Protecting healthcare workers and patients and holding responsible forces accountable
-
Ethiopia Security forces carried out widespread attacks against health workers, patients, and facilities in Amhara Region that amounted to war crimes.
-
Civilians are bearing the brunt of the fighting that began in August 2023 between Ethiopian forces and Amhara militias known as Fano.
-
Ethiopia’s international partners should resume monitoring of the country’s human rights record, demanding accountability and an end to attacks on health care.
(Nairobi) – Ethiopia In a report released today, Human Rights Watch said security forces have carried out widespread attacks against health workers, patients, and facilities in the country’s northwestern Amhara region that amount to war crimes.
The 66-page report, “‘If a Soldier Dies, It’s Your Fault’: Attacks on Healthcare in Ethiopia’s Amhara Conflict,” details how Ethiopian federal forces and pro-government militias have attacked health workers, medical facilities, and transport in at least 13 towns since fighting erupted between Ethiopian federal forces and Amhara militias known as Fano in August 2023. Ethiopia’s international partners should demand accountability and an end to attacks on health care, and resume monitoring of the country’s human rights record.
“Ethiopian federal forces are operating with near impunity and showing a natural disregard for civilian lives by attacking medical facilities that are providing desperately needed medical care,” he said. Leticia Bader“Unless governments feel pressured to hold abusers accountable, these atrocities are likely to continue,” said Hussein Abu al-Hassan, deputy Africa director at Human Rights Watch.
Human Rights Watch conducted remote interviews with 58 victims and witnesses of abuse, medical workers, and aid workers between August 2023 and May 2024. It also reviewed satellite imagery, videos, and photographs of a suspected government drone attack 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 medical personnel who treated the wounded and sick, including alleged Fano fighters. Soldiers also unlawfully attacked ambulances and medical transports, obstructing humanitarian access and denying the Amhara people their right to health.
In January, Ethiopian troops detained and interrogated medical professionals at a military camp for several days. [interrogating me] “He called me ‘Dr. Fano,'” he said. “He started asking me why I was treating Fano. He said, [the Fano] They are not human… they are monsters.”
Federal forces have blocked access to medical facilities, including by arbitrarily arresting patients based on suspected ties to Fano, inflicting widespread fear on those seeking and needing treatment.
International humanitarian law, also known as the law of war, prohibits attacks on civilians and civilian facilities. In addition, special protections are given to medical facilities, medical personnel, patients and ambulances. Even during armed conflicts, international human rights law remains in force and includes a core obligation for states to maintain minimum essential levels of the right to health.
Fighting in Amhara Region has disrupted medical supply chains, causing severe and long-term shortages of essential medicines in hospitals and health centers, affecting their ability to provide adequate medical care.
Doctors and medical staff are working under dire and difficult conditions. “We are struggling because there is a shortage of oxygen, medicines and we have no electricity,” said one doctor working at the hospital in November 2023. “The blood bank has stopped taking blood. … Yesterday we had to tell a pregnant woman’s family to bring 20 liters or as much fuel as they could carry so we could perform the operation using a generator.”
Doctors trying to replenish depleted hospital supplies have drawn the suspicions of, and in some cases been attacked by, government forces, affecting their ability to treat patients in a safe environment. On November 30, a clearly marked ambulance was hit by a drone attack in the town of Wegel Tena, killing at least four civilians, seriously injuring one, and destroying much-needed medical supplies. “Hospital staff are mentally shaken and living in fear of new attacks,” said a doctor. “All the medicines in the ambulance were burned. We have used up what little budget we had left to procure medicines.”
Humanitarian organizations working to fill shortages of medical supplies and equipment have also faced an increasingly difficult operating environment since August 2023. Their operations have been affected by ongoing fighting, attacks on aid workers, frequent changes of control of towns, and movement restrictions, including difficulties traveling to Fano-controlled areas. Nine aid workers have been killed in Amhara Region since the fighting began, at least four of them since January.
In March, Amhara regional health officials acknowledged that ongoing fighting between government forces and Fano militias in the region was taking a toll on the health system, but claimed that “extremist forces” had looted 967 facilities and seized 124 ambulances.
Human Rights Watch sent a letter about its findings to Ethiopian authorities in June but has not received a response from the government.
Since the United Nations Human Rights Council We’re screwed While the United Nations is set to reopen its investigation into Ethiopia in October 2023, international scrutiny of the country’s human rights record has been limited. Independent journalists have had little access to Amhara. The Office of the United Nations High Commissioner for Human Rights, as part of its global mandate, report On June 14, the United Nations High Commissioner for Human Rights issued a statement on the human rights situation in Ethiopia, stating that Ethiopian federal forces and Fano militias have committed numerous violations of international humanitarian law, resulting in more than 2,000 civilian deaths and injuries in the Amhara region.
The Ethiopian government should immediately end attacks on health workers, patients, medical facilities, and transport in the Amhara region. Ethiopian authorities should also work to pass specific laws to protect health workers, health care personnel, and medical facilities and strengthen the country’s legal framework to protect health care.
While international donors are working to repair damaged health facilities in Amhara and other conflict-affected areas, governments have not publicly condemned the attacks by Ethiopian federal forces or called on the government to hold those responsible for abuses accountable, Human Rights Watch said.
Ethiopia’s international partners, particularly the African Union and European Union, should press for the resumption of international monitoring of Ethiopia’s human rights record in multilateral forums, increase support for health services in the Amhara region, ensure strong independent human rights monitoring in agreements with the Ethiopian government, and publicly condemn aid restrictions and attacks on aid workers.
“Foreign governments and international organizations are seeking to return to ‘business as usual’ relations with the Ethiopian government despite the lack of normalcy on the ground,” Bader said. “The ongoing civilian suffering from the Amhara conflict means that Ethiopia needs increased international scrutiny.”
© 2024 Human Rights Watch