Caring for Ethiopian women in conflict-affected communities


In Tigray, Ethiopia, MSI’s multidisciplinary teams provide a lifeline to women and girls – providing contraception, abortion and STI testing, delivering babies, and providing mental health support to survivors of gender-based violence.

A group of local women from the Tigray region make their way to their homes in a rural area near Abi Adi on May 5, 2023. (Edgar Gutierrez / SOPA Images / LightRocket via Getty Images)

For two years, Tigray, northern Ethiopia, was rocked by a brutal civil war that claimed 600,000 lives and left 2.7 million people internally displaced. During the fighting, rape was used as a weapon of war and one in ten women and girls of childbearing age experienced physical, psychological and sexual violence.

In 2022 alone, an estimated 5.8 million people were in need of support following gender-based violence (GBV). Yet despite widespread sexual violence against women and girls, MSI was the only organization to provide sexual and reproductive care during the conflict in Tigray.

Offer holistic support

Due to limited financial resources, our work began with a single midwife working in conflict-affected communities, providing free, life-saving sexual and reproductive health services to as many people as she could help.

From a single provider, our mobile outreach teams grew and so did the support we could provide. Our multidisciplinary teams travel from IDP camps to settlements and host communities to makeshift clinics and gender-responsive “one-stop” centers, providing a lifeline for women and girls. In addition to providing contraceptives, abortions, STI testing and delivery of babies, they also provide psychological support and referrals to ensure survivors of gender-based violence have access to further comprehensive support.

They operate in Temporary Psychosocial Support (PSS) centers set up by the government for displaced communities and also provide individual and group counseling sessions, with a particular focus on the needs of young people.

When a peace agreement was signed in November 2022, we dared to hope that the abuses would stop and the need for our work would diminish. Yet a year later, sexual violence continues to be used to intimidate and terrorize women and girls displaced by the conflict.

At the end of this month, funding for our outreach teams in Tigray will expire, and unless new donors step in, our services will be limited to a single brick-and-mortar clinic.

Transformative care

On a recent visit to Mekelle, the capital of Tigray, I met Rahwa*. She had been forced to leave her home in western Tigray during the conflict and had been living alone in a refugee camp for several months. Rahwa had been raped by several men but was too afraid to report the crimes for fear of reprisals from the perpetrators.

When examined by MSI’s outreach team, Rahwa discovered that she was seven weeks pregnant. She received confidential, non-judgmental counseling and decided to terminate the pregnancy.

She told me: “After the conflict, I experienced months of cruel and harsh treatment in western Tigray and was forcibly displaced six months ago solely out of fear for my life. After my missed period, I suspected I was pregnant. I worried day and night and thought about suicide. I had no money to see a doctor and was thinking about seeing a traditional healer to terminate my pregnancy. But thank God he brought MSI here to save my life. From now on I can protect myself and start thinking about the future. Thank you for saving my life and giving me new hope.”

An uncertain future

Rahwa is one of tens of thousands of women and girls who have supported MSI’s mobile teams in Ethiopia since the start of the conflict, but without further funding this work is at risk. Pressure on the UK’s official development aid (ODA) budget has led to significant cuts to global sexual and reproductive health services in recent years and has already resulted in the scale of our work in Ethiopia being reduced.

In times of crisis, the need for sexual and reproductive health care increases while access decreases – and Tigray is no exception.

At the end of this month, funding for our outreach teams in Tigray will expire, and unless new donors step in, our services will be limited to a single brick-and-mortar clinic in Mekelle, which cannot hope to serve these large numbers of internally displaced people in surrounding areas .

In times of crisis, the need for sexual and reproductive health care increases while access decreases – and Tigray is no exception. The ongoing violence robs women of their physical autonomy; It is clear that sexual and reproductive health will continue to be an urgent need in communities affected by displacement, particularly in areas that were difficult or inaccessible during the conflict.

I am so proud of our outreach teams who are working tirelessly to meet the overwhelming needs of those caught up in this conflict. But without further funding, the contraception, safe abortion and post-abortion services our outreach teams provide are at risk – and with them the health, lives and futures of women in Tigray.

*Name has been changed to protect her identity.


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