Mary Grigoryan’s day starts when the electricity is switched on, so she can heat up sugarless tea for her children’s breakfast.
Energy use in the disputed territory of Nagorno-Karabakh, which has been at the centre of a brutal tug of war between Azerbaijan and Armenia for decades, is strictly rationed, and each neighbourhood receives power according to a rota. One day it might switch on at 7am; another day it might start at 9am or 11am. The gas supply was cut months ago.
After work as a paediatric surgeon at the under-resourced and understaffed local hospital, Grigoryan searches for food on her four-kilometre walk home. The lack of fuel means there is no public transport.
Dinner usually consists of one loaf of bread after waiting hours in the queue at bakeries, sometimes even coming away empty handed. Other times, it may be an overpriced kilogramme of potatoes, tomatoes, or parts of a watermelon – if Grigoryan is lucky – to share between herself, her two children and her husband.
“Sometimes I think I’m a bad parent because I haven’t stocked up on essential products, but we also try not to fixate on it,” Grigoryan, 42, told openDemocracy. “I hold explanatory conversations with [my children], explaining that we suffer all these deprivations for the right to live in our homeland.”
According to the office of Armenia’s human rights defender, there are tens of thousands of mothers living in Nagorno-Karabakh under Azerbaijan’s eight-month blockade struggling to feed and care for their children and family, let alone themselves.
Since 12 December 2022, Azerbaijan has been blocking the Lachin corridor – the sole road left connecting ethnic Armenian residents in Nagorno-Karabakh to Armenia and the rest of the world. A trilateral agreement between Moscow, Baku, and Yerevan in November 2020 stipulates that the 5km corridor should be under the control of Russian peacekeeping forces.
Azerbaijan defeated Armenia in the Second Karabakh war in 2020, and the status of Armenians living in Nagorno-Karabakh – whose borders are internationally recognised as part of Azerbaijan – was left unresolved in the Russia-brokered statement.
The crisis under the blockade escalated when the International Committee of the Red Cross (ICRC) – the only humanitarian aid organisation in the region – said Azerbaijani authorities had stopped it transporting food and medicine through the Lachin corridor or other routes where Russian peacekeepers had been deployed. Edem Wosornu, the UN humanitarian coordinator, confirmed the claim at an emergency United Nations Security Council (UNSC) meeting requested by Armenia on 16 August.
“Baby formula is even more important than medicine”— Vardan Tadevosyan, health minister of Artsakh (Nagorno-Karabakh)
Problems for the medical sphere
Although the ICRC said it was continuing to evacuate patients from Nagorno-Karabakh to Armenia for treatment, “several” dialysis patients are reportedly afraid to leave their homes after Azerbaijani authorities arrested a 68-year-old ICRC patient and evacuee on 29 July, Nagorno-Karabakh’s de facto health minister Vardan Tadevosyan told openDemocracy.
“All medical institutions are experiencing drug insufficiency, estimated at lower than 50%,” the office of the Artsakh/Nagorno-Karabakh human rights ombudsman said in a tweet on 18 August. “If this situation continues, the public health of Artsakh [the Armenian name for Nagorno-Karabakh] will experience a major collapse.”
The scarcity of fuel also poses serious problems for the medical sphere, Tadevosyan said: hospitals rely on diesel to run generators during power outages, and there are fewer ambulances available. The office of Armenia’s human rights defender said in a statement last week that a pregnant woman had suffered a miscarriage after there were no ambulances available to take her to hospital. The day before, a 40-year-old man in Stepanakert, the city capital, died as a result of “chronic malnutrition, protein, and energy deficiency”, the statement continued.
Additionally, Azerbaijani border control authorities have been blocking 19 trucks sent by Armenia containing more than 350 tonnes of food, medicine, hygiene products and other essential items since 26 July, according to the Armenian deputy foreign minister.
During the UN Security Council meeting last week, Armenia’s UN representative cited an expert opinion by the former chief prosecutor of the International Criminal Court, saying “there is a reasonable basis to believe that a genocide is being committed” as a result of the blockade.
Azerbaijan’s representative responded by “categorically rejecting all the unfounded and groundless allegations [of a] blockade or humanitarian crisis propagated by Armenia against my country”. Baku’s ambassador, Yashhar Aliyev, accused Armenia of engaging in a “provocative and irresponsible political campaign” to undermine Azerbaijan’s sovereignty and territorial integrity.
Meanwhile the Lachin corridor, despite international pressure and a binding order in February by the International Court of Justice to open it, remains closed.
“My unborn child is a victim of these harsh conditions of siege”— Ruzanna*, mother in blockaded Nagorno-Karabakh
Lack of baby formula and care for children
Gayane Aydinyan, a 39-year-old school teacher and mother to triplets born during the eight-month blockade, is haunted by the fear that baby formula and diapers may become impossible to find.
“I can’t sleep,” she told openDemocracy. “I live with those thoughts 24 hours a day. What will we do if their formula runs out? We can’t feed them with anything else.”
Baby formula is in high demand and scarce, according to Tadevosyan, the health minister.
“[Formula] is even more important than medicine,” he said. “We are engaged in daily negotiations and continuous efforts to acquire these supplies.”
In hospitals, all surgery has stopped except life-saving operations, Tadevosyan added. And there are dire shortages of painkillers, blood pressure medication and cardiovascular drugs.
“One of the paediatric problems is the shortage of vaccines,” said Grigoryan, the paedriatric surgeon. “We are prescribing drugs that cannot be found in the hospitals.” The lack of insulin is also a major concern for child and adult patients with diabetes, said Tadevosyan, who fears children may face “significant health issues”.
As for Aydinyan’s two other children, aged 10 and 13, classes are about to start in September, despite the shortages of food, gas, and electricity.
“It’s difficult to find stationery and clothes for them,” said the history teacher, adding that sometimes she feels upset that she can’t focus on her older children as much.
“We try to be satisfied with what we have,” she said. “I don’t even think about the wishes of my older children. They help me a lot in taking care of the little ones.”
Miscarriages
The eight-month blockade has increased levels of stress and malnutrition, leading to anaemia in more than 90% of pregnant women and a tripling of miscarriage rates, according to a statement by the Artsakh ministry of health.
Ruzanna* suffered her own miscarriage in July, seven months into the blockade. “My unborn child is a victim of these harsh conditions of siege,” she said.
She suspects the pains in her legs since her miscarriage are also linked to malnutrition and to her constant walking and standing in long lines for groceries.
Meanwhile, Ruzanna’s husband is in need of open heart surgery, but refuses to be evacuated by the ICRC. And her 15-year-old daughter hasn’t had a period in three months. Even if her menstrual cycle were to restart, there are no sanitary products available in pharmacies — people have resorted to using ripped pieces of cloth or stockings instead.
But the only place any of them could be fully examined and treated is in Yerevan – and they fear leaving their home in case they are unable to return.
“Every day it becomes increasingly challenging,” Ruzanna said. “The foremost concern is the question of security and survival.”
Editor’s note: Siranush Sargsyan reported from her home in Stepanakert, Nagorno-Karabakh under the blockade. * Names have been changed for security reasons
Lucy Martirosyan
Siranush Sargsyan
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