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The Ethiopian flag flies above Ethiopia’s embassy in Washington, D.C., on July 6, 2022. An uneasy peace in Ethiopia’s civil war had meant that, at least since March, the flow of wounded had paused. Then an airstrike in late August hit a nursery school.

The Ethiopian flag flies above Ethiopia’s embassy in Washington, D.C., on July 6, 2022. An uneasy peace in Ethiopia’s civil war had meant that, at least since March, the flow of wounded had paused. Then an airstrike in late August hit a nursery school. (Carlos Bongioanni/Stars and Stripes)

NAIROBI, Kenya - Even before the airstrikes began again, the hospital in the capital of Ethiopia's Tigray region was barely hanging on.

The electricity at Ayder Referral had been cut for weeks, said hospital head Kibrom Gebreselassie. Medical and fuel supplies were dwindling. Doctors and nurses had been working without pay for 16 months.

But an uneasy peace in Ethiopia's civil war had meant that, at least since March, the flow of wounded had paused. Then last week, an airstrike that residents, and local media all blamed on the Ethiopian government ripped through a nursery school. Gebreselassie said four people - including two children - were declared dead on arrival at the hospital. As staff at the Ayder hospital rushed to treat more than a dozen victims, he said, the staff were forced to forgo care for their regular cancer, kidney and cardiac patients.

"We cannot keep up," said Gebreselassie, a 44-year-old surgeon.

Nearly two years into Ethiopia's devastating civil war, which has left millions in Tigray on the brink of famine, intense fighting has resumed between government forces, led by Prime Minister Abiy Ahmed, and the Tigray People's Liberation Front (TPLF). The extent of the violence, which has included two airstrikes in the area of the regional capital, Mekelle, has dashed hopes for peace talks between the two sides.

Both sides blame each other for launching the attacks. In a statement about the airstrike, the Ethiopian government said that its Air Force only targets military sites and accused the TPLF of "dumping fake body bags in civilian areas."

Left to suffer are the 5.5 million people living in Tigray, where the Ethiopian government has largely cut off communication and banking services, restricted access for journalists and limited fuel distribution. About 9 in 10 Tigrayans are in need of food aid, according to a recent U.N. report.

At Ayder, the main hospital in Mekelle, food supplies have mostly come from nonprofits operating in the area, according to Gebreselassie, who said he has not been able to see his wife in Addis Ababa for more than a year and that his relatives in Mekelle are going hungry. He said the food supply has been sporadic, and staff have at times struggled to have enough food to feed the patients. Even though many staff members are themselves going hungry, Gebreselassie said, they have continued coming to work.

"Siege is a slow killer," he said, "slowly you lose your loved ones, slowly you see people starving to death or losing hope."

"When there is active fighting on top of the blockade, he added, "it is disastrous for civilians and everybody."

Ethiopia had once been a source of stability in the Horn of Africa, and a partner to the West. But the nation of 117 million, has also long been riven by ethnic divisions.

The TPLF, a guerrilla group from the country's mountainous north comprised mostly of ethnic Tigrayans, was welcomed by many Ethiopians after it seized power in 1991 from an oppressive Marxist regime. But over decades in government, the TPLF suppressed many of Ethiopia's larger ethnic groups, including the Amhara and Oromo. Abiy, who is half Amhara and half Ormoro, was heralded as a liberalizing figure when he came to power in 2018 and was awarded the 2019 Nobel Peace Prize for brokering peace with neighboring Eritrea.

What began as a political dispute between his government and the TPLF turned violent in the fall of 2020, when the TPLF attacked an Ethiopian military base in Tigray - the Tigrayans called it a preemptive strike- and Abiy launched a military offensive in Tigray. Abiy has framed the war as "existential" and referred to the TPLF as "weeds" and "cancer" that must be eliminated. Both sides have committed atrocities, according to a U.N. report last year, including executions and mass rapes.

Despite pressure from Western countries, peace talks have made little progress. In a news conference Tuesday, TPLF spokesman Getachew Reda said Abiy's government was able to "hoodwink the international community" into believing they were serious about peace. The Ethiopian government on Wednesday accused the TPLF of launching an invasion in the direction of Sudan's border, and the TPLF on Thursday claimed the government and Eritrean troops had launched a "massive" offensive against Tigray.

"The escalation risks the situation spiraling out of control," said William Davison, an analyst with the International Crisis Group. "It is all a major set back to a peace process that was already struggling."

Actions taken by both sides, including allegations that the Tigray authorities stole fuel from the World Food Program, make it unlikely that the federal government will end an effective blockade anytime soon, he said.

When the airstrike occurred last week, three loud booms rang out and an aide worker named Liwam and her co-workers scurried into their office for shelter. She said her mind went blank as she realized what was happening. Then she thought of her family and three children.

After about an hour, Liwam, who asked to be identified by her middle name because her job does not allow her to speak to media, headed to the scene of the airstrike at RES Kids Paradise. The nursery school near her home was closed for summer, she said, but its playground filled every day with children clamoring over its colorful play sets. What Liwam said she found were medical workers loading injured children into ambulances. Women crying as they looked for their own children. Blood everywhere.

One of the images she said she cannot get out of her head is that of two children killed in the strike, their bodies charred.

"For the siege and blockage, why let us die in front of everyone?" she said. "Our national government is telling us, either die or accept. . . Is our living of no interest to the government?"

Tewelde Legesse, a popular entertainment reporter from Tigray who fled to a neighboring country after war broke out, was sitting with friends when he got a message on WhatsApp that there had been an airstrike near his hometown. Legesse opened a local news channel on YouTube and he saw his cousin, her head covered in blood. She was telling the local television station she could not find her children.

He wanted desperately to call her but couldn't. There was no way to get through.

As he watched the aftermath of the airstrike unfold, he could not help wondering why it felt like so little of the world was paying attention. It's a concern that has been echoed in recent weeks, including by the head of the World Health Organization, who recently called the war "the worst disaster on earth" and sharply criticized Western leaders for their silence.

Legesse said he appreciated the attention given to the war in Ukraine, but it nonetheless left him questioning: "Why not for Tigray?"

In Mekelle, Liwam said her 7-year-old often begs her not to come home, worried she will be killed on the miles-long journey back from the office. Her 11-year-old tells her Tigray has not choice but to win the war, because they have already suffered so much. Her 16-year-old wonders when he can go back to school.

This week, a few days after the strike at the nursery, Liwam and her husband were awakened at dawn by the sound of three loud booms. She realized a another airstrike had just been carried out.


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