The renewed fighting has brought back painful memories of Ethiopia’s 2020-2022 civil war, which is estimated to have killed about 600,000 people and left communities across the region devastated.

Fighting is continuing on several fronts, but government forces appear to be moving north through Tigray towards Mekelle.

Pro-government forces said they captured the strategic town of Alamata in southern Tigray on Monday. Further north, residents arriving at a hospital in Mekelle described heavy shelling in the town of Maychew.

A senior health worker at Aydar Referral Hospital, Mekelle’s largest medical facility, said 44 critically injured civilians from Maychew and Alamata had been brought to the hospital between Saturday and Monday.

Thirty-three of those injured were children.

“Some are blinded, some have their legs and hands amputated from the bombing,” the health worker said.

At least four people also died while being transported to the hospital from the two towns, the health worker added.

AFP said it could not independently verify the casualty figures. Reporting from the conflict zone has been severely restricted, while widespread telecommunications disruptions have made it difficult to obtain reliable information from the area.

For people caught in the fighting, the violence has turned familiar streets and neighbourhoods into places of fear.

A resident of Maychew who travelled to the hospital with his wounded sister told AFP that the town had been bombed six times.

He said the shelling struck a residential area and killed two people he knew.

In Alamata, a market area was heavily shelled on Saturday, killing several civilians, according to another person at the hospital who was accompanying his wounded five-year-old sister.

The attacks have raised fears that the fragile peace reached after Ethiopia’s previous war could be breaking down.

The earlier conflict between Prime Minister Abiy Ahmed’s government and the TPLF, which dominates politics in Tigray, ended with the Pretoria Peace Agreement in 2022.

But the agreement was never fully implemented.

Since late 2025, the Ethiopian government has carried out multiple drone strikes in Tigray and massed troops along the border. The TPLF, meanwhile, expelled a government-appointed administration from the region.

On September 23, the TPLF seized airports in Tigray from federal police and launched attacks into neighbouring Amhara and Afar states, operating alongside local militias.

In Afar, a humanitarian source confirmed that TPLF forces had taken control of the town of Erebti.

Government forces subsequently shelled the town, according to the source, causing an unconfirmed number of civilian casualties.

As fighting continues across several fronts, civilians are once again being caught between opposing forces, raising concerns about the consequences of a wider conflict in northern Ethiopia.