‘Our patients come here needing life-saving treatment – we can only watch them die’

The 16-year-old boy with leukaemia, sits quietly in a hospital room. Teklit is stoic and calm. He’s trying to put on a good face on it all, but there are no cancer drugs left and his mother is beside herself with anger and grief. 

“He was so weak when we were coming here that he had to be carried,” Medhin Bahta said. “To watch your son suffer because there's no medication, that's just so difficult. The thought that he could get well but won't…just kills me.”

“There's no medication; whatever was available before had expired,” added Aaron, another sixteen-year-old boy with cancer in his blood suffering from severe headaches. “But there's nothing here now. All we're doing now is waiting.” 

Around them, Ayder hospital in Mekelle, the regional capital of Ethiopia's Tigray region, is in a state of quiet chaos.

It was once the largest and most advanced medical centre in the area. Now it is at the heart of one of the most brutal humanitarian crises on earth. Doctors say that urban starvation is spreading and everything from the MRI scanner to the washing machines have broken.

“Our patients come here only for us to watch them die,” said Dr Kibrom Gebresilasie, the hospital's Chief Medical Director. “A piece of the doctors is dying every day.”

Medics told the Telegraph that almost no reagents left to perform even basic tests, that most essential medicines were running out and vaccination rates for children had plummeted by about 90 per cent. Worse still, they said maternal deaths were spiralling out of control and surgeons often cannot sterilise their instruments because of rolling power cuts.

The Tigray region has been almost entirely isolated from the outside world since November 2020 as rebels battle the Eritrean military to the north and Ethiopian federal forces and its allied militias to the south.

A fragile ceasefire between March and late August allowed a small amount of medical aid to trickle through. But the war has erupted again with a vengeance, cutting off humanitarian access.

The United Nations announced it had managed to evacuate its staff out of the region on Wednesday. Now the Tigrayan doctors are their own, and the human toll is plain to see almost everywhere in Ayder hospital.

‘Hope disappeared into thin air’

Letay sits crying on the hospital stairs, in agony but unable to find a doctor. The young woman used to have a coffee shop in central Mekelle. When the war started almost two years ago, she says enemy soldiers took her prisoner and raped her for seven days and seven nights.

“I work as a prostitute now [to feed my children]. It's a haemorrhoid. I know it is,” she said, pointing at her groin. “I locked my children in the house and came here. I did not even have 30 Birr (£0.50) for transportation. I left early in the morning, but I needed several breaks.”

Ayder Hospital has the only kidney dialysis centre in the region. Doctors have already cut back treatments from three times a week to one to keep the machines running. But they reckon all of them will soon need to be turned off for good, leading to many painful, protracted deaths.

Last month a UN commission of human rights experts said that they had reasonable grounds to believe that the denial of access to healthcare and other aid by the federal government amounts to a crime against humanity.

Staff at Ayder say the toughest thing is seeing patients who they have treated for years for relatively mild conditions die suddenly. Last week, a 20-year-old woman called Helen, who cared for her mother with a mental illness, died after the hospital ran out of insulin shots.

“[Helen] had been coming here since she was sixteen,” said Dr Kibrom. “All the doctors and nurses knew her very well. It's a personal loss for them.”

While the situation in Mekelle is grim, it likely pales compared to other regions of Tigray where the fighting has been worse. The Ethiopian government has cut phone and internet lines to Tigray to hide the extent of the war, so little reliable information leaks out.

But data from the Tigray Health Bureau is bleak. One study by the organisation found that 90 per cent of Tigray's 40 hospitals and about 1,000 smaller clinics had been damaged or looted.

A letter sent by the local health authority to the global vaccine alliance Gavi last month said that the “hopes of the children… to grow healthier and happier were snatched away in a blink of an eye,” according to Reuters. 

The percentage of children receiving three doses of the Pentavalent vaccine – which protects against diphtheria, hepatitis B, Haemophilus influenzae type b (Hib), whooping cough, and tetanus – has plummeted from 99 per cent in 2020 to 7 per cent this year, the letter said.

Dr Kibrom fears that polio may be spreading through Tigray undetected because they can no longer test for it. “There's no way for us to confirm if the children we suspect of having polio actually have it. But some children are exhibiting Acute Flaccid Paralysis, which indicates polio and can cause a lifetime disability,” he said.

Maternal deaths are also soaring. One study by Tigrayan researchers earlier this year found that maternal mortality was now one of the highest on earth, ahead of countries like DR Congo, Syria and Iraq.

Before the civil war, there were less than 200 maternal deaths per 100,000 births in Tigray. Researchers say the average figure is now 840, with some war-torn districts up to more than 3,500 maternal deaths per 100,000, about 500 times higher than in the UK.

“A lot of medications are out of stock, even the most basic Misoprostol [a drug used for abortions or to induce pregnancy] and IV Fluid. We are no longer able to do rudimentary caesarean sections. We've done surgeries using non-sterilised instruments because of frequent power outages,” said Dr Awoll Yemane, an obstetrician and gynaecologist.

He added that the massive number of internally displaced people and an almost complete lack of contraception is leading to a wave of women dying from do-it-yourself abortions.

“Those who come for abortions were being sent outside to buy the medication [on the black market]. If they can afford it, they come back, but if they can't, they will come back again after a month or two, making the termination difficult,” Dr Awoll said.

“Before the war, we could do sophisticated surgeries and manage high-risk pregnancies. We had a lot of aspiration. But since the war, everything has gone into ruins. All the hope disappeared into thin air.”

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