NEW YORK — As the risk of renewed armed conflict in Ethiopia’s Tigray region grows and conflicts in the Amhara and Afar regions continue, all armed forces must cease the deliberate attacks on hospitals and health workers that have nearly collapsed the health system, Physicians for Human Rights (PHR) and the Organization for Justice and Accountability in the Horn of Africa (OJAH) urged in a new research brief released today.
Stolen, Broken, Destroyed: How Impunity Has Fueled Ongoing Attacks on Health Care in Ethiopia documents assaults on health care through 2026 in Tigray, Amhara, and Afar regions, continuing a pattern of attacks first documented in large numbers during the Tigray conflict from November 2020 to November 2022 that have been carried out with impunity. Multiple armed actors have been involved, including the Ethiopian National Defense Forces, Eritrean Defense Forces, the Tigray People’s Liberation Front, and Amhara Fano, as well as regional police and paramilitary forces.
“Every time a hospital is looted or a health worker killed for doing their job, it’s not an isolated event but part of a playbook that has been used across Ethiopia for more than five years without consequence,” said Lindsey Green, deputy director of research at Physicians for Human Rights and the research brief’s coauthor.
“Civilians experienced widespread, systematic attacks during the Tigray conflict, including conflict-related sexual and reproductive violence and attacks on health care. If perpetrators had faced accountability for these violations, this cycle might have ended. Instead, the Ethiopian government and armed groups have been emboldened by ongoing, widespread impunity. We are now seeing a resurgence of these patterns of violence in other regions against the backdrop of escalating tensions across the country, including worrying reports of renewed clashes between regional armed groups and the Ethiopian army in Tigray this month,” Green added.
The research brief draws on quantitative and qualitative data collected by PHR and OJAH across the regions of Afar, Amhara, and Tigray, including a survey of 602 health care workers; interviews and focus group discussions with more than 40 key informants conducted from July to September 2024; and ongoing monitoring data gathered by OJAH in 2025 and 2026.
- 63.5 percent of health care workers reported attacks on ambulances
- 61.1 percent reported theft or looting at their facilities
- 57 percent reported an armed takeover of their health facility
- 45 percent reported that colleagues had been targeted
- 28 percent reported being personally targeted or experiencing violence because of their role
OJAH has continued to document attacks on health care in the Amhara region in 2026, including drone attacks by the Ethiopian National Defense Forces that destroyed health care facilities and ambulances, and abduction and killing of health care workers. In July 2026, there were credible reports of the arrest of health care workers in Tigray under a new regional proclamation punishing alleged dissent.
“International law protects health care facilities and medical personnel. This report documents evidence of past and ongoing violations of these protections. Accountability is essential to disrupt the patterns of violence we have documented, and that accountability starts with independent, impartial investigation,” said Green.
Neither the Ethiopian government nor the international community has prioritized investigation and justice. Transitional justice in Ethiopia has failed to address these harms. The United Nations Human Rights Council allowed the only investigative mechanism on Ethiopia to lapse in 2023, and the Office of the High Commissioner for Human Rights has not released a report on Ethiopia since 2024. Further, the World Health Organization does not currently include Ethiopia in its public global surveillance system for attacks on health care.
This brief outlines how the sudden loss of $380 million in foreign assistance in 2025 compounded the crisis, disrupting medical supplies and services, ending critical health support for survivors of conflict-related sexual violence, putting food and cash transfer programs at risk of running out of funding, increasing malnutrition, and leaving health facilities unable to rebuild after attacks.
“The pain, suffering, and brutality people have continued to endure for years is devastating. Every time they begin to recover even slightly, new violence erupts, while support to treat urgent needs, let alone provide the dignity and tailored care every individual deserves, is disappearing. Medical professionals are working in fear of the strain of intensifying conflict that would bring, stockpiling resources and bracing for the worst,” said a senior OJAH official.
“We’ve seen this happen too many times before: as violence escalates, civilians are the first to suffer. Reports from the past week alone show violence intensifying in Western Tigray, with hundreds of civilians reportedly forced to flee into Sudan. Communities are living in fear, uncertain whether the fragile calm will hold from one day to the next. Meanwhile, without a functioning health system capable of responding to patients’ needs, the harm compounds and injuries go untreated, deaths increase, disease spreads, and psychological wounds deepen.”
Tigray’s health system, once considered a model for the region, is now approaching a fresh crisis. In March 2026, the Tigray Regional Health Bureau issued an urgent appeal warning of potential operational collapse, citing chronic shortages of medicines, supplies, and fuel, as well as health workers who have gone without salary since the start of the year. The ongoing conflict in the Amhara region continues to constrain community access to essential health care.
Ethiopia’s health system, still recovering after more than five years of conflict, is unprepared for the surge in need that further escalation would bring. PHR and OJAH are calling on the Ethiopian government and the international community, including the African Union and the United Nations, to ensure protection of health facilities and health care workers, document and investigate attacks on health care, hold perpetrators accountable, deliver justice to survivors, and restore critical health funding before conditions deteriorate further.
NOTES TO THE EDITOR:
Physicians for Human Rights and the Organization for Justice and Accountability in the Horn of Africa (OJAH) reached out to the Ethiopian government concerning the findings of this report and had not received a response at the time of publication.
For Further Information See:
- “‘You Will Never Be Able to Give Birth’: Conflict-Related Sexual and Reproductive Violence in Ethiopia,” PHR/OJAH report, July 2025
- “U.S. Aid Freeze Unleashes Devastating Health Crisis in Ethiopia: New PHR Research“, press release, June 2025
- “Broken Promises: Conflict-Related Sexual Violence Before and After the Cessation of Hostilities Agreement in Tigray, Ethiopia,” PHR/OJAH report, August 2023
Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.