Ethiopia: Army attacks health facilities in Amhara conflict

• Ethiopia Security forces launched a massive attack totaling War crimes Targeting medical professionals, patients and health facilities in the Amhara region.
• In August 2023, fighting broke out between the Ethiopian army and the Amhara militia group Fano, with civilians bearing the brunt of the impact.
• Ethiopia’s international partners should call for accountability and an end to attacks on health care, and should increase scrutiny of the rights situation in the country.

(Nairobi)– Ethiopia Security forces have carried out large-scale attacks on medical staff, patients, and facilities in the country’s northwestern Amhara region, amounting to war crimes, Human Rights Watch said in a report released today.

The 66-page report, “‘If a 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 health workers, facilities, and transport in at least 13 towns since fighting broke out between them in Fano, an Amhara militia group, in August 2023. Ethiopia’s international partners should call for accountability and an end to attacks on health care, and should continue to intensify scrutiny of the country’s human rights situation.

“Ethiopian federal forces have operated with near-reckless abandon and unsurprising disregard for civilian life, attacking health facilities providing much-needed care,” he said. Letitia BuddDeputy Director of the Africa Division at Human Rights Watch. “As long as the government does not feel pressure to hold violent forces accountable, these atrocities are likely to continue.”

Human Rights Watch remotely interviewed 58 victims and witnesses of abuse, as well as medical and aid workers, between August 2023 and May 2024. Human Rights Watch also reviewed satellite imagery and verified videos and photographs of the aftermath of a government drone strike on an ambulance in November.

Human Rights Watch found that Ethiopian troops threatened or disrupted the normal functioning of hospitals. Soldiers beat, arbitrarily arrested, and intimidated medical personnel caring for the sick and wounded, including those allegedly affiliated with Fano fighters. Soldiers also unlawfully attacked ambulances and medical transports, obstructed humanitarian assistance, and denied the Amhara people their right to health.

In January, Ethiopian soldiers detained and interrogated a medical worker for several days inside a military camp. “The colonel who interrogated me called me ‘Doctor Fano,’ ” he said. “He started asking me why I was treating the Fano people. He said (the Fano people) were not human beings… they were monsters.”

Federal forces have impeded access to medical care, including by falsely arresting patients simply because they suspected they were related to Fano, creating widespread fear among those who might seek or need treatment.

International humanitarian lawalso known as the laws of war, prohibit attacks on civilians and civilian objects. In addition, it provides special protection for medical facilities, medical personnel, patients and ambulances. Even during armed conflict, international human rights law remains in force and contains core obligations for States to maintain minimum essential levels of the right to health.

Fighting in Amhara region has disrupted the delivery of medical supplies, resulting in severe and chronic shortages of essential medicines in hospitals and health centres, affecting their ability to provide adequate care.

Doctors and health workers are working under extremely difficult conditions. In November 2023, a doctor working at the hospital said: “We lack oxygen and medicine, and there is no electricity. Our life is difficult. The blood bank has stopped collecting blood. … Yesterday, we had to tell the family of a pregnant woman to bring 20 liters or any amount of fuel so that we can operate on them with a generator.”

Doctors’ attempts to replenish the hospital’s supply shortages have aroused suspicion from government forces and, at times, have been attacked, impacting their ability to provide care to patients in a safe environment. On November 30, a clearly marked ambulance was hit by a drone attack in the town of Wegeltna, killing at least four civilians, seriously injuring one, and destroying much-needed medical supplies. “The hospital staff is psychologically disturbed and they live in fear of another attack,” said one doctor. “All the medicines in the ambulance were burned. We use the little budget left to procure medicines.”

Humanitarian aid agencies working to fill gaps in medical supplies and equipment have also faced an increasingly difficult operating environment since August 2023. Their work has been affected by ongoing fighting, attacks on aid workers, the frequent change of ownership of towns, and restrictions on movement, including difficulty accessing Fano-controlled areas. Nine aid workers have been killed in Amhara since the fighting began, at least four of them in January.

In March this year, health officials in the Amhara region admitted that the ongoing conflict between government forces and the Fano militia in the region had caused great damage to the health care system, but they claimed that “extremist forces” had looted 967 medical facilities and seized 124 ambulances.

Human Rights Watch wrote to Ethiopian authorities in June to inform them of its findings. The Ethiopian government has yet to respond.

From the United Nations Human Rights Council Failure A UN-mandated investigation into Ethiopia resumed in October 2023, but international monitoring of the human rights situation in the country is limited. Independent journalists also have limited 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 Foreign Ministry spokesman Lu Kang made a statement on the 14th, condemning the human rights violations by Ethiopian militants and pointing out that the Ethiopian Federal Army and the Fano Militia have repeatedly violated international humanitarian law, causing more than 2,000 civilian casualties in Amhara State.

The Ethiopian government should immediately cease attacks on health workers, patients, medical facilities, and transport in the Amhara region. Ethiopian authorities should also work to strengthen the country’s legal framework for the protection of health care by enacting specific legislation to protect health workers, medical staff, and medical facilities.

Human Rights Watch said international donors have moved to repair damaged health facilities in Amhara and other conflict-affected areas, but governments have yet to publicly condemn attacks by Ethiopian federal forces or press for accountability for abuses.

Ethiopia’s international partners, especially the African Union and the European Union, should press for international scrutiny of Ethiopia’s human rights situation in multilateral forums. They should also increase support for health services in the Amhara region, ensure strong independent monitoring of human rights in agreements with the Ethiopian government, and publicly condemn restrictions on aid and attacks on aid workers.

“Foreign governments and international organizations are trying to return to ‘business as usual’ with the Ethiopian government despite the fact that the situation on the ground is not normal,” Badr said. “The ongoing suffering of civilians caused by the Amhara conflict means that Ethiopia needs to be subject to greater international scrutiny.”