A new report reveals that Ethiopian and Eritrean soldiers systematically committed mass rape, sexual slavery, forced pregnancy, and sexual torture against women and children in Tigray. These widespread attacks, documented by hundreds of health workers, amount to crimes against humanity.
The research, conducted by Physicians for Human Rights and the Organization for Justice and Accountability in the Horn of Africa (OJAH), provides the most detailed account yet of sexual violence as a weapon of war in Tigray. It examined medical records of over 500 survivors, surveyed 600 health workers, and conducted in-depth interviews with doctors, nurses, psychiatrists, and community leaders.
The report presents evidence that these attacks were part of a deliberate effort to destroy the fertility of Tigrayan women. The authors call on international bodies to investigate whether these acts constitute genocide.
### Background: The Tigray Conflict
Where is Tigray?
Tigray is the northernmost of Ethiopia’s 11 regions, bordering Eritrea to the north and Sudan to the west.
How did the war start?
Tensions escalated into war in November 2020 when Ethiopia’s Prime Minister Abiy Ahmed accused Tigray’s ruling party of attacking a military base in the regional capital, Mekelle. He sent federal troops to remove Tigray’s government and imposed a communications blackout.
Who was involved?
The conflict pitted Ethiopian and Eritrean forces, along with Amhara regional troops, against Tigray’s ruling party, the Tigray People’s Liberation Front (TPLF), and its military wing, the Tigray Defense Forces. Eritrea, Ethiopia’s longtime rival, joined the fight despite initial denials from Abiy. Amhara forces also participated due to territorial disputes with Tigray.
Why did they fight?
The TPLF had dominated Ethiopian politics for decades but lost influence after Abiy came to power in 2018. Eritrea and Amhara both had historical grievances with Tigray, fueling their involvement.
What happened during the war?
The conflict caused massive civilian casualties, with all sides accused of atrocities. Ethiopia blockaded Tigray, cutting off aid and information. By the time a ceasefire was signed in November 2022, an estimated 300,000 to 800,000 people had died from violence or starvation. Sexual violence was rampant—around 10% of Tigrayan women were reportedly raped.
Is the conflict over?
While the war officially ended in 2022, violence persists. Eritrean troops still occupy parts of Tigray and continue to face accusations of rape, arbitrary detentions, and looting. NGOs report hundreds of new rape cases since the ceasefire, indicating ongoing abuses.The scale and brutality of these attacks remain unchanged. Now, fears are growing that the region could plunge back into war following renewed clashes between Eritrea and Ethiopia, as well as between Ethiopia’s federal government and Amhara state.
Healthcare workers describe horrific acts of violence that leave survivors with severe, lifelong injuries.
“This is unlike anything I’ve seen in two decades of working on gender-based violence,” said Payal Shah, a human rights lawyer and co-author of the report. “The sexual violence is exceptionally brutal and demands global attention.”
A rape survivor (left) is assisted at a safe house in Mekelle, February 2021. She struggles to walk after being attacked by Eritrean soldiers. (Photo: Eduardo Soteras/AFP/Getty Images)
Victims treated by medical staff ranged from infants to the elderly, with the youngest being less than a year old. Over 20% of healthcare workers reported treating very young children (ages 1-12), while 63% treated minors under 17.
Dr. Abraha Gebreegziabher, chief clinical director at Ayder Hospital in Tigray, told the Guardian that his facility treated thousands of rape survivors, sometimes admitting more than 100 per week.
“Certain patterns emerged during the war,” he said. “Gang rape was common, as was inserting foreign objects—like messages, rocks, or stones—into victims. There was also deliberate HIV transmission. The evidence strongly suggests rape was used as a weapon of war.”
In June, the Guardian uncovered cases where soldiers forced objects—including screws, stones, and debris—into women’s bodies. In at least two instances, they inserted plastic-wrapped notes declaring their intent to destroy Tigrayan women’s ability to bear children.
(Photo: Ximena Borrazas)
The new research includes accounts from multiple healthcare workers who independently treated victims of such assaults.
Many survivors reported soldiers vowing to eradicate the Tigrayan ethnicity—either by destroying women’s reproductive organs or forcing them to bear children of the rapists’ ethnicity.
One psychologist described treating a teenage girl: “Her arm was broken and paralyzed when attackers tried to remove her contraceptive implant, intending to force pregnancy. They told her, ‘You will bear our children, and the Tigrayan ethnicity will vanish.'”
Other women were held captive in military camps for months or years, giving birth to their attackers’ children.
Legal analysis of medical records and testimonies confirms crimes against humanity, including mass rape, forced pregnancy, and sterilization, Shah said.
Women were often assaulted publicly, by multiple attackers, in front of their families. The assaults included culturally taboo acts like anal rape and attacks on menstruating women. The resulting stigma led some survivors to be abandoned by husbands, rejected by families, or ostracized by their communities.
“This violence is designed to inflict trauma, humiliation, and fracture communities,” Shah said. “The consequences will span generations.”
(Photo: Most survivors of sexual violence during Tigray’s war…)Many survivors still live in displacement camps, with several clinics that supported them closing after USAID withdrew funding.
“The very core of these women’s identities has been shattered,” a psychiatrist explained.
Health workers reported treating many children—some too young to understand what had happened. “Most don’t know what rape is or its consequences,” a nurse said.
For girls who became pregnant, some as young as 12, the physical risks were severe. “Their bodies aren’t developed enough to handle pregnancy,” a reproductive health worker noted.
Ayder Hospital treated numerous children, many of whom developed long-term conditions like fistula, according to Abraha. Health workers also described cases of “forced witnessing,” where children were made to watch family members being raped or killed, leaving deep psychological scars.
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Esther, then 13, shows her scars. Weeks after the war began in November 2020, soldiers raped her mother. When Esther screamed for help, they stabbed her and poured boiling water on her to silence her.
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Health workers in Tigray risk retaliation for speaking out about sexual violence by government-linked forces. One surgeon, who remained anonymous, said the youngest rape survivor he treated was three years old.
“It’s hard to think of the worst cases,” he admitted. Staff at Ayder Hospital suffered severe distress and nightmares from what they witnessed.
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The report, covering events up to 2024, found that sexual violence as a weapon of war continued even after the ceasefire, spreading to new regions.
“The perpetrators must be punished,” a health worker insisted. “True healing requires justice.”
Anbassa*, a human rights worker involved in the surveys, said accountability was absent. Without consequences, abuses persist—now extending to Amhara and Afar.
“If this impunity continues, so will the violence, spreading to other regions,” he warned.
(*Name changed)
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Support resources:
– UK: Rape Crisis (England/Wales: 0808 802 9999; Scotland: 0808 801 0302; Northern Ireland: 0800 0246 991)
– US: RAINN (800-656-4673)
– Australia: 1800Respect (1800 737 732)
– International helplines: [ibiblio.org/rcip/internl.html](http://ibiblio.org/rcip/internl.html)
