Tigray, Ethiopia – At a large intersection in central Mekelle, the capital of Ethiopia’s Tigray region, Asmelash Mariam waits cautiously for a speeding blue bajaj to let him cross.

The 28-year-old walks with a limp, but eases his way through the crowd, a serious and proud look on his face. Beneath his grey-washed jeans a prosthetic on his right leg replaces the limb he lost in the war two years ago.

Asmelash was born into a farming family in a village in northern Tigray not far from Axum. After high school he became a teacher and taught at the local elementary school for two years. But then the war broke out and he decided to enlist.

“I thought it was important to defend the population. I was very motivated,” he says.

Between 2020 and 2022, a civil conflict devastated the region. Ethiopia’s federal government in Addis Ababa squared off against the Tigray People’s Liberation Front (TPLF), the ruling party in the region since 1975.

The war, which claimed some 600,000 lives and displaced more than 3 million people according to estimates, also involved armed militias from the neighbouring Amhara region and the Eritrean army, which fought alongside Addis Ababa.

Asmelash was fighting with the TPLF on the front lines in the northwest of the region when a mortar shell hit him in 2022, resulting in the loss of his leg.

“Life as a soldier is very hard. At first, I didn’t think about the pain because I was fighting for the cause. But when I was wounded, everything changed,” he says.

A worse ordeal soon began.

“Psychologically I even thought about suicide. I was in a devastating crisis,” he says. “But after getting a prosthetic leg, I started to recover.”

Now, Asmelash makes his way to the Mekelle Orthopedic and Physiotherapy Centre (MOPC) for a checkup.

The facility that has been in operation for more than 20 years is run by the Tigray Disabled Veterans Association (TDVA).

The centre, which is the only one active in northern Ethiopia, is where Asmelash trains extensively to learn how to walk with his prosthesis.

After greeting the guards at the entrance, Asmelash steps into a large room. Inside, around a dozen people, most of them war wounded civilians, are doing rehabilitation exercises.

Two patients walk back and forth in front of a mirror, learning how to walk straight, while a physical therapist in a white coat assists a woman as she balances on horizontal bars.

In one corner, at a worktable, a technician uses tools to test the functionality of a prosthetic limb.

According to management, MOPC has provided free assistance to more than 180,000 people since its founding, with around 65,000 of those cases occurring in the last four years.

Most of the current patients are victims of bombing or gunfire, many of whom are amputees or have suffered spinal injuries.

Although there are no extensive studies yet, preliminary research indicates that 44 percent of civilian casualties in the war died from wounds due to lack of medical care, while the other 56 percent survived but were left with disabilities.

The MOPC remained open even during the conflict with the help of the International Red Cross (ICRC).

“The number of arrivals from hospitals was huge and we went into burnout,” says centre director Brhame Teame.

“After peace, we worked at night to try to catch up with a waiting list of 2,400 people and it went on like that for nine months after the end of hostilities.”

After two years of fighting, the Pretoria Peace Accord was signed in November 2022, marking an official end to the hostilities.

For MOPC, the peace deal brought intervention from several donors, along with physiotherapists from the NGO Humanity & Inclusion.

Aid also arrived from the Ethiopian federal government as part of the pacification process, while the Ethiopian Prosthetic and Orthotic Service (EPOS) from the capital supported by supplying materials.

Attending to Asmelash in the rehabilitation room, physiotherapist Gebremedhin Haile says the young man’s recovery is not yet complete “because he still has 13 shrapnel present in his other leg”.

“But he has a strong spirit!” adds Gebremedhin, who has developed a close friendship with the former soldier during the months treating him.

Gebremedhin, who began working at the facility shortly after the peace agreement was signed, recalls the toughest moments.

“I cared for as many as 20 patients a day, both former soldiers and civilians, all deeply traumatised … It was challenging to support them.”

The physiotherapist believes that a good portion of the wounded from this war never got to the MOPC, either because they are unaware of its existence, live too far away, or lack the means to reach it.

In addition, “the general climate of uncertainty in some areas doesn’t help”, he says.

In Mekelle, which is the main urban centre of northern Ethiopia, normal life appears to have resumed. People crowd the streets, cafes and markets – even as the trauma and wounds of the war remain.

Across the region though, a sense of uncertainty still lingers.

Despite the progress made since the signing of the peace deal, many disputes and unresolved issues remain. Key among them is the disarmament and demobilisation of over 200,000 TPLF soldiers, and the movement’s official reinstatement as a political party by the National Electoral Board of Ethiopia (NEBE).

