The young mother realized that she couldn’t do more as food and money were scarce in a city under siege. Incapable to feed her children, she committed suicide.

A Catholic church in the town is running out of flour and oil needed to make communion wafers. The flagship hospital in Mekele (the capital of Ethiopia’s Tigray Region) is deciding whether to give expired medications to patients. Its bleach and soap are gone.

The city of half-million people has seen its stock of food, fuel and medicine shrink rapidly after a year of war. Rural areas are even worse, with thousands of people living on wild cactus fruits or selling the little aid they get. Man-made famine has started, which is the worst form of hunger in the last decade.

Despite being cut off almost all communication with outsiders, The Associated Press gathered on a dozen interviews from Mekele with people, as well as internal aid documents, to get the most complete picture of life in the Tigray region’s 6,000,000 inhabitants.

Mekele is lit with candles many people cannot afford, despite the sputtering electricity supply. The streets and shops are emptying fast, and the supply of cooking oil and baby formula is running low. Beggars have increased in numbers among rural residents and civil servants who went unpaid for many months. People are getting thinner. Radio broadcasts of funeral announcements have increased in frequency.

Mengstu Hailu, vice president of research at Mekele University where the mother who committed suicide herself was employed, said that “The next weeks will decide or break the situation here.”

The AP interviewed him about the suicide of his colleague last month, as well as the deaths two of his acquaintances due to hunger and a lack of medication. He asked, “Are people going be dying in the hundreds or thousands?”

Despite the failure of the United Nations, United States, European Union, and African countries to negotiate a cease-fire, the U.S. is threatening new sanctions against individuals in Africa’s second largest nation.

A new offensive has been launched by Ethiopian and allies forces to try to subdue Tigray fighters, who have dominated the national government for almost three decades, before being overthrown by Prime Minister Abiy Ahmad, the 2019 Nobel Peace Prize winner.

Ethiopia is one the largest recipients of U.S. humanitarian assistance. Fearing that the aid would end up supporting Tigray fighters, the government in Addis Ababa imposed a blockade in June. The war in neighboring Amhara and Afar was then started. Hundreds of thousands of people are now displaced in the region, escalating the humanitarian crisis. The government in Addis Ababa, fearing that the assistance will end up supporting Tigray forces, imposed the blockade in June after the fighters retook large swathes of Tigray. According to the U.S., the expulsions were “unprecedented” and “disturbing.”

According to the U.N. only 14% of the needed aid has reached Tigray since the blockade started, and there is no medicine.

InterAction, an alliance international aid groups, stated that ethnic cleansing is the only way to describe what is happening in Tigray.

In a separate statement, Mark Lowcock, former U.N. humanitarian chief, wrote that the Tigrayan population of six million faces mass starvation.

Billene Seyoum, spokesperson for Ethiopia’s prime minister, responded to questions and said that Tigray forces were to blame for aid disruptions. She also stated that “the government has worked tirelessly to ensure humanitarian assistance reaches those who need it.” She didn’t say when basic services would be available to Tigray.

Dr. Sintayehu Migina, a surgeon at Tigray’s Ayder referral Hospital, is seen in horror.

Sometimes patients go without food and have not had any meat, eggs, or milk since June. The fuel to power ambulances is depleted. Only when fuel is available, a diesel generator can power equipment for emergency surgery.

He said, “God has mercy on those who come when it is off.”

There is no help in sight. Sintayehu was told by a World Health Organization staffer that there was nothing left, even though Afar had a warehouse full of life-saving aid.

In recent weeks, the hospital has seen a lot of children who are severely malnourished or ill. Some have not survived.

Mizan Wolde said that there are no drugs. She is the mother of a 5-year old patient. Mehari Tesfa was devastated for his 4-year old daughter, who is suffering from a brain abscess.

He said, “It’s been three years since she arrived here.” “She was doing well, but then the medication stopped. She now takes only oxygen and nothing else.

According to the U.N. children’s agency, Tigray has seen an increase in the number of children admitted to hospital for severe acute malnutrition. This is compared to 8,900 children in 2020. According to the U.N., hospitals other than Mekele are running out of nutrition supplies.

Nahusenay Belay, a Mekele University lecturer, said that hundreds of people are dying every day due to lack of medical and agricultural care. Nahusenay Belay said that one of his acquaintances died due to lack of diabetes medication and that a young relative from the city’s outskirts was starved to death.

He said, “I’m surviving with the help of my family and friends as any other person,”

The prices of essential goods are on the rise. Last week, the U.N. reported that cooking oil in Mekele has increased by more than 400% and diesel by more than 600% since June. The town of Shire was flooded by thousands of refugees. Diesel was up 1,200%, flour 300%, and salt more 500%.

It is not known what the true impact of rural poverty in this largely agricultural region will be, as most people cannot travel due to lack of fuel.

A document from the AP that was part of an internal aid program, dated last month, described thousands of people in desperate situations who fled “trapped and starved villages” near Eritrea’s border. The soldiers responsible for many of the worst atrocities committed during the war.

The document stated that most people can eat at least one meal per week, thanks to the availability and affordability of cactus fruits. “The situation will likely deteriorate once wild fruits run out in September.”

Another document from Tigray said that there were “too many people trying to sell” items like soap and buckets distributed by humanitarian organizations. Some people simply walked from the distribution site to the roadside in order to sell.

The document said that they had no choice as they had to purchase food to supplement their inadequate food rations. It also stated that the “terrifying” forecast for famine was coming.

The Rev. Taum Berhane described conditions that echoed harsh stories from biblical times. Parts of Tigray were threatened by desert locusts even before the war. Then, hostile forces destroyed crops and killed farmers’ livestock. The blockade has led to people going hungry, despite having money in their bank accounts.

He said, “You see lactating mother with no milk.” “We see babies die. “I saw people eating leaves like goats.”

The church is struggling to support thousands of people displaced by the conflicting humanitarian aid programs, but “they are telling me, ‘Let’s go back to our villages even if it’s not there. It is better to die at home.

Adigrat’s Catholic bishop told him that eight children had died in the hospital.

70-year-old priest is now a diabetic and watches his medication diminish. The spirits of his congregation are also declining. The collection plate cannot be passed at Mass because Tigray has run out of cash. Soon, the bread for communion will run out.

He asked, “Even if my survival is not guaranteed, how am I going preach to a vacuum of people who die?” To be honest, the only hope for these people is to stop fighting and work together towards sustainable peace.