Protect medical workers and patients; hold law enforcement accountable
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Ethiopian Security forces have committed widespread attacks amounting to war crimes against health workers, patients and health facilities in the Amhara region.
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Civilians are the main victims of the fighting between the Ethiopian army and the Amhara militia known as Fano, which began in August 2023.
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Ethiopia’s international partners should demand accountability and an end to attacks on health care, and should resume a more thorough review of the human rights situation in the country.
(Nairobi) – Ethiopian Security forces have committed widespread attacks amounting to war crimes against health workers, patients, and health facilities in the northwestern Amhara region, Human Rights Watch said in a report released today.
The 66-page report, “‘If the Soldier Dies, It’s Your Fault’: Attacks on Health Care in Ethiopia’s Amhara Conflict,” documents how Ethiopian federal forces and a government-affiliated militia have attacked medical workers, health facilities, and transportation in at least 13 towns since fighting between Ethiopian federal forces and the Amhara militia known as Fano began in August 2023. Ethiopia’s international partners should demand accountability and end attacks on health care and should resume increased scrutiny of the rights situation in the country.
“Ethiopian federal forces, operating with near impunity, are likely not distinguishing between civilian lives and attacks on medical facilities providing desperately needed care,” the spokesperson said. Laetitia Bader“Until the government feels compelled to hold abusive forces to account, such atrocities are likely to continue,” said Human Rights Watch’s deputy Africa director.
Between August 2023 and May 2024, Human Rights Watch remotely interviewed 58 victims and witnesses of abuse, as well as health professionals and aid workers. Human Rights Watch also reviewed satellite imagery and verified videos and photographs following a government drone strike on an ambulance in November.
Human Rights Watch found that Ethiopian forces endangered or disrupted the functioning of hospitals. Soldiers beat, arbitrarily arrested, and intimidated health workers providing care to the wounded and sick, including suspected Fano fighters. Soldiers also unlawfully attacked ambulances and medical transports, obstructed access to humanitarian aid, and denied the Amhara population their right to health.
In January, Ethiopian soldiers detained and interrogated a medical professional for several days at a military camp. “Colonel [interrogating me] “He called me ‘Fano’s doctor,'” he said. “He started asking me why I was treating the Fano. He said [the Fano] “They are not humans…they are monsters.”
Federal forces have obstructed access to medical facilities, including by wrongly arresting patients based solely on suspicion of affiliation with Fano, causing widespread fear among those who might seek or need treatment.
International humanitarian law, also known as the laws of war, prohibits attacks on civilians and civilian objects. In addition, it provides special protections for health facilities, health professionals, patients, and ambulances. Even in situations of armed conflict, international human rights law remains in force and imposes fundamental obligations on countries to maintain minimum essential levels of the right to health.
The fighting in Amhara has disrupted the flow of medical supplies, leading to acute and prolonged shortages of essential medicines in hospitals and health centres, affecting their ability to provide adequate care.
Doctors and health workers are working in difficult conditions. “We are short of oxygen and medicines, and with no electricity, we are struggling,” a doctor working at a hospital said in November 2023. “The blood bank has stopped collecting blood. (…) Yesterday, we had to tell the family of an expectant mother to come with 20 liters or whatever amount of fuel they could bring so we can operate on them using the generator.”
Doctors seeking to replenish hospitals with depleted supplies have drawn suspicion from government forces and, in some cases, been attacked, affecting their ability to provide patient care in a safe environment. On November 30, a drone strike on a clearly marked ambulance in the town of Wegel Tena killed at least four civilians, seriously injured another, and destroyed much-needed medical supplies. “Psychologically, hospital staff are disturbed and live in fear of another attack,” one doctor said. “All the medicines in the ambulance burned. We had used the little budget we had left to buy the medicines.”
Humanitarian organizations working to fill shortages of medical supplies and equipment have also faced an increasingly challenging operating environment since August 2023. Their work has been affected by ongoing fighting, attacks on aid workers, frequent changes in control of cities, and restrictions on movement, including difficulty traveling to areas controlled by Fano. Nine aid workers have been killed in Amhara since the fighting began, including at least four since January.
In March, Amhara regional health officials acknowledged that the ongoing conflict in the region between government forces and Fano militias had caused significant damage to the health system, although they claimed that “extremist forces” had looted 967 facilities and seized 124 ambulances.
In June, Human Rights Watch wrote to Ethiopian authorities to share the organization’s findings. The Ethiopian government did not respond.
Since the United Nations Human Rights Council failed Although the UN decided to renew the investigation into Ethiopia in October 2023, international monitoring of the human rights situation in the country has been limited. Independent journalists have also had little access to the Amhara region. As part of its global mandate, the Office of the United Nations High Commissioner for Human Rights has published a report on the human rights situation in Ethiopia. report On 14 June, the Secretary-General delivered his position on the human rights situation in Ethiopia, saying that Ethiopian federal forces and the Fano militia had been involved in numerous violations of international humanitarian law, resulting in more than 2,000 civilian casualties in the Amhara region.
The Ethiopian government must immediately end attacks on health workers, patients, health facilities, and transportation in the Amhara region. Ethiopian authorities must also work to strengthen the country’s legal framework to protect health care by adopting specific legislation that protects health workers, health professionals, and health facilities.
International donors have acted to rehabilitate damaged health facilities in Amhara and other conflict-affected areas, but the governments concerned have not publicly condemned attacks by Ethiopian federal forces or urged the government to hold those responsible for the abuses accountable, Human Rights Watch said.
Ethiopia’s international partners, including the African Union and the European Union, should press for renewed international monitoring of Ethiopia’s human rights situation in multilateral forums. They should also increase their support for health services in the Amhara region, ensure rigorous independent monitoring of human rights under their agreements with the Ethiopian government, and publicly denounce restrictions on aid and attacks on humanitarian workers.
“Foreign governments and international organizations have sought to return to normalcy with the Ethiopian government despite the lack of normalcy on the ground,” Bader said. “The ongoing civilian suffering caused by the conflict in Amhara means that much greater international oversight is needed in Ethiopia.”
© 2024 Human Rights Watch
