Since the conflict in Ethiopia began in 2020, the Tigray region has seen horrific atrocities committed against civilians. Physicians for Human Rights (PHR) and others have documented egregious human rights violations, including attacks on health care and conflict-related sexual violence – abuses that did not stop even after the Cessation of Hostilities Agreement (CoHA) was signed in November 2022. In response to atrocities occurring largely in Tigray, the UN Human Rights Council (UN HRC) created the Independent Commission of Human Rights Experts on Ethiopia (ICHREE) in 2021.
Despite ICHREE’s critical work to independently document evidence of human rights violations in Ethiopia, Member States of the UN Human Rights Council bent to political pressure from Ethiopia and failed to renew the body’s mandate in 2023. They did so despite dire warnings from Ethiopian and international civil society groups including Health Professionals Network for Tigray (HPN4Tigray) and PHR, that the failure of the HRC to renew ICHREE’s mandate would prevent victims of human rights violations from any credible access to justice and could lead to further atrocities. Since that time, Tigray and many other regions of Ethiopia have faced an ongoing humanitarian and human rights crisis. Food shortages, inadequate medical supplies, and widespread insecurity have been compounded by the lack of comprehensive human rights monitoring, leaving little hope for justice or accountability
One year after the international community failed the people of Ethiopia, PHR spoke with a representative of HPN4Tigray, one of the leading organizations working to support survivors of traumatizing violence, including the thousands of people who have survived conflict-related sexual violence during the conflict.
Names have been withheld due to ongoing security risks faced by health professionals in Ethiopia and the diaspora.
PHR: What is happening now in Tigray? Give us a glimpse into daily life for communities who survived the conflict but continue to be impacted by this crisis.
HPN4Tigray: Life in Tigray remains incredibly difficult for communities that have endured years of conflict and are still dealing with its devastating aftermath. Despite the signing of the Cessation of Hostilities Agreement (CoHA), the region continues to struggle with widespread insecurity and a painfully slow recovery.
For survivors, daily life is a constant battle to access basic needs like food, clean water, and medical care. The destruction of infrastructure, including schools, health care facilities, and roads has made things even worse, cutting off many from essential services. Many families depend on the far too sporadic aid deliveries, and in addition, some roads are still unsafe or blocked, making this lifeline even more unreliable. Doctors in Tigray have told us of families who cannot afford health care are forced to take their children back home to die due to disease and malnutrition. Most schools, once a source of stability, are now either destroyed or serving as shelters for displaced families, leaving children without education or a safe space to heal.
“Fear and uncertainty dominate life, with many unsure of what tomorrow will bring. Even though the conflict has faded from global headlines, the people of Tigray are still living under its shadow.”
Over a third of Tigray remains occupied by non-Ethiopian National Defense forces from Eritrea and the Amhara region, and human rights abuses continue in these areas. Fear and uncertainty dominate life, with many unsure of what tomorrow will bring. Even though the conflict has faded from global headlines, the people of Tigray are still living under its shadow.
HPN4Tigray is one of the organizations working to support survivors of traumatizing violence, including the thousands of people who have survived conflict-related sexual violence during the conflict. What challenges do they face, and how is HPN4Tigray working to provide support?
In Tigray, survivors of conflict-related violence, including sexual violence, face serious challenges. With the widespread destruction of health care facilities and a shortage of mental health professionals, it is hard for survivors to get the medical and psychological support they need. In the Eastern zone of Tigray, I heard from our partners about survivors of conflict-related sexual violence traveling 12 hours to reach the nearest functioning clinic. By the time they arrive – often months after the incident – they are dealing with severe health issues like fistulas and HIV, showing how more accessible health care is direly needed.
Stigma is another huge barrier. Many survivors do not come forward because of the shame associated with sexual violence. Cultural barriers isolate them, and women who do speak out are sometimes rejected by their families or even divorced, adding to their trauma.
“I heard from our partners about survivors of conflict-related sexual violence traveling 12 hours to reach the nearest functioning clinic. By the time they arrive – often months after the incident – they are dealing with severe health issues like fistulas and HIV.”
