need both. Now Abiy Ahmed is learning that lesson.
As reported earlier this year in the influential South China Morning Post and later by the Global reporting center in The World, China is at a crossroads about how much more it can lend to Ethiopia. The Chinese are the first to say they did not cause the Ethiopian conflict with Tigray and other groups. This conflict works against Ethiopian prosperity and debt repayment.
Abiy Ahmed has said in the past he would always prefer loans from the International Monetary Fund or World Bank which he equates to “borrowing from one’s mother” rather then the Chinese because the terms of Chinese loans are high interest rates with short repayment schedules. In addition to which there are hidden costs that Ethiopia bears by “guaranteeing” the loans against business failure.
At an estimate of Ethiopia’s debt exceeding $60 billion by the end of 2022 and no agreement yet reached with special negotiators, China and France, for the IMF it is clear that Ethiopia will need to negotiate with the West to stay afloat. In the past Ethiopia tried to “play off Europe vs China” but now the bet that China or even the Middle East alone are a way to finance Ethiopia’s economic growth appears to have been a grave misjudgment.