The United Nations says Ethiopia’s embattled Tigray region faces a “very critical malnutrition situation” as vast rural areas where many people fled during three months of fighting remain out of reach of aid. The UN humanitarian agency also said in a new report that Ethiopian defence forces continue to occupy a hospital in the town of Abi Adi, “preventing up to 500,000 people from accessing health services” in a region where the health system has largely collapsed under looting and artillery fire. Alarm is growing over the fate of the Tigray region’s roughly six million people as fighting is reportedly as fierce as ever between Ethiopian and allied forces and those supporting the now-fugitive Tigray leaders who once dominated Ethiopia’s government. “The needs are tremendous, but we cannot pretend that we do not see or hear what is unfolding,” Ethiopian President Sahle-Work Zewde said in a statement on Friday after visiting the Tigray capital, Mekele. In one of the frankest public comments yet by Ethiopia’s government, she noted “significant delays that remain in reaching people in need.” Ethiopia on Friday said humanitarian aid has reached 2.7 million people in Tigray. But the UN report calls the current response “drastically inadequate,” even as some progress is made. With some 80 per cent of the population still unreachable, according to the Ethiopian Red Cross earlier this month, fears are growing that more people are starving to death. “Next few weeks decisive to prevent famines,” Germany’s Foreign Office said in a brief statement last week after hearing accounts of a European Union envoy’s visit to Ethiopia. The new UN report released Friday says even in areas that can be reached, a screening of 227 children under the age of five showed “staggeringly high malnutrition,” though it did not mention the number of cases. It also says a screening of more than 3,500 children found 109 with severe acute malnutrition. The World Health Organization describes that condition as “when a person is extremely thin and at risk of dying.” “Malnutrition (in Tigray) is expected to deteriorate as households are limited to fewer meals every day,” the UN report says. The Tigray conflict began at a vulnerable time, just before the harvest and after months of a regional locust outbreak. The majority of the population is subsistence farmers. The UN report cites “bureaucratic obstacles” and the presence of “various armed actors” as complications in the delivery of aid. Humanitarian workers have described trying to navigate a patchwork of authorities that include ones from the neighbouring Amhara region who have settled in some Tigray communities, as well as soldiers from neighbouring Eritrea whom witnesses have accused of widespread looting and burning of crops. Ethiopia’s government denies the presence of Eritrean soldiers, though the Tigray region’s interim government has confirmed it and accused them of looting food aid, according to a recent Voice of America interview. The UN report describes a “dire” situation in which “Covid-19 services have stopped” in the Tigray region, displaced people in some cases are sleeping 30 to a single classroom and host communities are under “incredible strain.”