3 month after truce still no substantial support for Hospitals in Tigray

Ethiopia's central government and Eritrea are deliberately obstructing an end to the severe humanitarian emergency in the crisis-ridden northern Ethiopian province of Tigray

Access to Tigray still unchanged since December 2022

A report from the German development aid association Etiopia Witten on the current situation in Tigray

Text of this new as .pdf for download


Ethiopia's central government and Eritrea are deliberately obstructing an end to the severe humanitarian emergency
in the crisis-ridden northern Ethiopian province of Tigray

Three months after the African Union-brokered cease-fire between the Ethiopian central government and the provincial government of Tigray, the Ethiopian central government refuses to approve the legal financial budget for the destroyed and looted hospitals in Tigray. International aid money allocated to it for Tigray does not arrive there.

The board of the development aid association Etiopia-Witten e. V. has received confidential reports (February 2023) from Tigray's health care system, whose responsible persons are no longer allowed to address the public with their concerns and needs due to an explicit ban by Ethiopian government authorities. These reports give a detailed insight into the current extreme humanitarian emergency in Tigray..

The descriptions give the impression that the Ethiopian and Eritrean governments are continuing to intensively pursue the originally publicly stated goal of destroying the livelihoods of Tigray's population, now hidden from the international public and in the slipstream of numerous other international conflicts. The entire province of Tigray remains functionally in a state of siege, and even the very hesitant opening of the banks and, to some extent, of the communications systems has done little to change this.

The following messages substantiate this impression:

  • Even after the ceasefire, which has been in place for more than three months, the total collapse of the Tigray health care system continues unchanged. 80% of clinics and health centers have been destroyed or looted
  • The Ethiopian central government with its Ministry of Finance and Health continues to refuse, without giving any reasons, to decide on a financial budget for the health sector in Tigray or to pay funds to bridge the emergency

  • As a result, employees of the university hospitals directly under the central government, who have been waiting for their outstanding salary payments for more than 20 months, must continue to work without pay or leave their jobs

  • As a consequence, university hospital employees, who are directly under the central government and have been waiting for their outstanding salary payments for more than 20 months, must continue to work without pay or leave their jobs

  • Provincial hospitals and health centers throughout Ethiopia are funded by provincial government tax revenues. Due to the war and the siege, all tax revenues in Tigray have so far been lacking, as has an emergency budget from the central government or funding from international aid organizations for the provincial government. As a result, it is not possible to initiate a restoration of basic services for the suffering population due to the mostly completely destroyed and looted healthcare structures in the entire province of Tigray

  • - For the reasons mentioned above, all hospitals lack the financial means to purchase the completely used medicines, dressing and suture materials, anesthetics, laboratory chemicals and everything else that a hospital needs for diagnostics and treatment. Most of the supplies could be procured on the domestic Ethiopian market. Likewise, there is a lack of financial resources to rebuild the destroyed premises and facilities

  • The lack of funds also means that inpatients whose relatives are unable to bring them food regularly cannot stay in the hospital and receive treatment

  • There are reports of concealed and informal obstructions by the Ethiopian authorities in Addis Ababa when donations to institutions in Tigray are to be used to purchase medical supplies on the domestic Ethiopian market. These further exacerbate the situation and also point to the central government's unchanged hostile attitude toward Tigray

  • Increasingly, clinic staff, including specialized doctors and university lecturers, are leaving Tigray province because they can no longer endure the complete helplessness in the face of the masses of patients flooding into the hospitals and the increasing lack of prospects for improvement. In addition, their families continue to starve, and they have sufficient positive professional alternatives outside Tigray

  • Reports describe that the restoration of the destroyed administrative infrastructure in Tigray is being hampered, for example, by the fact that UN financial aid for reconstruction in Tigray is not to be approved by the Ethiopian central government until the establishment of a new provisional government of Tigray recognized by the central government has been completed and an administrative structure for the distribution of funds down to the county levels has been restored

  • No funding for salaries and material resources has been provided or announced for the required establishment of a provisional provincial government for Tigray that is independent of the TPLF party. The impression is that this is to be done "honorarily" by people there who have not received a salary for more than two years and in some cases continue to suffer hunger with their families

