Mekelle, February 25፡2025 (Tigray Herald)
The Plight of Internally Displaced Persons in Tigray
Written by Batseba Seifu
The genocidal war in Tigray represents one of the most devastating humanitarian crises of the 21st century, culminating in the displacement of millions within a short span. While the international community has observed this calamitous situation, the day-to-day experiences of Internally Displaced Persons (IDPs) remain dire. This article aims to delve deeply into the complex realities faced by IDPs, specifically those residing in overcrowded and under-resourced camps.
As of March 2024, in Tigray, approximately 950,000 individuals remain displaced, comprised of those residing in formal camps and others living among host communities (International Organization for Migration, 2024). The camps where the IDPs reside epitomize the myriad challenges faced by these vulnerable populations, characterized by dire shortages of food, water, medical care, and safety protections. The inhabitants mainly come from the forcefully and illegally occupied areas, each carrying their unique stories of loss, trauma, and resilience.
The Human Cost of War – Displacement Dynamics
The Tigray genocidal war, ignited in November 2020, marked a critical turning point in the region’s history, thrusting millions into a cycle of instability, and life-altering displacement. The complexity of the war, involving regional, national, and international powers, illustrates how war, not to mention genocidal war, leads to profound humanitarian crises. As the genocidal war escalated, civilians found themselves in the crossfire, forced to abandon their homes in search of safety. Refugees International pointed out that the war displaced nearly 3 million people (Refugees International, 2024). These individuals, many leaving with little more than the clothes on their backs, witnessed first-hand the horrors of genocidal war — loss of loved ones, the destruction of their communities, and the tragic severing of familiar ties to home, tradition, and culture. Displaced individuals and families recounted traumatic experiences of fleeing their homes amid violence and destruction. Many reported witnessing the killing of family members, destruction of property, and widespread looting by perpetrator forces. A study of 3,572 internally displaced persons (IDPs) found that 15% reported the killing of family members, while 6.83% faced physical disabilities due to injuries sustained during the war (Gebreyesus A, et. al.2023).
Upon arriving at IDP camps, the struggle for survival began anew. The overwhelming influx of individuals seeking refuge strained already limited resources, leading to overcrowding and inadequate living conditions. Camps exhibit these challenges explosively; individuals are packed into makeshift shelters that fail to provide the basic dignity of privacy and safety. The resultant communal living conditions undermine the fabric of social relations, as disputes over limited resources, such as food and water, escalate under the pressures of deprivation. The economic impact of the genocidal war is severe, with many families losing their primary sources of income and livelihood. A study found that 69.1% of IDPs had assets looted, while 15.8% reported total destruction (Nature, 2023).
Research indicates that the psychological toll of displacement extends far beyond immediate physical survival; individuals frequently grapple with grief, anxiety, and post-traumatic stress. The psychological scars of genocide and loss are documented across populations, with PTSD rates alarmingly high amongst IDPs. The desperate need for emergency aid often overshadows the critical need for mental health services, leaving individuals without adequate support systems to process trauma.
Furthermore, the consequences of displacement ripple outward, impacting not only the IDPs but also host communities. This phenomenon often breeds tension and competition, as local inhabitants face resource exhaustion due to the influx of displaced individuals. Questions of social cohesion, economic viability, and cultural integration become paramount as communities navigate the dual pressure of humanitarian need and resource scarcity.
Living Conditions in IDP Camps
Living conditions within IDP camps in Tigray epitomize the culmination of systemic failures in humanitarian response and resource allocation. Overcrowding, poor infrastructure, and limited access to essential services characterize the daily realities of IDPs, who navigate a precarious existence in an environment not designed to support their basic needs. This section will detail these living conditions.
Crowding in camps heightens risks related to the spread of communicable diseases, including tuberculosis and other airborne infections. Poor ventilation and sanitation exacerbate these issues, leaving inhabitants vulnerable to illness. The lack of adequate shelter further complicates health outcomes; many IDPs reside in makeshift structures that fail to provide insulation from harsh weather, ultimately impacting their physical and mental well-being (The Reporter Ethiopia, 2024).
Access to basic necessities, such as food and water, is alarmingly insufficient in these camps. Food distribution, characterized by uncertainty and disparities, often leaves many families in dire situations. Monthly rations are insufficient to meet nutritional requirements. In acute phases of food insecurity, IDPs often resort to foraging for wild edibles or bartering with limited possessions, reinforcing the cycle of vulnerability.
