In over the past few weeks, reports have been coming in from across Tigray about starvation-related deaths resulting from the suspension of food aid, which is now in its second month. These deaths have been reported in IDP hosting sites in Abiy Adi1In all cases, spelling of Tigrayan locations is from the original source of the information. and in May-Kinetal in the Central Zone, in several areas throughout the Northwestern Zone, and in the capital of Mekelle. In the Southeastern Zone, Tghat reported starvation deaths in May, which was followed up by articles in The Ethiopian Reporter and New Humanitarian describing further deteriorating conditions. Tigrai Television and the Addis Standard have reported an immediate increase in starvation deaths of children under five across the region following the start of the suspension. The primary hospital in the city of Axum in the Central Zone reported a 96% increase in the hospitalization of children under five for severe acute malnutrition from March to April.
The aid suspension is being blamed on a variety of issues in getting food to those who need it, including theft, diversion, and inflated caseloads. The World Food Programme (WFP) and USAID are investigating what is being privately described by US officials as possibly the largest theft of humanitarian aid in history, in which regional and federal governments are implicated, as well as the Ethiopian and Eritrean armies, in at least seven regions of Ethiopia. As reported in Reuters, a senior WFP official indicated that food distribution may resume in late July for some in Tigray, which would bring the suspension beyond the 100-day mark. However, the official’s statement was ambiguous and conditional, suggesting that the suspension may continue beyond July, in whole or in part. As usual, the people of Tigray are asked to starve in the meantime.
Reports of suffering and starvation related to the aid suspension do not appear to have increased the urgency from humanitarian groups to resume services. This raises concerns, given the WFP’s previous failure to detect starvation-related deaths in Tigray, which were only investigated through “informal checking,” as described by former Ethiopia Country Director Steve Omamo. However, recent assessment reports reviewed by the author show that UNOCHA was informed, in late April, that the suspension of food aid was already causing starvation-related deaths and conditions were getting increasingly worse for civilians in Endabaguna and the Southeast Zone of Tigray2 Both reports are unpublished. The Endabaguna Report is a Multi-Sectoral Assessment conducted by the UNOCHA and Shire AoR and completed on April 21 (although the report contains some data collected a week later.) The Southeastern Zone Report is a DRAFT of a Rapid Inter-Agency Humanitarian Assessment Report conducted by UNOCHA and UNFPA from April 27-29. . Both assessments found that significant portions of the populations-in-need did not receive food rations during the surge of food aid that immediately preceded the suspension. Both assessments found a large number of people who needed food assistance to begin immediately and were clearly not in a favorable position to survive a protracted suspension of food aid. If these assessment reports are reflective of conditions more broadly in Tigray, then the human toll of the food aid suspension could be severe. It is not clear that these reports are being circulated to WFP or USAID.
While the assessment found that the people who were already living in Endabaguna had received some food aid, the 36,964 confirmed new IDPs have received nothing: “…zero food was distributed and IDPs and partners claim that there is mass starvation. …the need for food remains unmet, and contacted IDPs have mentioned that there is mass starvation, and if not acted on time, it may result in mass deaths.”3Endabaguna Assessment, p.1 However, the assessment notes that the WFP representative still felt that food distribution to the new IDPs was “almost impossible” because some displaced families are registered to multiple hosting site lists and have been forced to live in close proximity to the host community. These are predictable but daunting challenges. However, the report also notes that the IDP population had been screened multiple times and the assessment team included 31 humanitarian professionals. This process has failed for too long with too many lives at stake to continue to operate in the shadows.
The Southeastern Zone Assessment found that “…Food is the most critical need and allegedly reported to cause deaths,”4Southeastern Zone Assessment, p.1 which was clarified as “Focus group discussants in Samre reported 20 people in Adi Weyane Kebele have died of starvation they confirmed through a multiagency assessment.” 5Southeastern Zone Assessment, p.5 The woredas selected for this assessment were deeply impacted by the genocidal violence committed by the Ethiopian government and its allies, but they appear to have been accessible for months now.
Each assessment team produced a nuanced list of recommendations tailored to the unique needs of each community. Two recommendations were common: (1) food is the highest priority and must be resumed as soon as possible to mitigate the increased risk of starvation-related death and (2) humanitarian assistance must be scaled up across the board to mitigate a public health meltdown that could put entire communities in jeopardy. Neither of the assessment reports described conditions that would allow the populations observed to survive a protracted suspension of food aid. There are ample reasons to believe that a significant number of people and families in the Southeast Zone and Endabaguna were at the end of their rope.
Low levels of food distribution
The combined data from both assessments covers half a million people in need of food aid. Of this total, only 27% received a food ration during the surge of food aid that took place in March just prior to the food suspension. Everyone else had received aid so long ago that it was no longer a factor in their survival. The table below contains data from the Southeastern Zone and the Endabaguna Assessments6 Data found on pages 2 and 8 of the Southeastern Assessment and pages 1 and 3 of the Endabaguna Assessment..
In the case of the Southeastern Zone, food distribution only reached between 50-60% of the people in need in each woreda and only in December for Samre and Saherti. In Endabaguna, a majority of people in need of food aid had been displaced since the last time they received any food aid. Nearly three-quarters of the population covered had already effectively been cut from food assistance long before the suspension began.
Why didn’t food reach those in need?