  • The supply of food and daily necessities remains very poor due to repeated blockades of aid convoys to Tigray by local provincial political institutions in Amhara and Afar, which are tolerated by the central government. Since early January 2023, about 80% of planned humanitarian supplies have been distributed in Afar and 60% in Amhara, compared to only 11% in Tigray. (Source: UNOCHA as of 10.02.2023). In localities far from the main roads or in the not yet pacified areas of Tigray, which are under the control of Eritrean troops or Amharic militias of FANO, almost no humanitarian aid has arrived since the beginning of the war

  • In the numerous refugee camps in central Tigray, the greatest need remains. There is a lack of everything

  • The prices for food and daily necessities such as hygiene articles, which are only available to a very limited extent, continue to be staggering on the local markets and are several times higher than in Addis Ababa

  • Because of the central government's failure to open all roads to and from Tigray to private traffic, all trade between Tigray and the rest of Ethiopia, as well as private travel, continues to be blocked

  • Transport and passenger traffic on the heavily restricted flights between Tigray and Addis Ababa remains strictly controlled and limited. International aid flights directly to Mekelle are not allowed

  • Because of the strict ban on travel for independent journalists, as well as almost regularly for foreign politicians, there is virtually no independently verifiable flow of information about the actual situation in Tigray and throughout Ethiopia. Only contacts with personally known and trusted persons in Tigray can provide clues to what is actually happening on the ground. In order to protect these persons from possible reenactments, no names or references to their function in local organizations are given here.

In summary: The people in Tigray are happy that there is no more fighting, and especially no more attacks with drones and airplanes. What is disappointing and threatening is that there are still only very hesitant improvements in their living conditions more than three months after the ceasefire. The day-to-day hardship and lack of medical care is virtually unchanged so far. There are reports of serious concealed obstructions to humanitarian aid and the restoration of economic life by the central government, which is seen as an indication of a continuation of the announced destruction of Tigray by the Ethiopian and Eritrean governments.

Ayder Hospital closed doors

Etiopia-Witten actual situation

Since 2009, members of the association Etiopia-Witten e. V. have been committed to improving medical care for people in Ethiopia. Since 2012, the Ayder University Hospital in the town of Mekelle, the capital of Tigray province, has emerged as the main focus. The young, dedicated, curious and smart medical and administrative team of Ayder Hospital made a close cooperation in the form of training and medical-technical equipment easy and successful. Thus, together with numerous other international partners, the Ayder Hospital could be developed into one of the most modern maximum care hospitals in the country by Ethiopian standards. Due to the long-standing cooperation, numerous personal friendships developed, also with the associated families. With the creation of the twinning between the hometown of Etiopia-Witten, the town of Witten, and the town of Mekelle, an additional important expansion of the aid spectrum of the association was created.

The numerous personal connections to the people working in the Ayder Hospital have made it possible to help them in the war situation that came as a complete surprise to all of us. Thanks to the generous donations made available to the association, Etiopia-Witten was able to ensure the nutrition of the staff at the Ayder Hospital during the time of extreme need, so that they could continue to care for the patients. The leading doctors of the Ayder Hospital expressed their gratitude to Etiopia-Witten in particular and emphasized that Etiopia-Witten was the only aid organization in this particularly threatening time that found a way to bring financial help to the Ayder Hospital in Tigray, which was completely cut off from the outside world.

Due to the mentioned contacts to responsible persons in the University of Mekelle, in the municipality of Mekelle and in the provincial government of Tigray, as well as the detailed knowledge of numerous members about the conditions in the Ayder Hospital, the association Etiopia-Witten will be able to continue to bring help despite further existing or increasingly difficult conditions. As before, the help for the Ayder Hospital will continue to be very specific and measured by the effort with a high degree of efficiency. As soon as possible, this will also apply again to the rural elementary school built by Etiopia-Witten. Thus, Etiopia-Witten makes a difference to the big, "rich" NGOs, which are mostly bound to their standards.


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