When it comes to water, the situation is equally dire: contamination and scarcity define the water access experience in IDP camps. Many camps lack reliable and safe water sources, resulting in reliance on contaminated options such as rivers or unprotected wells. Not only does this lead to health crises stemming from waterborne diseases, but the burden of sourcing water often falls disproportionately on women and girls, who may face further vulnerabilities in their quest for this essential resource.
A Hunger for Safety: Food Security and Health Impacts
In the context of Internally Displaced Persons (IDPs) in Tigray, food security is not merely a question of access; it embodies the very essence of survival and dignity. The genocidal war’s impact on agricultural practices and supply chains, including looting and deliberate destruction, unleashed a calamity of food scarcity, with a disproportionate number of IDPs reporting insufficient food supplies. As a result, many individuals resort to extreme measures, which significantly affect their physical and mental health.
Food insecurity emerges as an immediate consequence of the war, with agricultural destruction and looting forcing millions to abandon traditional livelihoods. The blockade severely hampered transportation, access to markets, and the normal functioning of commercial networks. Consequently, the reliance on humanitarian assistance became acutely pronounced. Logistical hurdles and security issues in the illegally and forcefully occupied areas also lef to inconsistent aid delivery, exacerbating the crisis.
The repercussions of food scarcity extend far beyond the immediate physicality of hunger; they reverberate within the fabric of society, affecting mental well-being. The psychological toll on IDPs manifests through increased anxiety, hopelessness, and depression. Reports indicate that 43.8% of IDPs experienced severe depression, a reflection of the trauma compounded by food insecurity (Gebreyesus A, et. al 2024). The struggle to secure basic nourishment creates a relentless cycle of despair, inundating individuals with fear of future shortages while triggering an instinctive focus on survival.
Malnutrition has emerged as a critical public health issue, with a concerning prevalence observed among children. A research as early as 2010 identified that “among the children surveyed, 46.9%, 33.0%, and 11.6% were stunted, underweight, and wasted, respectively” (Afework Mulugeta et al 2010). Malnutrition often sets the stage for a series of complications, including stunted growth, increased susceptibility to diseases, and higher mortality rates among infants. In many instances, the effects of malnutrition can have intergenerational repercussions, impacting educational attainment, economic viability, and overall community resilience for years to come.
To address the crisis of food security, humanitarian organizations are working to implement targeted nutritional programs aimed at improving health outcomes. Specialized feeding programs for vulnerable groups, particularly children and mothers, are critical interventions designed to combat acute malnutrition. But much more is needed. Further, these efforts necessitate collaboration among various stakeholders, including local healthcare providers and community leaders, to ensure an effective approach that respects the dignity of those served.
Water Scarcity and Sanitation Challenges in IDP Camps
Access to clean water and adequate sanitation facilities is a fundamental human right that tragically remains unmet for many internally displaced persons (IDPs) in Tigray. The dire conditions within IDP camps chronicle a critical failure in providing one of the most essential elements of survival, exacerbating the vulnerabilities associated with displacement. As this section highlights, the water scarcity context in IDP camps is layered with complex challenges that intersect with public health, gender dynamics, and community resilience.
Water scarcity in Tigray’s IDP camps arises from a combination of infrastructural damage, resource allocation failures, and insufficient humanitarian support. Many camps lack reliable water sources, compelling residents to rely on contaminated rivers and unprotected wells (Doctors Without Borders, 2024). These unsafe water sources serve as breeding grounds for waterborne diseases, contributing to health crises such as cholera and acute diarrhea.
The inadequate sanitation infrastructure compounds the dangers posed by inaccessible clean water. Overcrowded conditions and limited latrine facilities create unsanitary environments that facilitate the transmission of communicable diseases. Insufficient latrines lead to the practice of open defecation, which is particularly dangerous for women and girls experiencing increased vulnerability in such situations. The intersections of overcrowding, gendered dynamics, and limited facilities produce a dire cycle of insecurity and health risks.
Women and girls are also disproportionately affected by the scarcity of water and sanitation resources. The burden of sourcing water traditionally falls on women, creating physical and psychological stressors as they are often compelled to travel significant distances to access safer sources. These journeys expose them to risks of violence, harassment, and exploitation — risks that are exacerbated in environments lacking proper lighting and security measures. When sanitation facilities are inadequate, the impacts are especially acute for women, who may avoid seeking basic needs or using communal latrines due to privacy concerns.
