Women and children in Tigray are still subject to sexual violence despite a peace agreement signed in November 2022, according to a new report. Survivors accuse both Ethiopian and Eritrean soldiers of rape.
"The situation that Tigrayan women are experiencing through sexual violence is deeply distressing," social worker Birhan Gebrekirstos told DW.
Her quiet voice sounded muffled as she talked about her experience of working with survivors of sexual violence in Mekelle, the capital of the northern Ethiopian region of Tigray, over the past three years.
Many women and girls were raped during and also after the two-year civil war in Tigray.
A new report by Physicians for Human Rights (PHR) and the Organization for Justice and Accountability in the Horn of Africa (OJAH), two human rights organizations both based in the US, states that rape continues to be deployed as a weapon of war despite a peace agreement signed by the Ethiopian government and the Tigray People's Liberation Front in November 2022.
The findings are based on data from 304 randomly selected medical records on conflict-related sexual violence from multiple health facilities in Tigray.
According to the authors, it is the first time conflict-related sexual violence has been documented based on medical records.
Severely traumatized women
The 304 cases are thought to represent only a small percentage of the actual number of incidents of sexual violence in Tigray, as those involving male victims and other groups are probably underreported.
Furthermore, 120 of the incidents occurred after November 2022, when the peace agreement was officially in force.
Gebrekirstos has set up her aid organization in Mekelle, Wegahta. She said that many of the women who were raped during the civil war had only just now been able to get to a clinic.
"The survivors are coming to the capital city to get medication after two or three years, and the hospital is very crowded. [...] so they are not getting enough medication, medical support," Gebrekirstos said.
Mekelle General Hospital was not involved in the study but its director Filimon Mesfin largely confirmed this account.
"We have accepted many cases of sexual violence," he said. "But they happened before the peace agreement; they didn't have access to health facilities, and so much has been done in recent months to raise awareness about sexual violence so as a result many victims are coming to the hospital now."
He also said that some women "have already given birth, some of them are pregnant and asking for an abortion, and some of them are already HIV-positive."
Stigmatization of rape victims
Sexual violence also has serious socioeconomic consequences, a "familial and economic trauma" for victims, according to Gebrekirstos, who published Tearing The Body, Breaking The Spirit, a book of survivor testimonies, earlier this year.
She told DW that the stigma of sexual violence had severe repercussions: "Awareness in the community is so slow and the community is not accepting the situation, helping the survivors in the right way, while the economic strains further exacerbate their vulnerability."
She added that giving birth to a child conceived as a result of rape compounded the trauma.
The two-year war in Tigray, which caused 600,000 deaths, is one of the deadliest conflicts in recent times.
While it officially ended with a peace agreement, the PHR and OJAH report found that it was highly probable that military forces thought to be linked to the Ethiopian and Eritrean governments had continued to commit serious human rights violations, including torture and rape.
Rape as a weapon
"We can't know for sure [that government-linked fighters are responsible] because we've reviewed the medical records but haven't interviewed the survivors themselves," said Ranit Mishori, a professor of family medicine at the Georgetown University School of Medicine in Washington, DC and a co-author of the report.
"[But] our research shows that Eritrean and Ethiopian armed forces and associated militias [such as the Amhara Fano group] appear to have perpetrated sexual violence on a widespread and systematic basis in Tigray, Ethiopia," he continued. "Tigrayan forces were also involved, albeit on a smaller scale."
According to the report, in over 75% of cases, several men were involved in the rape of one woman, leading the authors to conclude that sexual violence was premeditated and systematically used as a means of warfare.
"Our most important finding is that sexual violence in the context of this conflict is still ongoing," said Mishori. "The medical records we reviewed document serious short and long-term physical and psychological consequences, such as post-traumatic stress disorder, depression, and various types of injuries and disorders of the reproductive organs."
The United Nations and the African Union need to make more of an effort to hold perpetrators accountable -- even in an environment where the Ethiopian government is trying to prevent independent investigations, Mishori said.