COVID-19 and the War on Tigray

The year 2020 is going to be remembered as one of the most troubling years in the world’s history. A time when the world united to fight against an emergent coronavirus (Covid-19) that caused a pandemic, in which an estimated 194 million people were infected and 4.2 million were killed globally. In addition to the lives lost, virus containment efforts have led to the separation of families and communities, affecting the mental health of the world’s population.

Until November 4, 2020, this would have been how most remembered the year 2020, but for Tigrayans in the northernmost region of Ethiopia, it is a year that would come to be remembered as the start of a genocidal war against them. The genocidal war against Tigray is a full-blown war waged by Ethiopian National Defense Forces (ENDF) and its allies: the Eritrean Defense Forces (EDF) and other regional special forces and militias. Ten months into the ongoing armed conflict, ethnic cleansing, war crimes, massacres, and mass killings, have been reported. A man-made famine has ensued and sexual violence has been used as weapons of war against civilians.

Tigray Before the War

Tigray regional state is the northernmost regional state of the 10 regional states and two chartered cities that make up the Federal Democratic Republic of Ethiopia. Tigray is home to an estimated 7 million people with rich history in ancient civilizations, such as the Kingdom of D’mt and the Kingdom of Axum, which are home to multiple archaeological sites that are protected as world heritage sites by UNESCO. In addition to Tigrayans’  rich history in ancient civilizations is their long history of struggle for self-rule, self-determination and freedom: from fighting against Italian colonizers in the early 1900s to spearheading the war against the Derg regime (military dictatorship) of Ethiopia, which led to its defeat in 1991 after 17 years of civil war.

Following the fall of the Derg regime, the people of Tigray in collaboration with Ethiopia’s other major nations and nationalities established a federal system that embodied a multinational state with the right to self-determination for nationalities. They formed a front in the name of the Ethiopian People’s Revolutionary Democratic Front (EPRDF). During the last three decades under the EPRDF prior to its dismantling, Ethiopia’s image changed dramatically as it became one of the fastest growing economies in Africa, with an economy growing 8 to 10 percent yearly. As reported by the World Bank, Ethiopia was poised to become a middle-income country by 2025. Millions were pulled out of poverty, and significant improvements to the healthcare system were made. Between 2000 and 2011 poverty substantially decreased from 44% to 30%. Healthcare facilities, hospitals and local clinics opened throughout the country, and Ethiopia witnessed increased life expectancy, reduced child and infant mortality and significant achievements in the overall health of the country.

Covid-19 in Tigray and in Ethiopia

Ethiopia reported its first Covid-19 case on March 13, 2020, eventually leading the country to declare a Covid-19 State of Emergency on April 8, 2020. Prior to that, the Tigray regional government declared a region-wide state of emergency on March 26, 2020 which included restricting travel within the region, enforcing wearing a mask, and banning large gatherings in market places, religious institutions, cafes and restaurants to prevent the spread of the virus. Travelers entering Tigray were required to report to the nearest health office for monitoring. The pandemic was also given extensive media coverage throughout Tigray by government media agencies such as Tigray TV and Dimtsi Woyane Radio and TV, as well as private Radio stations such as FM Mekelle 104.4 radio. The regional government was working with all parts of society to inform and educate the people.

According to UNICEF, as of November 30, 2020, Ethiopia had 110,074 confirmed cases with 1,636,729 samples tested since the first positive case reported in the country. With consideration to the limited access to testing sites in some areas and suspension of reports from Tigray after November, 4, 2020, due to the war, the distribution of the cases were reported as follows: 58,457 cases in Addis Ababa, 18,509 cases in Oromia, 6,662 cases in Tigray, 6,383 cases in Amhara, 4,084 cases in Southern Nations Nationalities and People region, 3,412 cases in Sidama, 2,863 cases in Diredawa, 2,727 cases in Harari, 2,496 cases in Benshangul Gumuz, 1,810 cases in Afar, 1,610 cases in Somali, and 1,001 cases in Gambela.

The Covid-19 Pandemic Delays Federal Elections and Intensifies Tension

The tension between the Ethiopian federal government and the Tigray regional government started soon after Prime Minister Abiy Ahmed came to power in 2018 and deteriorated further during the Covid-19 pandemic. 
Ethiopia was to hold its 6th national election in August 2020. With rising political tensions in the country at that time, Abiy used the pandemic as an excuse to postpone the national election. Opposition groups and parties opposed Abiy’s decision to postpone the elections. They accused Abiy of using the pandemic to extend his term in office and to weaken his opponents. They  suggested having a transitional government if elections were to be postponed. The Ethiopian parliament rejected these legitimate concerns and approved the postponement of the election and for Abiy to stay in office beyond his term limit.

The Tigray regional government opposed the decision of the rubber stamp parliament as unconstitutional, and conducted their regional election. The federal government dismissed the regional election as ‘null and void’ and decided to suspend the federal budget for Tigray as punishment. This escalated the crisis and eventually led to the war on Tigray, which Abiy waged, in collaboration with Eritrea’s dictator Isaias Afework, on November 4, 2020.

Although Abiy’s administration was preparing to attack Tigray for months prior to November 4, Abiy’s administration accused the Tigray regional government of attacking the federal northern military base to justify the war on Tigray. Though Eritrea’s involvement in the war was initially denied by higher Ethiopian and Eritrean officials, Abiy later admitted that Eritrean troops had crossed the border into Tigray. The Ethiopian and Eritrean armies with the help of Amhara militias have been working hand-in-hand in committing widespread atrocities, human rights violations, and blocking humanitarian aid from entering Tigray.

Healthcare Failure in Tigray during the War

As a result of the genocidal war on Tigray, the region has experienced a humanitarian crisis with severe public health consequences. About 5.2 million people are in dire need of humanitarian aid, more than 2 million people are internally displaced, and over 900,000 people are living in famine conditions. Besides looting private Tigrayan properties and homes, killing livestocks, and burning sacks of grains, Ethiopian and Eritrean troops have looted and destroyed hospitals and clinics throughout Tigray. They burned and soiled patient medical records, and approximately 80% of the healthcare facilities are not operational. People are unable to get basic healthcare services and are suffering from previously preventable and treatable communicable diseases such as malaria and cholera.

Most people who managed to flee the war zones have sought refuge in larger towns and cities, in informal sites such as schools, universities, and community centers, while others have been forced to hide in bushes and caves. These people have been deprived of humanitarian assistance and proper medical care since the war started. Patients with chronic diseases such as HIV, TB, and diabetes have not received any medications for months. In addition to diseases commonly observed in overcrowded areas, like cholera and other waterborne diseases, respiratory tract infections are very prevalent. 

With the ongoing war and humanitarian crisis in Tigray, there are no federal or regional efforts to help track or stop the spread of Covid-19 in Tigray. As the Ethiopian federal government is conducting a siege on Tigray, there is limited access to clean water, sufficient food, sanitation and hygiene in most areas, and social distancing is difficult to maintain due to the chaos that the conflict has caused and existing living arrangements in the region.

Due to the total destruction of the healthcare system of the Tigray region and the disruption of the Covid-19 response, the incidence and mortality rates of the virus are unclear. Although the Ethiopian government claimed that it distributed vaccines in Tigray before it was forced to retreat from the region in June 2021, it is difficult to verify due to the lack of data and the tele-communication blackout that has persisted throughout Tigray during the last 10 months.