International humanitarian organizations are acutely aware of these challenges and have initiated efforts to improve water supply and sanitation in the camps, although inadequately. Water, Sanitation and Hygiene (WASH) programs are critical interventions aimed at addressing these gaps. Such programs entail the establishment of potable water access points, repair of boreholes, and training community members in hygiene practices. Collaborating with local governments and community organizations can ensure sustainable approaches to WASH programming.
However, access to clean water and sanitation cannot be extricated from the broader political and security context in Tigray, which complicates the delivery of humanitarian aid. Bureaucratic hurdles delay essential resources reaching vulnerable populations. Coordinated efforts that prioritize local engagement are essential for efficacious humanitarian interventions.
The Healthcare Catastrophe: Access, Coverage, and Consequences
The health crisis in Tigray’s IDP camps cannot be overstated; it represents a significant collapse of the healthcare infrastructure in a region already reeling from the effects of genocidal war and prolonged forceful and illegal occupation by Amhara and Eritrea forces. The devastation of health facilities, coupled with the exacerbation of chronic health challenges, leads to dire consequences for economically and emotionally vulnerable displaced populations. This section examines the healthcare catastrophe in Tigray’s IDP camps by exploring the ramifications of availability and access issues, the quality of care, and the pressing need for sustainable solutions.
The genocidal war has inflicted substantial damage on Tigray’s healthcare system, with an estimated 70% of health facilities either completely destroyed or rendered non-functional (Conflict and Health, 2024). The aftermath of genocidal war has been further compounded by the looting of medical supplies and critical upkeep resources. Consequently, many IDPs find themselves deprived of essential healthcare services, leading to a wave of preventable morbidity and mortality.
Access to primary healthcare services faces a myriad of obstacles in IDP camps. Limited mobility, compounded by security concerns, prevents many IDPs from reaching the few existing healthcare facilities. Those that do often encounter overcrowding, under-resourced staff, and insufficient medical supplies; in many instances, compounded health challenges such as maternal health emergencies and communicable disease outbreaks are met with inadequate response capabilities.
Maternal health, in particular, emerges as a critical health outcome within these camps. The breakdown of healthcare services has resulted in a profound maternal health crisis, where only 36.5% of pregnant women have managed to receive antenatal care (BMC Public Health, 2024). Alarmingly low rates of postnatal care — merely 15% obtained follow-up examination within 24 hours of delivery — contribute to heightened risks for maternal, neonatal, and child health outcomes (BMC Public Health, 2024). The deepening consequences are stark and include increased maternal and infant mortality rates, reversing years of advancement in health indicators within Tigray.
Mental health considerations are inherently tied to the healthcare disaster unfolding in Tigray. With approximately 58.8% of IDPs experiencing post-traumatic stress disorder (PTSD) (Gebreyesus A. et al, 2024), the psychological toll of displacement, violence, and loss is palpable. Limited access to mental health services curtails the potential for healing, perpetuating cycles of suffering and hindering recovery. Traditional stigmas surrounding mental health exacerbate the issue, as many IDPs remain unwilling or unable to seek aid.
While the healthcare context in IDP camps appears bleak, various grassroots and international organizations have mobilized efforts to ameliorate health outcomes among these vulnerable populations, although insufficiently. Emergency response teams provide basic medical services, including vaccination campaigns to reduce outbreaks of preventable diseases. Integrating mental health services into primary healthcare frameworks could prove essential for addressing the multifaceted health challenges faced by IDPs.
The urgency for rebuilding Tigray’s healthcare system cannot be overstated. Strategic investments in health infrastructure, training healthcare personnel, and developing sustainable medical supply chains are paramount. Local governments, humanitarian actors, and international organizations must collaborate cohesively, ensuring a holistic approach to health system recovery that prioritizes resilience and community engagement in service delivery.
Political Challenges and International Humanitarian Response
The situation in Tigray’s IDP camps is inexorably linked to the broader political landscape of Ethiopia, where the interplay of power dynamics, governance, and humanitarian response shapes the lived experiences of displaced communities. Lack of implementation of the Pretoria Peace Agreement and subsequent Nairobi Declaration exacerbate the multifaceted vulnerabilities faced by Internally Displaced Persons (IDPs). This section explores the intricate relationship between local governance, the role of the international community, and the mechanisms through which humanitarian aid is both delivered and restricted.
