December 14, 2021 — An interior view of a hospital in the Amhara region, Ethiopia, captured by Minasse Wondimu Hailu from the Anadolu Agency, starkly reveals the grim reality faced by medical professionals and patients amidst ongoing conflict.
Ethiopian security forces have been accused of committing widespread attacks amounting to war crimes against medical professionals, patients, and healthcare facilities in the northwestern Amhara region. According to a report released by Human Rights Watch, civilians are bearing the brunt of the fighting between the Ethiopian military and the Amhara militia known as Fano, which erupted in August 2023.
Human Rights Watch’s report, titled “‘If the Soldier Dies, It’s On You’: Attacks on Medical Care in Ethiopia’s Amhara Conflict,” documents how Ethiopian federal forces and a government-affiliated militia have targeted medical workers, healthcare facilities, and transports in at least 13 towns. The 66-page report highlights the dire consequences of these attacks on the Amhara population, calling for immediate accountability and increased international scrutiny of the rights situation in Ethiopia.
Laetitia Bader, deputy Africa director at Human Rights Watch, emphasized the impunity with which Ethiopian federal forces are operating, resulting in disregard for civilian lives and attacks on medical facilities providing desperately needed care. “So long as the government feels no pressure to hold abusive forces to account, such atrocities are likely to continue,” Bader stated.
Between August 2023 and May 2024, Human Rights Watch remotely interviewed 58 victims and witnesses of abuses, as well as medical professionals and aid workers. They also reviewed satellite imagery and verified videos and photographs following a government drone strike on an ambulance in November.
The report details numerous incidents where Ethiopian forces disrupted the functioning of hospitals, beat and arbitrarily arrested medical professionals, and unlawfully attacked ambulances and medical transports. These actions have interfered with access to humanitarian assistance and denied the Amhara population their right to health.
One alarming case involved Ethiopian soldiers detaining and interrogating a medical professional in January. The interrogator accused the doctor of being a “Fano doctor” and questioned why treatment was provided to Fano fighters, whom he dehumanized as “monsters.”
Federal forces have also obstructed access to medical facilities, arresting patients on suspicion of Fano affiliation, creating widespread fear among those needing treatment. International humanitarian law prohibits such attacks on civilians and civilian objects and affords special protections to health facilities and medical professionals.
The ongoing conflict has severely disrupted medical supply delivery, leading to acute shortages of essential medicines in hospitals and health centers. Doctors and health staff have been working under dire conditions, with power outages and depleted supplies exacerbating the situation. For example, in November 2023, a doctor reported struggles with oxygen shortages and a non-functional blood bank, forcing families of patients to bring fuel for generators to perform surgeries.
In Wegel Tena town, a drone strike on a marked ambulance killed four civilians, wounded one, and destroyed crucial medical supplies. This incident has left hospital staff psychologically distressed and fearful of further attacks.
Humanitarian aid agencies have also faced significant challenges, including ongoing fighting, attacks on aid workers, and movement restrictions. Since the conflict began, nine aid workers have been killed in the Amhara region, including four since January.
In March, regional health officials acknowledged extensive damage to the healthcare system due to the conflict but attributed it to “extremist forces” allegedly pillaging facilities and seizing ambulances.
Despite these acknowledgments, the Ethiopian government has not responded to Human Rights Watch’s findings. Since the UN Human Rights Council failed to renew the UN-mandated inquiry on Ethiopia in October 2023, there has been limited international monitoring of the human rights situation in the country. Independent journalists have also struggled to access the Amhara region.
The Ethiopian government is urged to immediately end attacks on medical professionals, patients, health facilities, and transports. Strengthening the legal framework to protect healthcare workers and facilities is crucial.
International donors have acted to rehabilitate damaged health facilities, but more concerted efforts are needed. The African Union and the European Union should press for resumed international scrutiny of Ethiopia’s human rights situation and increase support for health services in Amhara. They should also ensure robust independent human rights monitoring in agreements with the Ethiopian government and publicly denounce restrictions on aid and attacks on aid workers.
“Foreign governments and international organizations have sought to return to ‘business as usual’ with the Ethiopian government despite the absence of normality on the ground,” Bader said. “Continued civilian suffering from the conflict in Amhara means much greater international scrutiny is needed in Ethiopia.”
