Vascular surgeon Dr. Matthew Spreadbury picked up my call as he was finishing a full day of surgery alongside local Tigrayan doctors Dr. Aregawi and Dr. Haymnot. The three gave a sobering rundown of their situation: “There are 3,000 orthopedic patients waiting, 1,000 plastic surgery patients waiting, and 300 neurosurgery cases.”
The war that erupted in November 2020 between Ethiopia’s federal forces, supported by Eritrea, and the Tigray People’s Liberation Front (TPLF) killed hundreds of thousands and devastated Tigray’s health system. Field assessments found that of 106 medical facilities surveyed, nearly 70 percent were looted, more than 30 percent damaged, and only 13 percent remained functional. These conditions left patients without access to surgery, antibiotics, or obstetric care, leading to countless preventable deaths.
Medical groups have documented widespread sexual violence amounting to crimes against humanity, leaving deep trauma and long-term medical needs across Tigray. Hunger persisted even after the ceasefire, with local researchers verifying at least 1,329 starvation deaths in the months that followed. The 2022 Pretoria Agreement halted large-scale fighting but failed to resolve the underlying issues.
By 2025, new volatility has emerged: rival TPLF factions have clashed and seized towns such as Adigrat, while Eritrean and Amhara forces remain in disputed areas, blocking returns and straining essential services. One clause of the agreement required the federal government to fund hospitals and restore public services, yet that support has barely materialized.
Wars always create a surge of patients, but what makes Tigray’s situation unique is that the war ended three years ago and people are still waiting for care. The doctors described the desperate conditions under which they work: “We don’t have basic supplies. Even finding soap is hard. You walk around the men’s ward and smell sewage pretty frequently. The cleaning and maintenance services just aren’t in place, which you’d hope the Ethiopian government would fund. They’re running out of soap, running out of sutures.”
Yet payments from the capital, Addis Ababa, have not come. As of mid-2025, about 740,000 to 760,000 people remain displaced in Tigray, which hosts roughly 39 percent of all internally displaced persons in Ethiopia. Many are sheltering in overcrowded schools with minimal access to water, sanitation, and healthcare.
The World Food Programme has closed much of its operations in the region, and funding gaps have forced it to suspend malnutrition treatment for 650,000 women and children in parts of Tigray and Afar. Humanitarian partners are warning of rising acute malnutrition and an increased risk of cholera, exactly the cases volunteer doctors are encountering upon arrival. Meanwhile, there are growing fears that the International Committee of the Red Cross, the only large-scale international donor still active, may pull out in 2026.
Spreadbury works for what he jokingly calls Norway’s smallest missionary organization, TesfaIsHope.org, which consists of five doctors and one or two support staff who volunteer their time in crisis zones like Ethiopia and Rwanda, saving lives. But without large-scale international support, the need in Tigray is overwhelming.
The doctors expressed their frustration at seeing protests around the world focused on 60,000 deaths in Gaza while ignoring ten times as many dead, and an equal number displaced, in Tigray, the lingering effects of one of the largest wars of the past 40 years. The Second Congo War claimed between 3.8 and 5.4 million lives, followed by the Tigray War with up to 800,000 deaths, and the war in Ukraine, currently estimated at approximately 250,000 to 350,000.
Spreadbury said, “It’s not uncommon to see between 20 to 100 guys with crutches or wheelchairs crawling around the hospital campus. And that’s because, as they’re military, they’ve got a place to stay, a hospital bed, and they get some food every day. But they’ve stayed here even after the war ended.”
Dr. Aregawi added context: “Because if they go outside, no one will help them. There’s nowhere else to go. No one’s going to take them in, give them a job, or an education. They just hang around.”
Dr. Haymnot continued, They’ve been hanging around for three years “because there is no rehabilitation center.”
All three doctors emphasized the urgent need for prosthetics and rehabilitation programs, as well as job training to help these young men rebuild their lives. It is tragic enough that they remain dependent on the hospital simply to survive, but in doing so, they continue to occupy space and resources that could otherwise serve patients in need of immediate medical intervention rather than long-term financial support.
Despite the hopelessness of the situation, or perhaps because of it, Dr. Spreadbury explained why he is committed to helping in Tigray. “For many years, we wanted to come to Tigray to find out who was taking care of vascular injuries,” he said. “There are many patients here with chronic vascular injuries, basically, gunshot wounds or bomb fragments that have damaged arteries or veins and never healed properly. So, patients are living with these injuries without ever having surgery. And these two courageous men sitting next to me have been doing these cases.”
He explained that most of the patients were between 21 and 29 years old, underscoring how the war has decimated a generation and robbed the region of its productivity. Spreadbury had also volunteered in Burma alongside the Free Burma Rangers (FBR), where injuries were more typical of an active war zone, gunshots, shrapnel wounds, and amputations from landmines. But in Tigray, the experience was very different. “It’s all chronic,” he said. “Yeah, chronic war injuries.”
The world community picks and chooses which causes it supports and which it ignores, not based on the scale or severity of suffering, but on political and social agendas. Currently, Gaza is in vogue, while in Burma, Sudan, Syria, the Democratic Republic of Congo, and Tigray, people are suffering on a magnitude ten times, or more, greater than Gaza.
Read the full article here