The northern highlands of Ethiopia became a global byword for famine in the mid-1980s, when drought and conflict combined to create a disaster that killed as many as one million people. Now hunger is stalking the Tigray region again, and a senior UN official alleges that starvation is being used as a weapon of war. More than 350,000 of Tigray"s nearly 6 million people are living in famine conditions, according to an analysis by United Nations agencies and global aid groups first reported by Reuters on Thursday. Nearly 2 million others are one step away from such dire deprivation, they said. Ethiopia has disputed these estimates. Fighting since November between Ethiopia"s government and the region"s ousted ruling party, the Tigray People"s Liberation Front (TPLF), has displaced more than 2 million people. The conflict broke out just before the main harvest, with each side blaming the other. The neighbouring country of Eritrea and the next-door Ethiopian region of Amhara sent forces in support of Prime Minister Abiy Ahmed"s government. In some of his strongest public comments to date on the crisis, the UN"s top humanitarian official, Mark Lowcock, accused Eritrean forces of "trying to deal with the Tigrayan population by starving them." In an interview with Reuters on Thursday, Lowcock said Eritrean soldiers and local fighters are deliberately blocking supplies to the more than 1 million people in areas outside government control. "Food is definitely being used as a weapon of war." Ethiopia"s government, the United Nations and aid agencies have delivered food and other help to some 3.3 million Tigray residents since March, according to the UN humanitarian agency OCHA. But most of that aid is going to government-controlled areas, Lowcock said. Eritrea - which fought a brutal border war against Ethiopia in 1998-2000, when the TPLF dominated the central government - didn"t respond to questions for this article. Minister of Information Yemane Gebremeskel has previously said accusations that Eritrean soldiers are blocking or looting aid are "fabricated." The Ethiopian military, the prime minister"s office and the head of a national taskforce on Tigray did not respond to requests for comment on Lowcock"s remarks. At a June 3 news conference, Abiy"s spokesperson, Billene Seyoum, dismissed accusations that the country"s defence forces are using food as a weapon as baseless and politically motivated. Mitiku Kassa, head of Ethiopia"s National Disaster Risk Management Commission, which manages the government"s crisis response, accused the TPLF, the former ruling party, of attacking food trucks and aid personnel, but didn"t respond to a request for examples. He told reporters on Wednesday that more than 90% of people in Tigray had been provided aid. "We don’t have any food shortage," he said. The UN, however, has said it has received reports from local Tigrayan officials of more than 150 people starving to death. Lowcock said he believed many more had died but could not provide a figure. He is already seeing echoes of the "colossal tragedy" of the 1984-85 famine in Ethiopia, he said. "It’s not outlandish … to think that could happen (again) if action to tackle the problem doesn"t improve." In the fertile lands of western Tigray, farmers abandoned fields full of sorghum, teff and sesame to escape the violence, Reuters reporting shows. Some residents accused Amhara forces of stealing their crops and livestock, or chasing them off their farms. In northern and eastern Tigray, farmers told Reuters that soldiers from Eritrea had torched their crops and grain stores, and slaughtered oxen needed for ploughing. An estimated 90% of the harvest for 2020 was lost, according to the UN"s analysis. Some farmers said they were now eating the seeds they needed to plant the next crop. Gizachew Muluneh, spokesman for the Amhara regional administration, told Reuters that Amhara forces would never steal crops, livestock or block aid. GROWING NEED In the paediatric ward of Adigrat General Hospital, about 30 km from the Eritrea border, Adan Muez huddled beneath a warm blanket in mid-March, his skeletal frame too weak to lift up his head and eyes closed despite the chatter around him. The 14-year-old used to be "strong as a lion," his uncle Tadesse Aregawi said at the boy"s bedside, as Adan laboured to breathe. But when he was admitted earlier that month, he weighed barely 14.9 kilograms, or 33 pounds - about a third of the normal weight for his age. The family had spent more than three months hiding in a cave to escape Eritrean soldiers, who they heard had been killing and