An emaciated child with large eyes stares at the camera. Another photo shows a boy, his tiny legs bent and ribs protruding. These were images smuggled out of a hospital in Mekelle, the capital of northern Ethiopia's Tigray region, where millions of civilians affected by a 10-month-long war remain under what the United Nations calls "a de facto humanitarian aid blockade".
In July, the United Nations said 400,000 people in the region were experiencing famine and a further 1.8 million people were on the brink of it. The UN Children's Fund (UNICEF) predicted that more than 100,000 children in Tigray could suffer from life-threatening severe acute malnutrition over the following year. The UN's then-acting humanitarian aid chief, Ramesh Rajasingham, called it "the worst famine situation we have seen in decades". "Close to 5.2 million people required humanitarian assistance, the great majority of them women and children," he said.
War broke out in November 2020, when Ethiopian prime minister Abiy Ahmed, the winner of the 2019 Nobel Peace Prize, announced a military offensive aimed at toppling Tigray’s regional ruling party, the Tigray People’s Liberation Front (TPLF). Abiy said this was a necessary response to TPLF attacks on military camps. Since the conflict began, thousands of people have been killed and more than two million displaced.
In late June – when the TPLF managed to recapture much of Tigray, including Mekelle – communications with the outside world were largely cut off.
All sides in the war have been accused of perpetrating human rights abuses and mass killings. In July, Geraldine Byrne Nason, Ireland’s permanent representative to the UN, said Ireland had been calling for an open discussion on Tigray at the UN Security Council. “Women, we know, have been subjected to sexual violence… We’re deeply worried people are starving to death… We want to see the Council assume its responsibility,” she told journalists.
This week, Dr Hayelom Kebede, research director of Mekelle's Ayder Referral Hospital, told AFP news agency he was witnessing people dying of starvation. "The bad thing is you will see people in the throes of death, but they will not die immediately. It takes time, after their body is weakened and weakened and weakened. It's more horrific than bullet deaths."
At least 50 children in the hospital needed intensive care treatment for malnutrition, he said, but medics had run out of medicine and food stock to treat them.
Three of MSF's staff members were killed in June, and at least a dozen aid workers have been killed since the conflict began last November
The US ambassador to the UN, Linda Thomas-Greenfield, has said denial of aid access by the Ethiopian government is an indication of "a siege".
At the end of July, humanitarian agency the Norwegian Refugee Council (NRC), and medical charity Médecins Sans Frontières (MSF), were forced to suspend work in Tigray after the Ethiopian government accused them of "spreading misinformation".
NRC had previously worked in camps sheltering more than 25,000 Eritrean refugees, which were destroyed in what Jan Egeland, the NRC's secretary general, called "a rampage of burning and looting by armed men", which was deepening "an already dire crisis for millions of people."
MSF said it had to stop work in the Amhara, Gambella and Somali regions of Ethiopia, as well as in the west and northwest of Tigray region. MSF staff had spoken out about the destruction of health facilities and witnessing the executions of civilians.
"Before the fighting broke out in early November, Tigray had one of the best health systems in the whole of Ethiopia, but now the health system has almost completely collapsed with dire consequences for the whole population," Kate Nolan, an MSF emergency coordinator, told The Irish Times in March.
"Blanket accusations [against] humanitarian aid workers need to stop … They need to be backed up by evidence if there is any and, frankly, it's dangerous," said Martin Griffiths, the UN's new humanitarian chief, in August.
Three of MSF's staff members were killed in June, and at least a dozen aid workers have been killed since the conflict began last November.
As Tigrayans in Ethiopia suffer under the communication blackout, relatives elsewhere have turned to the internet to appeal on their behalf. Writing in Teen Vogue, activist Ariam Kidane said two months passed before her family abroad learnt her grandmother had died in Tigray. "The Tigrayan diaspora, meanwhile, has used the internet to bring awareness to the ongoing genocide – from making TikToks about what constitutes genocide, to sharing personal accounts of escaping the region."
Last week, Ethiopians in Ireland staged a protest outside the Dáil, where they held signs with messages like "end Tigray siege" and "children in Tigray are dying," while calling on the Irish Government to do more to help their friends and relatives.
“Wherever you go in Tigray right now you see our mass graves,” said Desta Fitwi, one of the protesters. “I know seven people who have been killed: children, men and women… Since last June we don’t know what is happening to our families… We want the Irish Government to speak up for Tigray. To use every leverage that the Irish Government has in order to put pressure on the Ethiopian government to end the siege and allow humanitarian access to the people, because our people are starving right now.”