A new study on Ethiopia’s conflict-ridden Tigray region has come out with some alarming statistics. Babies in the region are dying in their first month of life at four times the rate before the war cut off access to most medical care for over 5 million people, according to the most sweeping study yet of how mothers and children are suffering. Women are dying during pregnancy or within 42 days of giving birth at five times the rate before the war, and children under 5 are dying at twice the pre-war rate, often because of easily preventable reasons, according to the yet-unpublished study shared by its authors with the Associated Press.

Almost two years have passed since the war started and Ethiopia’s government isolated the Tigray region from the rest of the world, severing basic services such as electricity, phone, internet and banking. While United Nations-backed investigators last month said all sides including the Tigray forces have committed abuses, they said the Ethiopian government is using “starvation of civilians” as a weapon of war.

The problem is that pregnant women and young children, least to blame for the fighting, are among the most vulnerable. The new study was conducted in May and June by local health authorities with financial support from two UN agencies and studied more than 189,000 households in six of the region’s seven zones via cluster sampling. With limited fuel for transport, researchers at times walked for hours to reach rural areas. Maternal mortality was at 840 deaths per 100,000 live births, up from a low of 186 before the war, with obstetric haemorrhage and hypertension the most common causes.

More than 80% of mothers died outside a health facility, another stark contrast, the study says. More than 90% of mothers in Tigray before the war had prenatal care and more than 70% benefited from skilled delivery, according to an analysis.

The increase in maternal mortality in Tigray has been “phenomenal,” the UN Population Fund said this year.

Neonatal mortality, or children dying in the first 28 days of life, was at 36 in 1,000 live births, the new study says. That’s a four-fold increase from pre-war levels, and more than half of the deaths occurred at home without medical intervention. The most common causes were prematurity, infections and perinatal asphyxia, or the inability to establish breathing at birth.

Under-5 mortality was 59 in 1,000 live births, double the rate before the war. In one photograph from Tigray’s flagship hospital in the capital, Mekele, a health worker pinches the thin stomach of a small child, 2-year-old Selam Mulu. The skin stays pinched after the hand is removed, a sign of dehydration in malnutrition. The study calls for more medical supplies including painkillers, antibiotics, anticonvulsants, vaccines, IV fluid and drugs to induce labour after foetal death.

“For women here, it’s hell,” a gynaecologist in Mekele said. “If she’s in labour and if she lives in the mountains, which is the case for most pregnant mothers in the outskirts, they cannot travel. They cannot call an ambulance. There is no money to pay for private transportation. Even if they arrive at a health facility, there is nothing.”

The war has claimed thousands of lives. Exact figures are yet to be determined. The conflict has also destroyed Tigray’s once well-funded health system. The international community should step forward to stem the damage and prevent further suffering. A newborn is universally called a bundle of joy but happiness has completely eluded the women of this conflict zone. Women are a key pillar of society and addressing basic health issues is key to their welfare and existence. Those involved in the conflict should realise this before any more babies, or women, breathe their last.