In the case of Endabaguna, there are obvious reasons why WFP distributed aid to just 37% of those who needed it. Most of the population currently targeted for food assistance in Endabaguna were only displaced to the district in March, which would not have given WFP enough time to redirect resources. Particularly given the enduring obstacles to the corridor in the Northwest. The reasons why only around a quarter of the population-in-need in the woredas visited in the Southeastern Zone received food during the recent surge are less obvious. According to the assessment, host communities and IDPs in Samre and Seharti received aid in December 20227Endabaguna Assessment, p.5, while the other three woredas received aid in March. If this is true, then the food distributed in Samre and Seharti would have been from an earlier distribution round, which should not have excluded them from food distribution in March8According to the Food Cluster, the surge of food distribution in late February to early March completed Round 3 of 2022, which started on December 30. Round 3 distribution did not begin in the Southeastern zone until early February and did not reach the number of rations distributed in Samre and Saherti until the end of that month..
Samre and the other districts visited are effectively on the outskirts of Mekelle, which serves as the primary hub of humanitarian aid distribution in the region. According to the Logistics Cluster update from June 16, at least 82% of food and supplies that have entered Tigray since access was granted under the cessations of hostilities agreement came through Mekelle and almost 100% before that. Despite some structural challenges to food security, these woredas should have been post-Pretoria success stories for the humanitarian response in Tigray. With conditions this bad in the Southeastern Zone, they will likely be much worse in areas of Tigray that are harder to reach, which is almost everywhere.
Early impact of the food suspension on malnutrition
Aside from the reported starvation-related deaths, both areas experienced an alarming spike in child malnutrition. As the table below shows, the malnutrition rate for children in the Southeastern zone doubled since the Emergency Food Security Assessment was performed in February 2023. The findings in Endabaguna are based on a relatively small sample of youth screened by MSF, but the results are chilling. According to the Endabaguna Assessment, the area crossed the 30% GAM threshold for famine conditions between the first and second screening9This is not the only criteria for famine, further investigation would be needed to confirm starvation deaths. .
The conditions of life were different for the newly displaced population in Endabaguna and the five woredas covered in the Southeastern Zone, but both faced some similar and some unique challenges. The lack of services and support for large numbers of CRSBV survivors was observed in both assessments.
In Endabaguna, there are no facilities to house the large number of IDPs who arrived in March and are now believed to outnumber the host community. Aside from the lack of food distribution, the broader failure to respond effectively with humanitarian support has created a public health nightmare. These conditions are particularly concerning due to the spreading Cholera outbreak in Ethiopia.
In the Southeastern Zone, IDPs and host communities there were limited or no services for hundreds of CRSBV survivors across all of the woredas covered in the assessment. Civilian infrastructure has been destroyed across the board, including schools, health posts, and water and sanitation facilities. At one school the assessment team observed visible UXO still present. Conditions for the most vulnerable populations, including persons with disabilities or chronic health conditions and unaccompanied children, were found to be dire.
The assessment team also found a health system in the Southeastern Zone that was mostly non-functional and undersupplied. A severe shortage of medical professionals, no functioning ambulances, and a lack of basic supplies and drugs. The provision of health services was largely confined to a handful of hospitals and health centers, as well as INGOs like MSF and ICRC. Cases of malaria and anthrax, as well as maternal mortality were at alarming levels.
Time for accountability
The conditions described in these assessments are not surprising to anyone who has been following the media accounts of the humanitarian catastrophe associated with the genocide in Tigray. However, the reports could be shocking to anyone who gets their information solely from the agencies who performed the assessments. The assessments show that the humanitarian agencies serving Tigray are already well informed of the impact of the aid suspension. This begs the question:
Why haven’t the WFP, UNOCHA, UNHCR, IOM, US State Department and USAID been transparent about the conditions of life being faced by people on the ground in Tigray?
It is clear that the major humanitarian actors operating in Tigray are making a deliberate effort to suppress information about conditions on the ground. The findings of the two assessments covered in this article contain the kind of information that agencies like UNOCHA, IOM, and UNHCR have taken unusual measures to keep hidden from public view.
Since February, major humanitarian agencies have withheld at least one assessment each month of the conditions of life for civilians in Tigray who survived nearly three years of genocidal violence and siege warfare. These include WFP’s Emergency Food Security Assessment, UNHCR’s Eastern Zone assessment, UNOCHA’s Endabaguna assessment, UNOCHA/UNFPA’s Southeastern Zone assessment, and finally the IOM-DTC’s IDP Hosting Site assessment. These are just the ones that are known to exist, there are likely more.
The data in these assessments tell the world the conditions that human beings in Tigray are facing, where more help and advocacy is needed, and where most critical gaps and vulnerabilities exist. These data are also essential for oversight and accountability. There are no good reasons to withhold this information, only bad and suspicious reasons.
Whether humanitarian groups are seeking to “manage the narrative” about the current aid suspension by withholding evidence of mass starvation in Tigray or if they are hiding their findings because they fear accountability it is a sign that the humanitarian response is dangerously adrift.
It is time for donors to step in and demand answers. It is time for the United Nations to launch an independent investigation into the practices of international humanitarian organizations in Tigray. But most importantly, it is time to seek and quickly find alternative means of delivering food and other life-saving aid to starving Tigrayan civilians.