In times of war and conflict, women and girls often pay a heavy cost. It’s not just the ever-present threat of violence striking their communities, losing their homes, or struggling to find basic needs like food and water. The awful truth is that when war breaks out, women are often the targets of sexual and gender-based violence.
Since 2020, the Northern regions of Ethiopia have been engulfed in conflict. The civil war in Tigray and the surrounding regions has claimed the lives of more than one million people through a combination of violent confrontation and starvation. Over five million people have been forced to flee their homes. Women, girls, and children have endured the most suffering and the heaviest cost throughout the war.
It is not uncommon for military personnel to carry out systematic sexual and gender-based violence (SGBV) against women and children. People who have been displaced are particularly at risk. Nearly 30% of young women in Tigray have experienced sexual and gender-based violence.
The crisis in Tigray, which began in 2020, has severely disrupted healthcare services. There is a dire need for humanitarian intervention.
Because of the ongoing conflict, many areas are still inaccessible. Government facilities face severe shortages in resources, medical supplies and service providers.
The community also faces significant challenges related to trauma, with many individuals requiring mental health support and other services. Sexual and reproductive healthcare is particularly hard to come by. This has led to a rise in unintended pregnancies, unsafe abortions, and a dramatic increase in maternal mortality. Pregnancy-related deaths have quadrupled in the region according to recent data.
Meaza is a 19-year-old student enrolled in an Applied Biology course at Mekele University. When war broke out, she was prevented from finishing her education, and decided to stay with relatives in the small town of Zalanbesa.
During her journey to Zalanbesa, she was approached by two armed men who demanded sex. She tried to continue on her way, but the men hit her, raped her and left her to find her way to a camp for internally displaced persons, injured and terrified.
Meaza was uncertain about what to do. She didn’t know if she would become pregnant, or whether she would be exposed to HIV/AIDs or other sexually transmitted diseases. She understood very little about contraceptive methods and had never used one before.
In her own words, Meaza said, “I’ll relive this experience for the rest of my life. I have no idea how I’ll return to my regular life. I doubt I will.”
Meaza is currently living at one of the several IDP camps designated specifically for women and young girls who have experienced sexual abuse. Along with hundreds of other women, the girls are receiving assistance from MSI Ethiopia and other humanitarian partners, accessing reproductive health care and psychological therapy.
MSI Ethiopia provides contraception, family planning, safe abortions, and other associated services in addition to mental healthcare for women and girls impacted by the war. We adapted our service delivery to better reach displaced populations while supporting the public sector to rebuild and be able to provide such services.
Since March 2024, two mobile health teams have been operating exclusively in Tigray, delivering comprehensive family planning services. The teams also provide clinical services for survivors of SGBV and refer complex cases to nearby hospitals.
Community engagement is key to raise awareness about sexual and reproductive health services, so MSI’s outreach teams collaborate with health extension workers, community gatekeepers, and local leaders prior to visiting. This also includes working with schools, where gender officers and teachers support adolescents to make informed sexual health decisions.
Coordination and information sharing with other partners is also critical, facilitating shared resources like transportation, equipment, and service delivery spaces, while also integrating services such as vaccination and nutrition by aligning educational activities and setting up referral links. MSI Ethiopia has partnered with 26 public sector sites in the region, providing capacity-building support to providers through training, mentoring, and essential supplies.
The hours are long and the work is sobering, but the United Nations estimates that there are 6.4 million people across Ethiopia in need of care following sexual and gender-based violence. MSI will keep working to ensure women who have faced devastating sexual violence have the care that can start them on the road to rebuilding their lives.