raping people, Tadesse said - charges denied by the Eritrean government. They survived on a handful of roasted barley per day; six other people from their village of Tsasie died of hunger and illness while in hiding, Tadesse said. "When we came back to the village, there was nothing left - no cattle, no food, no water. Someone donated clothes to us," he said, a coat hanging off his skinny frame. He said the family had received food aid only once since then - 20 kilos of wheat for 10 people. Like many malnourished children, Adan had a complicating health issue - he has a gastric ulcer that makes it hard to digest some food, including certain types of grain, his medical records showed. On May 4, the hospital referred him to another facility in the regional capital, Mekelle, a doctor at Adigrat told Reuters. Adigrat had run out of the fortified milk used to treat malnourished children. But doctors in Mekelle could find no record of Adan"s admission. Reuters was unable to reach the family to find out what happened to him. Officials at Adigrat hospital say they don"t know what happened after Adan"s discharge. Information on the extent of malnutrition in Tigray is spotty. Healthcare facilities were heavily damaged in the fighting, and many are barely functioning. Soldiers block main roads for weeks at a time, and much of the region still has no functioning cell phone service. Figures collected by the UN children"s agency UNICEF and shared with Reuters offer a rare snapshot of the worsening crisis. In March, 1,187 children were treated for "severe wasting" at hospitals covering about a third of Tigray. That"s about the same number who would have been treated in the entire region before the war, UNICEF said. In April, the number rose to 1,723. In May, it reached 2,931. The international medical aid group Medecins Sans Frontieres (MSF), which runs mobile clinics in some remote rural areas, said it had seen "alarming" levels of malnutrition. About 19% of children visiting its clinics in May were malnourished, MSF told Reuters. More than 4% were suffering from the most severe form of malnutrition and could die without care. AID BLOCKED, LOOTED Hunger is a perennial threat in Tigray, a heavily agricultural region prone to drought and locust plagues. Its population is overwhelmingly ethnic Tigrayan. The TPLF dominated Ethiopia"s government for almost three decades until 2018, when protests swept one of Africa"s most repressive regimes from power. The TPLF then retrenched to its home region. In November 2020, the federal government drove the TPLF from the regional capital and installed a new interim administration in Tigray. Most people are subsistence farmers whose stone houses dot carefully terraced fields. Nearly a million were already dependent on food aid before the conflict between the federal government and the TPLF began. The number in need of emergency food has now soared to 5.2 million, or 91% of Tigray"s population, according to the UN World Food Program. The government refused to let aid convoys into the region for the first five weeks of fighting, citing safety concerns. Although access has improved since December, weekly reports from OCHA show swathes of Tigray remain out of reach. Persistent clashes have blocked access to many rural areas, according to the UN. By the end of May, OCHA had recorded some 130 incidents of aid agencies being turned away at checkpoints and of staff being assaulted, interrogated or hindered from working in the region, Lowcock told Reuters. He said Eritreans were "clearly" responsible for 50 such incidents and men in Ethiopian military uniforms for 50 others. Volunteer militiamen from Amhara were responsible for 27 incidents, he said. Tigrayan opposition forces also hindered operations on at least one occasion. At least 10 aid workers have been killed in the conflict, Lowcock said. They include an employee of the Relief Society of Tigray - a partner of the U.S. Agency for International Development - who was shot dead on April 28 in the central Kola Tembien district. The U.S. Embassy released a statement on May 20 saying Eritrean and Ethiopian soldiers had reportedly shot him. "According to eyewitnesses, he clearly identified himself as a humanitarian worker and pleaded for his life before he was killed," the statement said. Neither the Ethiopian military nor the Eritrean government responded to Reuters" questions about the killing. Ethiopian soldiers and their allies from the Eritrean Defense Forces (EDF) were still turning away aid vehicles at checkpoints and assaulting and detaining aid workers in the