The Ethiopian government’s stance on sovereignty significantly influences the flow of humanitarian assistance to Tigray. Politicization of aid and diversion have fueled tensions between local authorities and international humanitarian actors. It also means the aid is not getting to the people.
The impact of political considerations extends beyond bureaucratic challenges; it shapes the broader context in which IDPs live and survive. Restrictions on access for international observers and humanitarian organizations limit the accurate assessment of needs and inhibit timely responses.
Human rights violations, including deliberate starvation and obstruction of aid, have drawn international condemnation and raised questions surrounding accountability, albeit not to the extent they should. Human rights organizations have documented instances of war crimes, including sexual violence and extrajudicial killings, compelling calls for investigations and intervention. However, the complex geopolitical situation, characterized by shifting alliances and national interests, often blurs the lines of accountability, complicating international humanitarian efforts.
Despite the myriad challenges, the international community plays a critical role in responding to the crisis in Tigray. Organizations such as the United Nations, the World Food Programme, and various non-governmental organizations have mobilized resources and expertise to address immediate humanitarian needs. However, existing efforts often are inadequate and face constraints due to the aforementioned political dynamics, which hinder the efficacy of interventions. Thus, pressure on the Ethiopian government is critical.
A major challenge remains the coordination of humanitarian responses amidst competing objectives and actors. The pressures of bureaucratic delays, fragmented communication, and competing priorities dilute the impact of aid interventions, leading to gaps in resource allocation. There is a need for a more cohesive humanitarian response framework emphasize the necessity of aligning donor priorities with on-ground needs while fostering effective collaboration among stakeholders. This necessitates channelling funds through local civil society organizations.
Conclusion
Tigray experienced one of the most significant internal displacement crises in Africa, driven by genocidal war and insecurity. While humanitarian efforts provided essential relief, challenges related to access, funding, and security persisted. As the region moves towards stabilization, comprehensive and coordinated approaches are required to address immediate needs and lay the groundwork for sustainable development and peace. Further, full implementation of the Pretoria Peace Agreement and subsequent Nairobi Declaration is essential to ensure the safe and dignified return of the displaced to their rightful lands.
Bibliography and Further Reading
- International Organization for Migration (IOM). “Ethiopia National Displacement Reports (7–19),” 2020–2024. IOM Displacement Tracking Matrix.
- United Nations Office for the Coordination of Humanitarian Affairs (OCHA). “Ethiopia – Tigray Region Humanitarian Update,” 2020–2024. OCHA Ethiopia.
- United Nations High Commissioner for Refugees (UNHCR). “Ethiopia Emergency Situation Reports,” 2020–2024. UNHCR Ethiopia.
- World Food Programme (WFP). “Food Security and Nutrition Assessments in Tigray,” 2020–2024. WFP Ethiopia.
- Human Rights Watch (HRW). “Ethiopia: Crisis in Tigray,” 2020–2024. HRW Reports.
- ReliefWeb. “Ethiopia: Tigray Region Humanitarian Reports,” 2020–2024. ReliefWeb Ethiopia.
- Doctors Without Borders. “Bringing the Water System Back to Life in Tigray, Ethiopia,” 2024.
- Conflict and Health. “The Impact of War on Healthcare Infrastructure in Tigray,” 2024.
- BMC Public Health. “Maternal Health in Crisis: Tigray’s IDP Camps,” 2024.
- East African Medical Journal, Afework Mulugeta et. Al, 2010, Child Malnutrition in Tigray, Northern Ethiopia
- The Reporter Ethiopia. “Living Conditions in Tigray’s IDP Camps,” 2024.
- Gebreyesus A, Mulugeta A, Woldemichael A, Asgedom AA, Fisseha G, Tsadik M, Gebrehiwot TG, Mitiku M, Teferi M, Godifay H, Alemayehu Y. Immediate health and economic impact of the Tigray war on internally displaced persons and hosting households. Sci Rep. 2023 Oct 23;13(1):18071. doi: 10.1038/s41598-023-45328-4. PMID: 37872386; PMCID: PMC10593803.
-Gebreyesus A, Gebremariam AG, Kidanu KG, Gidey S, Haftu H, Nigusse AT, Shishay F, Mamo L. Post-traumatic stress disorder symptoms among internally displaced persons: unveiling the impact of the war of Tigray. Discov Ment Health. 2024 May 28;4(1):18. doi: 10.1007/s44192-024-00069-2. PMID: 38806962; PMCID: PMC11133275.
