The roof of the five-story Tsegay Berhe school building in the Ethiopian city of Adwa is open to the blue, cloudless sky. Back in November, in the first days of the conflict that now grips Ethiopia’s Tigray region, the school was hit by rockets. Two of the classrooms are littered with the smashed remains of computers, monitors, chairs, and books. In the undamaged rooms the wooden benches have been stacked in corners or taken outside. Chalked lessons are still visible on the blackboards.
At the gate of the school administrators are busy registering names in notebooks, but they are not the names of students. School is off until further notice. Primary and secondary schools in towns and cities across the entire Tigray region, such as Adwa, Axum, and Shire, are quickly filling with tens of thousands of people displaced displaced by violence in Tigray. As they arrive, they join others who are already sheltering in schools and empty buildings, in poor conditions and without basic services. Many have already been displaced multiple times since the fighting began.
In response, Doctors Without Borders/Médecins Sans Frontières (MSF) teams are rehabilitating a number of health facilities across the Tigray region and providing them with drugs and other medical supplies. We’re also providing hands-on medical support in emergency rooms, maternity wards, and outpatient departments. MSF teams run mobile clinics in rural towns and villages where the health system has been disrupted by the fighting and in informal sites where displaced people are staying.
Cycles of displacement
Thirty-eight-year-old Ken Alew Gebrekristos, a metal welder from the central Tigrayan town of Edaga Arbi, about 31 miles southeast of Adwa, arrived here in the second week of March. During the day, his wife and two older children go into town in search of aid, while he remains in the school, hoping to learn any new information that could improve their situation. “So far we have been given some injera (flatbreads) and T-shirts,” he says. During the night, they sleep on the hard floor of one of the classrooms.
Adwa is just the most recent destination for this family of six. In the early days of the crisis, they saw their home town filling up with people fleeing violence elsewhere and later witnessed it being attacked by Eritrean soldiers.
In November, the family was forced to flee into the hills, taking nothing but their clothes and carrying the youngest children on their shoulders. On the way, they passed dead bodies on the ground. They kept on walking, asking locals along the way for shelter and food.
“We fetched water from the river to drink,” says Ken. “Some days we ate nothing. One girl who was displaced with us gave birth, with no doctor around. We had just a bedsheet to offer them, so we made a fire to warm up the baby.”
They attempted to return to their destroyed home, but the feeling of insecurity deterred them from staying there.
“Now I have no plans, no idea what my immediate future looks like,” says Ken, his voice breaking. “I can’t go back home—how could I go back without guarantees [of safety]? I feel safer here surrounded by other people.”
An unprecedented crisis
Inside Adwa’s crowded schools, women carry babies wrapped in long scarves on their backs. Some kneel on the ground roasting coffee beans, others carry bundles of firewood. Groups of men engage in heated discussion and children sleep in the shade of small trees, taking refuge from the scorching sun of the dry season.
The rooms of the schools are sparsely furnished. Most contain a few buckets, some bags of food, and some plastic sheeting to sleep on. At night, the rooms are filled with dozens of people crammed in next to each other on the floor. Those who can’t find space sleep outside the building, on the grass or on pathways.
No one knows how long they will be here. Nobody really expected something like this to happen. Even those who remember the border war between Ethiopia and Eritrea, which peaked in the late 1990s, can see no comparison with what is happening in Ethiopia today.
Some 15 miles from Adwa stands the historic university city of Axum. On the outskirts, surrounded by fields and stalled construction sites, is the Basin school, the first destination for most new arrivals in the city since the conflict started. Those staying here say the movement of people is constant, but the influx has intensified since early March. There are currently 12 sites likes this in Axum, which together host several thousand displaced people.
“I’ve been here for 42 days now,” says Bayesh Danyo, 25, the mother of two young children including a 10-month-old baby boy. Like many other women here, Bayesh does not know the whereabouts of her husband and has had no contact with him for some months. It’s likely that he, like many others, is now a refugee in neighboring Sudan.
She has received some food assistance but is concerned that her supplies are running out. “At the beginning I got five liters of cooking oil, 30 kilograms of flour [about 66 pounds] and 50 kilograms of wheat [about 110 pounds]. These are all about to run out. The few food distributions that happen are not always fair. I try to share whatever I have with other newcomers, particularly pregnant women.”
She adds that the little water they get is mostly used for drinking, with the children always coming first. “We haven’t really had a chance to wash ourselves since we arrived,” says Bayesh. “My baby gets sick because of the harsh conditions in which we sleep.”
Forced to flee western Tigray
Bayesh comes from Humera, in western Tigray, a town at the junction of Ethiopia, Eritrea, and Sudan. Many of the displaced people in the central and eastern areas of Tigray come from the west. Inhabitants of towns including Humera, Dansha, and Mai Kadra say they were forced to leave their homes by militias and armed groups, sometimes being forcibly put into buses that took them across the Tekeze river.
Others say that they suffered and witnessed violence of various types that left them no choice but to flee. While the routes traveled by displaced people vary depending on family links or the ability to afford transport, Shire is often the first main town approached by people fleeing western Tigray. But Shire already hosts very high numbers of displaced people and is becoming increasingly crowded, so many new arrivals opt to continue their journeys.
Informal settlements without basic services
“We have seen displacement happening since the beginning of the crisis, but people were not [being displaced] in such big numbers and those who had to leave their homes were often supported by host communities, staying mostly in the houses of relatives or of people they knew and sharing resources with them,” says Esperanza Santos, MSF emergency coordinator in Tigray.
“Recently this has changed and we are seeing a bigger influx of people, especially in Shire, Adwa, and Axum. Most are settling in informal sites that don’t have the capacity to host this number of people and that lack services for them. It is an extremely concerning situation because we are not seeing an adequate response from the humanitarian community to address people’s need for water, sanitation, food, or medical services.”
Displaced people are also arriving in smaller towns such as Abi Adi, a two-hour drive west of Mekele, Tigray’s capital, located in an area where fighting has been frequent and where some pockets are held by the armed opposition. Worku, 22, who owned a small clothes shop in Shire, arrived in Abi Adi on March 1. In November he moved from one area to another in western Tigray but, as a young man, he felt unsafe and decided to approach a distant relative living in a village not far from Abi Adi. He had also heard that aid was available in the town.
“I finally came to Abi Adi because there is more presence of humanitarian organizations,” he says. “Over the past few months, I had to beg from local people. At the most, I received an injera each day. I need food, clothes, water, shelter . . . Everywhere I’ve been, I’ve been sleeping on the ground. Health-wise I am still fine, but I have seen others get sick on the way and die.”
Leterbrahn left Humera four months ago and now shares an eight-square-meter room at Abi Adi elementary school with nearly 20 other people, including her two small daughters. Leterbrahn says she has lost almost everything she owned.
“I only have the clothes you see here,” she says. “I can’t even cook for myself as I don’t have any utensils. I don’t even own a blanket. At one point I was given four bedsheets by local people, but I gave them to the pregnant women. We feel forgotten by the international community and the Ethiopian government. Nobody reaches us. Even after such a long time, we have nothing.”
There are still rural areas in Tigray that neither MSF nor any other organization has been able to reach. We can only assume that people in these areas are also living without access to health care. In response to this wave of newly arrived internally displaced people, MSF is also focusing on water and sanitation activities in some of the main towns.