Dr. Matthew Spreadbury, a vascular surgeon, answered my call as he concluded a day of surgery with fellow doctors Dr. Aregawi and Dr. Haymnot from Tigray. Their update was grim: “3,000 orthopedic patients are on hold, 1,000 await plastic surgeries, and 300 neurosurgery cases are pending.”
The conflict that erupted in November 2020 between the Ethiopian federal forces and the Tigray People’s Liberation Front (TPLF) claimed hundreds of thousands of lives and obliterated Tigray’s healthcare infrastructure. Comprehensive assessments reported that of 106 medical facilities reviewed, nearly 70 percent had been robbed, over 30 percent were damaged, and only 13 percent remained operational. The repercussions left countless patients without access to vital surgeries, antibiotics, or obstetric care, leading to untold preventable fatalities.
Healthcare organizations have documented pervasive sexual violence, which amounts to crimes against humanity and has left lasting trauma and medical needs throughout Tigray. Despite a ceasefire, hunger remained rampant, with researchers confirming at least 1,329 deaths due to starvation in the following months. While the 2022 Pretoria Agreement curtailed large-scale hostilities, it did little to address the core issues.
Fast forward to 2025, new instability has surfaced as factions within the TPLF battle for control of towns like Adigrat, while Eritrean and Amhara forces persist in contentious regions, obstructing returns and taxing essential services. An agreement’s stipulation for the federal government to finance hospitals and restore public services has largely gone unfulfilled.
Typically, wars generate a surge in patients, but Tigray’s predicament is particularly troubling as the conflict ended three years ago and patients continue to languish without care. The doctors described the dire circumstances under which they operate: “We lack basic supplies. Finding soap is a challenge. The men’s ward frequently has a sewage odor. Cleaning and maintenance are virtually nonexistent, which one would hope the Ethiopian government would support. We’re short on soap, even sutures.”
Yet, promised financial aid from Addis Ababa remains non-existent. As of mid-2025, approximately 740,000 to 760,000 individuals are still displaced in Tigray, housing nearly 39 percent of all internally displaced persons in Ethiopia. Many seek refuge in overcrowded schools with scant access to water, sanitation, and medical care.
The World Food Programme has terminated a significant portion of its operations in the area, while budget shortfalls forced it to suspend treatment for malnutrition affecting 650,000 women and children in Tigray and Afar. Humanitarian partners are warning of increasing cases of acute malnutrition and a higher risk of cholera—exactly the scenarios volunteer doctors confront upon arrival. Furthermore, concerns grow that the International Committee of the Red Cross, the only major international donor still present, may withdraw in 2026.
Dr. Spreadbury works with what he half-jokingly describes as Norway’s smallest missionary organization, TesfaIsHope.org, comprised of five doctors and one or two support staff who volunteer their skills in crisis zones such as Ethiopia and Rwanda, saving lives under challenging circumstances. However, the plight in Tigray is staggering without widespread international support.
The doctors expressed their frustrations at seeing worldwide protests</a focusing on 60,000 deaths in Gaza while overlooking tenfold that number dead, along with a similar count displaced, in Tigray—aftermath of arguably one of the largest conflicts in the past four decades. Comparing wars, the Second Congo War accounted for between 3.8 and 5.4 million casualties, with the Tigray War resulting in approximately 800,000 fatalities, and the ongoing conflict in Ukraine estimated between 250,000 and 350,000 deaths.
Dr. Spreadbury noted, “It’s common to see between 20 to 100 individuals with crutches or wheelchairs navigating the hospital grounds. Since they’re military, they have shelter, a hospital bed, and receive food daily. However, they linger here even after the war ended.”
Dr. Aregawi elaborated, “If they leave, they receive no help. There’s nowhere for them to go. No one will provide housing, work, or education. So they remain here.”
Dr. Haymnot added that they have been lingering for three years, “because there is no rehabilitation center.”
All three doctors reiterated the urgent call for prosthetic and rehabilitation services, alongside job training programs to assist these young men in reclaiming their lives. It’s tragic that their dependence on the hospital merely for survival occupies resources needed for patients requiring immediate medical assistance.
Despite the bleakness of the situation, or perhaps in response to it, Dr. Spreadbury explained his commitment to helping in Tigray. “For years, we aimed to understand who was addressing vascular injuries,” he said. “Many patients are living with chronic injuries from gunshot wounds or bomb fragments that have never healed properly. These two dedicated men beside me have been addressing these cases.”
He shared that most of the patients are between 21 and 29 years old, highlighting the war’s toll on a generation and the productivity of the region. Dr. Spreadbury had previously volunteered in Burma with the Free Burma Rangers, where injuries were consistent with an active war zone: gunshots, shrapnel wounds, and landmine amputations. In contrast, Tigray presents an alarming case of “chronic” war injuries.
The international community selectively prioritizes which causes to support, often influenced not by the magnitude or severity of suffering but rather by political and social interests. Currently, Gaza garners attention, while in regions like Burma, Sudan, Syria, the Democratic Republic of Congo, and Tigray, the level of suffering surpasses that of Gaza by a factor of ten or more.