Despite these challenges, HPN4Tigray is dedicated to helping survivors heal and rebuild their lives. We work with local partners to provide trauma-informed care, addressing immediate medical needs and long-term psychological recovery. We are also raising awareness about the difficulties survivors face and pushing for international action to ensure they get the services they need.
During the conflict in Tigray, health care was also targeted. How are health care workers there dealing with the aftermath of the violence, particularly now in the midst of the ongoing humanitarian crisis?
Health care workers in Tigray have been profoundly impacted by the conflict, both personally and professionally. The health care system in Tigray was intentionally attacked during the conflict, with the majority of health care facilities being destroyed, looted, and vandalized. Additionally, a “de facto humanitarian aid blockade” was imposed on Tigray, with aid and medical supplies being blocked from entering the region, in addition to little to no access to telecommunications, electricity, and banking services.
As a result, many health care professionals worked for several months without pay under dangerous and traumatic conditions. Often, they lost patients who could have been saved with proper supplies. Now, as they try to rebuild amid an ongoing humanitarian crisis, they face the daunting task of providing care with extremely limited resources.
Many health care facilities still remain damaged and under-resourced, with critical shortages of medications and supplies, even for basic lab tests, which has led to the spread of preventable diseases. On top of this, health care workers are dealing with the psychological toll of the conflict, suffering from depression, burnout, and vicarious trauma. Some have lost colleagues, loved ones, and even their own homes. Despite these hardships, they continue to work long hours to treat patients suffering not just from war-related injuries, but also from the effects of malnutrition and disease. In the face of these overwhelming challenges, the resilience and dedication of these professionals stand out. They continue to provide life-saving care to their communities, even in the most difficult circumstances.
PHR has been proud to partner with HPN4Tigray. What in your view has been the most impactful part of the collaboration with PHR?
HPN4Tigray is deeply honored to partner with PHR. The most impactful aspect of our collaboration has been blending PHR’s expertise in documenting conflict-related sexual violence and other violations with HPN4Tigray’s commitment to providing survivors with comprehensive mental health and psychosocial support. This integrated approach not only shines a light on the atrocities but also ensures survivors get the care they need to heal. With our network of health care and mental health professionals in Ethiopia, along with our understanding of cultural context, we ensure all documentation protocols are culturally- and trauma-informed, as well as provide survivors access to essential referral networks. Our partnership has also been key in amplifying survivors’ voices, strengthening advocacy efforts, and pushing for stronger international action to address the ongoing crisis in Tigray.
It has been a year since the Human Rights Council effectively closed ICHREE, the one international mechanism set up to independently monitor the situation in Ethiopia. What is HPN4Tigray calling for now a year later related to ongoing humanitarian needs, as well as for justice and accountability?
HPN4Tigray was deeply disappointed by the disbandment of ICHREE. This closure undermined crucial efforts to address past and ongoing human rights violations in Ethiopia. On this one-year mark, we urge renewed international efforts to tackle the humanitarian crisis and ensure justice and accountability for the atrocities committed. We call on the international community to work with the Ethiopian government to secure unrestricted humanitarian access and ensure aid reaches all regions in need.
“We urge the global community to remain focused on Ethiopia and continue to advocate for sufficient funding for humanitarian needs, rebuilding efforts, and initiatives aimed at justice and accountability”.
Additionally, we advocate for international oversight of Ethiopia’s transitional justice process, ensuring that the voices of survivors are central to the implementation of the CoHA, including the safe return of internally displaced people. Ongoing monitoring and transparent reporting of humanitarian aid delivery and the CoHA’s implementation are essential, as is independent monitoring, investigation, and documentation of human rights violations across the country.
It is crucial that future efforts prioritize justice for survivors, address their immediate needs, and provide long-term support for their recovery. We urge the global community to remain focused on Ethiopia and continue to advocate for sufficient funding for humanitarian needs, rebuilding efforts, and initiatives aimed at justice and accountability.
Learn more about Health Professionals Network for Tigray
Photo (top): Dr. Genet attends to a mother and child in Yechila, Tigray, who are beneficiaries of the HPN4Tigray-RecTOR program in partnership with Ayder Comprehensive and Specialized Hospital. This initiative addresses rising maternal and child mortality rates by delivering essential obstetric, gynecologic, and pediatric care to Tigray’s most affected areas. Courtesy of HPN4Tigray.