News: Aid blockage, destruction of health facilities hinder response to sexual violence in Tigray: HRW

By Addis Standard Staff 

Addis Abeba, November 10, 2021- The Human Rights Watch in a report released yesterday documented the health impacts of conflict-related sexual violence in Tigray citing humanitarian agencies and other service providers. The report thoroughly explained the effect of  the devastation of the healthcare system and the lack of availability of post-rape health care and related psychosocial support services among many other factors have hindered the access to care for sexual violence survivors, including girls and women from 6 to 80 years old. 

The HRW also listed insecurity, armed men’s presence in health settings, and Ethiopian government restrictions on communications, electricity, and humanitarian assistance among the reasons  that hampered the rehabilitation of the health sector and the ramping-up of a comprehensive response to gender-based violence. The report covers the period between between June and November 2021, in it containing the interviews with sexual violence survivors, local and international healthcare workers, service providers, humanitarian aid workers, members of community organizations, and government donor agencies in addition to previous Human Rights Watch interviews conducted between January and June 2021 with two Eritrean refugee sexual violence survivors and five health workers, service providers, and witnesses.

“Priority should be placed on developing safe spaces and confidential services where survivors can seek support voluntarily and at the time of their choosing.”

Human Rights Watch

Underscoring that the abscence of reliable estimates of the prevalence of sexual violence in the conflict, and comprehensive incident data the HRW said “Priority should be placed on developing safe spaces and confidential services where survivors can seek support voluntarily and at the time of their choosing.” The report also factors in insecurity, deeply rooted social stigma, and the lack of functioning healthcare facilities when arguing that the actual number of cases of sexual violence far exceeds the number reported. Moreover, it notes that certain groups of sexual violence survivors, including men, boys, older people, and people with disabilities, typically have fewer channels to seek confidential help from trained personnel equipped to provide support to them and for their specific needs.

The HRW established that sexual violence survivors are able to seek services such as  testing, treatment, and termination of pregnancy, testing and treatment for sexually transmitted infections including HIV and Hepatitis B, and physical trauma, including broken bones, bruises, stab wounds, and traumatic fistula, in addition to psychological treatment. 

Citing the UN Population Fund (UNFPA), the HRW report revealed critical shortages in medical supplies used in the clinical management of rape threaten the provison of care to sexual survivors. It also showed that only 1 percent of health facilities in Tigray had the capacity to provide comprehensive gender-based violence services as of April 2021. 

The report also factors in insecurity, deeply rooted social stigma, and the lack of functioning healthcare facilities when arguing that the actual number of cases of sexual violence far exceeds the number reported.

Observing the acknowledgment of  reports of sexual violence by the Ethiopian government, the HRW criticized the response. “The investigations have been slow, and while senior officials, including Prime Minister Abiy Ahmed and Attorney General Gedion Timothewos, have personally acknowledged the occurrence of rape, senior officials have also downplayed media reporting around rape as sensational, referencing it as TPLF propaganda.” While paying regard to the Ethiopian government’s engagement with the aid community on medical and psychosocial support, through initially co-chairing the humanitarian coordination cluster focusing on protection issues, including gender-based violence, the HRW said, “However, these efforts pale in comparison to the effects of the severe restrictions to access and essential services that the Ethiopian government has imposed repeatedly on the Tigray region since the beginning of the conflict.”

The report recalled the three-month suspension on Médecins Sans Frontières (Doctors Without Borders, MSF) Holland and the Norwegian Refugee Council after being accused of “misinformation” and failure to obtain appropriate work permits as well as the expulsion of UN staff members in September and explained that these actions  severely constrained the rehabilitation of the health sector.

Humanitarian groups told HRW that they have found it difficult to meet the minimum standards of care to ensure an appropriate and quality humanitarian response as laid out in the Sphere Standards and other international guidelines.

The HRW received the statements of healthcare workers and service providers working in Tigray who complained of lack of adequate medicines and medical supplies preventing them from providing service outside of urban centers for community-based outreach due to lack of cash, transportation, and fuel. Similarly, humanitarian groups told HRW that they have found it difficult to meet the minimum standards of care to ensure an appropriate and quality humanitarian response as laid out in the Sphere Standards and other international guidelines.

While it acknowledged that warring parties may take military action to restrict electricity or communications to opposing forces as long as such actions do not cause disproportionate civilian harm, the HRW said, “The Ethiopian government should immediately provide full and unimpeded access for humanitarian aid to the Tigray region and restore essential services to meet the pressing healthcare and psychosocial support service needs of sexual violence survivors.” 

The HRW called on international donors to commit support and resources for the long-term rehabilitation of the healthcare system, including for clinical management of rape across the region. It also called on the United Nations Human Rights Council to urgently establish an independent, international investigation that examines the pattern and scale of violations, identifies those responsible for the worst crimes up to the present, and collects and preserves evidence to pave the way for future accountability and reparations.AS