Lying on a metal hospital bed with rolled-up blankets propping up the remains of her severed legs, 10-year-old double-amputee Iyerusalem is among scores of innocent civilians caught in the deadly crossfire of renewed fighting across northern Ethiopia.
“I was in our compound with my older brother and our horse when we were hit. My brother and the horse died,” she whispered from her bed at the Ayder Comprehensive Specialised Hospital in Mekelle, the capital of the northern Tigray state.
Fresh hostilties broke out between the rebel Tigray People’s Liberation Front (TPLF) and Ethiopian federal forces on September 23, ending months of fragile calm. Federal troops pushed back the initial assault and seized control of Mekelle over the weekend after TPLF leaders and forces abandoned the city. Yet, despite the military’s rapid advance, the human cost of the conflict is rapidly mounting across the region.
Many of the wounded arriving at Ayder Hospital hail from remote farming villages hours away along hazardous roads battered by heavy artillery shelling and ongoing military movements.
For Iyerusalem, who traveled from Qarsole village in the Alamata district south of Mekelle, simple survival is now a daily struggle.
“Right now, my amputated legs hurt badly,” she said, her father Hiluf watching over her anxiously. “If I get medical treatment and can walk again, I want to go back to school.”
In an adjacent ward, 12-year-old Hana lies immobilized, her face badly torn apart by an explosion that shattered her leg and claimed the lives of both her mother and brother.
“First I heard a loud explosion, and the whole house shook. I was scared and did not even know what had happened. I could not open my eyes or my mouth,” Hana recalled, clutching her bedsheets. “The sound of the explosion keeps coming back in my head.”
A few doors down, 10-year-old Betelhem suffers from a severe leg fracture while her six-year-old sister, Melet, recovers from shrapnel wounds to her neck. Their pregnant mother was killed instantly when heavy artillery struck their residence.
“The bomb hit our house directly. All these people have died, but no one is being held responsible,” said their father, Haftom, a 39-year-old shopkeeper, his voice trembling with anger and grief. “There is no government.”
Medical personnel at Ayder Hospital are working around the clock under severe resource constraints. According to Birhanu Hailemariam, the hospital’s emergency coordinator, a large proportion of the recent casualties have arrived from southern Tigray.
“In recent days, 34 people wounded by heavy artillery, drones, gunfire, and explosives have arrived at our hospital,” Hailemariam confirmed, noting that 23 of the victims were children. One patient succumbed to their injuries shortly after arrival.
Doctors and nurses face critical shortages of basic life-saving medical supplies, including essential pharmaceuticals and general anesthesia. “We are lacking basic equipment and medicine, but we are doing our best to treat everyone,” Hailemariam added.
While health workers note the current crisis has not yet reached the scale of the devastating 2020–2022 Tigray war—which claimed an estimated 600,000 lives—an intense atmosphere of fear and trauma grips the facility.
Medical personnel speaking on condition of anonymity voiced frustration at the relentless destruction, stressing that whether it is rebel forces or federal troops, “both are hurting people.”
For victims’ families, assigning blame offers little solace when survival remains uncertain.
“We do not know who carried out the bombardment. It is war,” said Iyerusalem’s father, Hiluf, deliberately avoiding assigning guilt to either federal forces or the TPLF out of fear of retribution. Looking down at his daughter as she stared silently ahead, he issued a simple plea to the international community and combatants alike “I do not want to fight with anyone. Let there be peace for us.”
