Nagorno Karabakh, where 120,000 Armenian Christians live in their ancient homeland, has been under siege by Azerbaijan for 221 days. In the last few weeks, the situation has deteriorated dramatically. CSI spoke to Vardan Tadevosyan, our principal partner in the besieged region, to find out about conditions on the ground.
For the very sick in besieged Nagorno Karabakh, a Red Cross truck is the only way to leave to seek treatment in neighboring Armenia. (Photo credit: Artsakh Human Rights Ombudsman)
“Last Friday, we had planned to send a sick mother in a Red Cross van to Yerevan for treatment. Her husband planned to go with her, and to take their two young children along. At the last second, the Azerbaijanis told them they couldn’t take their kids along, and they decided they couldn’t leave their kids. We lost four seats in that van.”
Vardan Tadevosyan is the director of the Lady Cox Rehabilitation Centre, and CSI’s main partner in Nagorno Karabakh, where 120,000 Armenian Christians have been under siege by Azerbaijan for the last eight months. On December 12, Azerbaijan blocked the Lachin Corridor, the only road that connects Nagorno Karabakh to the outside world.
Since the siege began, the only way for sick Armenians to leave the region for medical treatment has been in vans operated by the International Committee of the Red Cross (ICRC), which is allowed to make occasional visits to the territory. But there are limited places available in these vans.
Vardan was recently appointed Minister of Health in Nagorno Karabakh (also called Artsakh). That means he is responsible for putting sick people on the ICRC list to be taken to Yerevan, the capital of Armenia, for treatment.
But Azerbaijan has the final say on who can leave the territory. Until recently, patients who go to Armenia for treatment could take along a caregiver – a spouse, for example – and their children under five, so that they could continue to take care of them.
Under the blockade, leaving Nagorno Karabakh is always a risk for Armenians – there is no guarantee that Azerbaijan will let them back in.
On July 14, Azerbaijan changed the “rules.” Now, no patients can take along their children, no matter what their age. Vardan says, “I asked the head of the Red Cross delegation, ‘What about mothers who are still nursing their babies? Can they take their babies along?’ He said no, and simply explained, ‘Believe me, I am not the decision-maker.’”
And those people who are allowed to go for treatment face other forms of harassment. Recently, Vardan said, Azerbaijan put its own team of doctors at the checkpoint, and demanded that they be allowed to examine the patients to make sure they are “really sick.” Sometimes, the Azerbaijanis make videos of the sick people at the checkpoint, and put them on social media.
“At one point, they demanded the complete medical histories of all the patients who go,” Vardan says. “I refused. It’s against all medical ethics – it wouldn’t be allowed anywhere. In the end, they dropped it.”
Azerbaijan launched a war of conquest and ethnic cleansing against the Armenians of Nagorno Karabakh in September 2020. 44 days later, Russia forced a ceasefire on Azerbaijan, and since then, a small group of Russian peacekeepers has been responsible for security in the region. But the Russians, distracted by the war in Ukraine, have not acted to stop the blockade.
For most of the siege, the Armenians of Nagorno Karabakh have relied on small deliveries of food, fuel and medicine from the Red Cross and Russian peacekeepers to survive. But on June 15, Azerbaijan stopped the Russians from using the Lachin Corridor. In July, Azerbaijan sharply curtailed the Red Cross’ access, accusing them of “smuggling.”
The Russians now bring in their own supplies to their base by helicopter. “But,” Vardan says, “these supplies are only for them, not for us. No humanitarian aid is coming in – no medicine, no food, no fuel, nothing.”
Without any supplies from the outside world, the situation in Nagorno Karabakh has become truly dire. “The price of eggs has tripled,” Vardan says. “The price of tomatoes is ten times higher than before. The price of apples is 30 times higher.” Last week, CSI spoke to a former government minister in Nagorno Karabakh who had go to the bakery at 2 am, just to get two loaves of bread.
This week, authorities in Nagorno Karabakh announced that the miscarriage rate for expecting mothers had tripled during the blockade.
The streets of Stepanakert, the capital city, are almost completely deserted now, because there is no gasoline for cars. Only emergency vehicles and a handful of buses are still running. “Farmers cannot bring their food to Stepanakert, because there is no petrol,” Vardan says.
Nagorno Karabakh’s health ministry is operating on 30% of the fuel it normally uses. Most of this fuel is used to power generators that provide electricity to hospitals. Vardan fears that if the fuel runs out, much of the ministry’s equipment will be ruined. Specialized equipment like MRI machines requires a constant electricity source, or they will break down.
“There are hundreds of people who cannot get the surgeries they need, because we have no medicine,” Vardan says. “Eventually, they will be so sick that they will have to be put on the Red Cross list to be taken to Armenia.”
Even under these extreme circumstances, Vardan continues his work at the CSI-sponsored Rehabilitation Centre. During the day, he works as Health Minister, and in the evening, he goes to the Rehabilitation Centre to solve problems with his staff. They have managed to keep hydrotherapy sessions for their patients going, by redesigning their heating system to run on diesel. They have enough diesel stocked to last for several months more. They have also renovated some of their bathrooms, to make them more accessible to people in wheelchairs.
Still, the outlook is grim. “People are going to start dying soon,” Vardan says. And the population lives with the knowledge that an Azerbaijani attack may come at any time.
Christian Solidarity International has issued a Genocide Warning for Armenian Christians in the region. CSI calls on the U.S., UK, and EU, to pressure their ally Azerbaijan to end the blockade, provide humanitarian aid to Nagorno Karabakh, and recognize the right of self-determination of the people of Nagorno Karabakh, as affirmed in the 2007 OSCE Minsk Group’s Basic Principles.