On the latter point, internal divisions have surfaced within the TPLF leadership, revealing power struggles between two factions: one led by the party’s chairman, Debretsion Gebremichael, and the other by his former deputy Getachew Reda, who is the current chairman of the Interim Administration of the region created after the peace agreement. Recently, Getachew Reda was expelled along with 16 other members of the leadership, further fuelling tensions.

This political uncertainty is a further obstacle to reconstruction efforts and the consolidation of a fragile peace.

During the war, much of Tigray was cut off from food and medicine for months, and most hospitals and much infrastructure was destroyed or damaged.

By the end of the conflict, according to the World Health Organization, only 3 percent of health facilities were functional. The bill for reconstruction has been calculated at $20bn, and it will take decades to recover.

But money does not repair everything.

The trauma of war, and in particular the widespread human rights violations and sexual violence on thousands of people revealed by several reports, have left deep scars on the population.

Additionally, there are still dozens of camps for internally displaced people (IDPs) around major urban centres such as Axum, Adwa, and Mekelle itself.

According to the UN, there are still about 950,000 IDPs in the region, and in the northwest they mostly live crammed inside old or abandoned school buildings.

Shire, a town of 100,000 in north-central Tigray, was at the forefront of the conflict, leading to a significant influx of people seeking refuge, with tens of thousands still here.

The Hibret camp consists of hundreds of white tents around an old school complex with crumbling walls.

Inside, classrooms have been converted into shelters that can accommodate up to 50 people.

Mebrahtu Tesfay, 50, who comes from southwest Tigray bordering the Amhara region, lives in one of the classrooms.

“I still remember the day Amhara militiamen came to the village and burned our houses. They killed 62 people and said, ‘if you stay here, we will kill you,’” he said, referring to the militias who invaded his area in 2021.

“We cannot return because they are still there.”

Mebrahtu says “the TPLF government keeps promising us action but then postpones it”.

“We are losing hope,” he adds with a sense of disillusionment.

Most of the IDPs cannot return to their lands because they are still occupied by the Eritrean army and the Amhara FANO militias.

The complete military withdrawal from the western and southern parts of Tigray has yet to take place, which is a clear violation of the peace agreement.

This situation has also led the TPLF military to hesitate in disarming.

These circumstances are difficult for Ethiopia to address, as the country is already grappling with an economic crisis, and new violent internal regional divisions in Oromia and Amhara that share roots with the war in Tigray.

The fact that the areas still occupied are the most fertile in Tigray has also contributed to the severe food crisis that’s impacted the region after the conflict.

The prolonged blockade of agricultural activities, coupled with a severe drought caused by the climate crisis, has left the population and displaced people struggling, reducing the harvest by half by early 2024 and forcing more than 4 million people to rely on aid. Improvement is only anticipated with the onset of the rainy season.

In a valley north of Shire, some farmers who have managed to return to their land are nearing the end of their day’s work in the fields of teff, the staple cereal of the Ethiopian diet cultivated on terraced mountainsides.

“We had to start from scratch because they stole and destroyed everything, even our work tools,” says farmer Alene Berhe, who lost a son and several family members in the conflict. “We went through starvation. But now, with the rains, we hope to rebuild everything.”

From the villages to the capital, two years on Tigrayans have high hopes that life will improve, given the suffering they have endured.

In Mekelle, young bajaj driver Haslemu Haileh ferries passengers to their destinations in the city. “We need politicians to dialogue to keep hope alive,” the 26-year-old says.

Originally from the east of the region, he had moved to Mekelle in search of work when, in 2021, a bombing destroyed the iron store where he worked, and he lost both his legs.

“I saw too many wounded and dead during the war,” he says. But he held on to hope, and with prosthetics from MOPC, he now walks on his own and was able to modify his vehicle to suit his needs and continue working. “The hardest thing is feeling dependent on others all the time.”

Now “trauma and pain have passed”, Haslemu says, zigzagging through traffic. “Disability does not mean inability, you have to get back on your feet.”

At the MPOC rehab centre, Asmelash is also on the mend. He says he has grown mentally stronger and now provides support to other wounded people who are in even greater need.

“I help them out for the moment,” he says, while for himself, he dreams of returning to the life he had before all of this began.

“I would like to go back to the village, (to carry on) teaching, if peace continues as I hope.”