GENEVA - The World Health Organization warns that millions of people in conflict-ridden Tigray in northern Ethiopia lack access to basic health care and risk falling ill. The agency has been able to reach only a fraction of them.

According to the WHO, about 3.8 million people in Tigray need health assistance. The agency wants to scale up its health services to assist at least 2.3 million this year but only 87,000 have been reached since May 1.

WHO spokeswoman Fadela Chaib says lack of cash and fuel, limited access, insecurity, and depleted medical stocks are some of the many obstacles hampering WHO's life-saving operation.

"What we are most concerned with is the fact that it is the season for cholera and cholera is a problem in the region," said Chaib. "Measles, malaria, providing health care for people who are injured from the current conflict, and also people who need help. For example, pregnant women, lactating women, children with vaccination. All are very urgent needs."

A couple of months ago, a first round of an oral cholera vaccination campaign reached more than two million people out of the four million targeted. Chaib says holding a second round is key to reaching more at risk people.

Chaib, however, says the campaign cannot happen if the WHO is unable to get enough vaccine supplies and maintain a cold chain to store the doses. This, she notes, is difficult because access to electricity is often unavailable and fuel stocks are dwindling.

Chaib notes multiple cases of violence or threats of violence against aid workers are hampering efforts to take actions to respond to diseases of epidemic potential, including cholera, measles, malaria and COVID-19.

Another problem of deep concern is the rising level of severe acute malnutrition in the Tigray region. In the first two weeks of this month, Chaib says 458 severely acute malnourished children were admitted to stabilization centers for specialized care.

"When you get a severely malnourished child and he gets a disease like malaria and measles, it is really a death sentence for that child," said Chaib. "We have 92 stabilization centers previously in place, but we have only 23 that are operational. Now, 200 more would be needed to address the health risk of malnutrition."

More than nine months ago, Ethiopian government forces launched a military offensive to gain control of the Tigray region. After the government declared a unilateral cease-fire on May 8, Tigrayan rebels quickly retook the regional capital Mekelle, and fighting goes on.

Under these circumstances, WHO says restoring health services is extremely challenging. It says health facilities have been damaged, equipment looted and destroyed, and essential medicines are lacking.

Additionally, it says many health workers no longer are available because they are not being paid and face dangers from the prevailing chaotic conditions.