northern, central and southeastern zones of Tigray this month, according to 11 internal UN reports reviewed by Reuters and interviews with five aid workers. The region"s justice bureau head, Abera Nigus, a Tigrayan, said the issue of food-aid access was being discussed at weekly meetings between the military and the interim administration in Tigray. For the past two months, he said, he has repeatedly raised problems with Eritrean soldiers blocking food trucks along the road between two major towns, Axum and Adwa, with no results. "The food blockage is not an accident - it is very purposefully done," Abera said. Reuters sent detailed questions to government officials in Ethiopia and Eritrea about obstructions to food supplies but did not receive a response. NEXT YEAR"S CROP IN PERIL Abebe Gebrehiwot, deputy head of the Tigray interim administration, told Reuters that Eritrean soldiers were now preventing farmers from planting the next crop, while Amhara regional forces were blocking the transportation of agricultural supplies, such as seeds, into Tigray. "It is not Ethiopian national defence forces that campaign against farming, it is the Eritrean defence force. The other challenge is coming from Amhara region militia or special forces," Abebe told Reuters in a text message. "We are on good terms with the Ethiopian military force." But a senior Tigrayan regional official told Reuters that both countries" militaries were chasing farmers from their fields. "This is the case for the past month – primarily Eritreans but also Ethiopian forces. They say, don"t plough. Go away," he said. Eritrean and Ethiopian officials didn"t respond to questions from Reuters. Billene, the Ethiopian prime minister"s spokesperson, has previously denied that farmers are being prevented from going about their work. In the town of Ziban Gedena, in northwestern Tigray, Eritrean soldiers had burned 150 houses, killed 300 civilians, looted or slaughtered 90% of oxen and livestock, burnt and stolen harvests and set fire to animal fodder, according to notes from a UN briefing after a June 6 visit. Continuing harassment from Eritrean forces meant that no one was plowing the land for the next crop, farmers told aid workers. Many villages on the main road to Adwa are deserted, and no work on the land is taking place, a report from an aid agency noted last week. PROBLEMS IN THE WEST The UN"s warning of famine conditions did not contain an assessment on western Tigray, now under the control of Amhara regional forces who claim the area as their own. The UN said it didn"t have sufficient data from there. Driving through the area in March, Reuters saw fields of damaged crops left to rot. Hundreds of thousands of ethnic Tigrayans have fled the area, many saying they were driven out by Amhara forces, including a part-time militia known as Fano. Mizan Berhanu, 23, said he left the town of Division in March, finding shelter at an overcrowded school in Shire, a town 150 km to the northeast, to where many from western Tigray are fleeing. "Fano and Amhara police were robbing everyone"s cows," he said. "Anyone who followed them was shot at." Gizachew, the Amhara regional spokesman, said western Tigray was now part of Amhara. He rejected the accusations that Amhara forces had taken grain or livestock. "Amhara forces are not robbers," he said. "They are keeping people from TPLF dangers." Neither Fano nor Amhara police responded to questions from Reuters. Fano has previously denied looting. Few of the new arrivals in Shire could find space in the crowded classrooms; even the space under trees had been taken. The town is hosting over half a million people, according to the UN’s analysis. Local authorities said they are unable to feed them all. At a gathering of farmers at the agricultural office in Shire in March, representatives from nearby districts told Reuters that their crops had been torched, their ploughing oxen stolen and the seeds they would have planted burnt or eaten. Most were supporting relatives who had fled violence elsewhere. "The children are coughing and getting diarrhea. We eat once a day," said Mekonnen Lake, an Ethiopian Orthodox priest from central Tigray, who has 13 displaced relatives living with him. Half his harvest had to be abandoned due to fighting, and the half he had gathered in was burned, he said at the meeting. "I think about killing myself, but it is forbidden as a priest," he said. (Katharine Houreld reported from Adigrat and Giulia Paravicini from Addis Ababa; Additional reporting by Dawit Endeshaw and Silvia Aloisi; editing by Alexandra Zavis and Janet McBride)