A panel of medical and humanitarian aid workers discussed their experiences working in Ethiopia during a major civil conflict and humanitarian crisis at the Elliott School of International Affairs on Monday.
The four panelists discussed their experiences working on the front lines of medical clinics and refugee camps during the Tigray conflict, a three-year civil war in northern Ethiopia marked by ethnic and sexual violence, severe humanitarian crises and the displacement of millions. The Elliott school’s Humanitarian Action Initiative, Institute for African Studies and Gender Equality Initiative in International Affairs co-hosted the event, moderated by Eden Hailu, the program coordinator for the humanitarian action and gender equality initiatives.
The Tigray conflict, which lasted from November 2020 to 2022, was a violent clash between the Tigray People’s Liberation Front, a paramilitary group and former ruling party of Ethiopia, and the Ethiopian federal government. The conflict started as political and ethnic tensions escalated between the two groups in the Tigray region, leading to violence against civilians, mass displacement, famine and allegations of war crimes from multiple parties.
The conflict left over 70 percent of health facilities in Tigray looted, damaged or destroyed, leaving millions without access to basic medical care, according to the medical charity Doctors Without Borders.
Biserat Gebremedhin, a surgeon who provided health care support in aid camps on the Eritrean and Sudanese borders of Ethiopia, said when the conflict began, aid workers initially treated soldiers from both sides but soon had to prioritize civilians as injuries and deaths began to pile up. He said aid workers struggled to treat the growing number of patients because they had few medical supplies due to low funding from aid organizations and difficulty resupplying.
“There were people laying in front of us and there was nothing we could do to help them,” Gebremedhin said.
Death toll estimates from the conflict vary, but it may have killed up to 378,000 people due to direct violence, starvation and a lack of medical care, according to the U.S think tank New Lines Institute.
Gebremedhin said humanitarian aid in the Tigray region for those affected by the war’s aftermath was severely impacted by President Donald Trump’s executive order freezing all aid provided by the U.S. Agency for International Development in January and subsequent dissolution of the agency in March. He said “most of the time” health care services in regions like Tigray were supported by USAID and other international aid agencies, causing them to fail without U.S. support.
“We have lost a lot of lives because of this condition,” Gebremedhin said. “And following the suspension of USAID, this is worsening.”
Kahsa Hagos, a nurse and the coordinator of the Adigrat One-Stop Center, a network of safe houses in the Tigray Region for victims and survivors of “conflict-related sexual violence,” said she saw many cases where women and girls would come to her clinic with “enforced pregnancy” and various foreign objects, like stones, plastics bags and hair, forced inside of them.
Hagos, speaking through a translator, said the clinic had no access to medication for abortions, so they had to be performed surgically, and had to prescribe patients other medicines, like for pain management, that were up to six months expired.
“Every day they would get an average of 15 to 20 women coming to the center,” Hagos’ translator said. “She said they would come only with extreme complications, having had fistula or unwanted pregnancies or having been raped for the third or fourth time.”
Rita Kahsay, a human rights advocate and researcher who documented sexual violence during the Tigray conflict, said it erupted amidst the 2020 U.S. presidential election, diverting global attention from Ethiopia. She said Ethiopian Prime Minister Abiy Ahmed Ali enforced a 730-day internet and phone blackout to block information from leaving the region, limiting the ability of humanitarian organizations to communicate.
“There was no information coming out, people could not go in. Investigations could not meaningfully be done,” Kahsay said.
She added that universities like GW should support research efforts in countries like Ethiopia through funding and personnel to help better understand the region’s challenges and create more effective plans of action for future humanitarian aid.
“I think that’s the best thing that we could do in terms of advocacy,” Kahsay said. “Identifying these numbers and knowing what their problems are would help the rest of us effectively intervene.”
Dawit Kassa, the co-founder and director of Extending Access and Systems Enhancement, or EASE, an organization established to improve access to medical and humanitarian resources for hard-to-reach populations in Tigray, said he faced “a lot of challenges” while working at aid camps in Sudan and Tigray, especially a lack of medical supplies and staff.
“Providing service in that context was extremely confusing and very difficult to manage,” Kassa said. “It raised a lot of like moral questions, like times we were washing surgical gloves to still reuse them, so it was like a big moral dilemma and ethical considerations.”
He said with minimal supplies and few resources aid workers like himself relied on a community of other professionals and volunteers to provide at least a “minimum standard of service” to patients while working in Ethiopia.
“The community gives you hope, the community gives you energy, the community supports each other,” Kassa said. “You get your energy from your community, and that’s what keeps us going.”
Kassa said the cuts to USAID have caused aid organizations in Tigray to lose almost all support. He said before the U.S.’s cuts to foreign aid, four nonprofit organizations were providing medical care in the region, but since the cuts, “none of them exist.”
“The water services almost doesn’t exist now, the protection doesn’t exist, the food support doesn’t exist,” Kassa said.
Megan Churchill contributed reporting.
