Mass rape, forced pregnancy and sexual torture in Tigray amount to crimes against humanity – report

Hundreds of health workers across Tigray have documented mass rape, sexual slavery, forced pregnancy and sexual torture of women and children by Ethiopian and Eritrean soldiers, in systematic attacks that amount to crimes against humanity, a new report has found.

The research, compiled by Physicians for Human Rights and the Organization for Justice and Accountability in the Horn of Africa (OJAH), represents the most comprehensive documentation yet of weaponised sexual violence in Tigray. It reviewed medical records of more than 500 patients, surveys of 600 health workers, and in-depth interviews with doctors, nurses, psychiatrists and community leaders.

The authors outline evidence of systematic attacks designed to destroy the fertility of Tigrayan women and call for international bodies to investigate the crime of genocide.

Quick Guide What was the conflict in Tigray, who was fighting, and why? Show Where is Tigray? Tigray is the most northern of Ethiopia's 11 regional states, lying along the southern border of Eritrea with Sudan to the west. How did the war start? Years of tensions erupted into war in November 2020. Ethiopia's prime minister, Abiy Ahmed, who had inflamed hostilities by delaying federal elections, alleged that Tigray's ruling party had attacked a military camp in the state capital, Mekelle. He sent in troops to oust the state government and ordered a communications blackout. Who is involved? The invasion became a joint effort between three parties: Ethiopia, Eritrea, and regional forces from Tigray's neighbouring state of Amhara. Ethiopia's prime minister denied the presence of Eritrean troops in Tigray for months, despite it becoming clear he had formed an alliance with the country's former enemy to mobilise both nations' armies. Amhara has long-standing territorial disputes with Tigray and its own tensions with the federal government – they, too, sent troops. On the other side, the ruling party in Tigray's regional government, the Tigray People's Liberation Front (TPLF), founded and mobilised its own army when the war began, the Tigray Defence Forces, and was joined by militias from the ethnically marginalised Oromo people. Why are they fighting? Each party has a complex history of disputes. Ethiopia has a federal system, and historically its states have maintained a high level of autonomy. Tigray's ruling party, the TPLF, had been a dominant force in national politics, and led the coalition which ruled Ethiopia for three decades until 2018. The group lost much of its power when Abiy Ahmed was elected prime minister in April 2018, and a political rift began to grow between the TPLF and Abiy's administration. Eritrea and Amhara both have long-standing territorial disputes with Tigray. Eritrea brought violence along Tigray's border during the two decades of the Ethiopia-Eritrea war, a conflict which saw Abiy awarded the Nobel Peace Prize for ending in 2019. What happened during the conflict? The war resulted in massive civilian casualties, with atrocities and crimes against humanity committed by all parties. As troops moved into Tigray, Ethiopia blockaded the region, preventing journalists, UN agencies and aid from entering and limiting information getting out. Tigray quickly descended into an acute hunger crisis. By the time the ceasefire was signed in November 2022, academics estimated that between 300,000 and 800,000 people had died from violence or starvation as a result of the blockade. The capital Mekelle was decimated. Rates of sexual violence were extreme: surveys indicate that around 10% of Tigrayan women were raped during the conflict. Is the conflict over? The war formally ended in 2022, but violence in the region has continued and is reported to be again escalating. By mid-2025 Eritrean troops were still occupying chunks of Tigray, according to the UN, and continue to be accused of mass rape, arbitrary detention and looting. Large-scale sexual violence by Ethiopian and Eritrean forces in the region continues: NGOs have documented hundreds of cases of rape since hostilities ended, and concluded that "the scale and nature of these violations has not materially changed". Now, there are fears the region could descend into war again, after fresh conflicts erupted between Eritrea and Ethiopia, and between Ethiopia's federal government and Amhara state. Was this helpful? Thank you for your feedback.

The attacks described by healthcare workers are extreme in their brutality, often leaving survivors with severe, long-term injuries.

“Having worked on gender-based violence for two decades … this is not something I have ever seen in other conflicts,” said Payal Shah, a human rights lawyer and co-author of the report. “It is a really horrific and extreme form of sexual violence, and one that deserves the world’s attention.”

View image in fullscreen A rape survivor (left) is helped by an assistant at a safe house in Mekelle, February 2021. She has difficulties walking after being attacked by Eritrean soldiers. Photograph: Eduardo Soteras/AFP/Getty Images

Survivors treated by health professionals ranged from infants to elderly people. The youngest was less than a year old. More than 20% of health workers said those they treated for sexual violence included very young children (1-12 years); and 63% treated children under the age of 17.

Dr Abraha Gebreegziabher, chief clinical director of Ayder hospital in Tigray, told the Guardian his hospital treated thousands of rape survivors, at times admitting more than 100 a week.

“Some [trends] stand out during the war,” he said. “One is gang raping. Second is the insertion of foreign bodies, including messages and broken rocks or stones … Then, the intentional spread of infection, HIV particularly,” he said. “I am convinced, and see strong evidence, that rape was used as a weapon of war.”

In June, the Guardian revealed a pattern of extreme sexual violence where soldiers forced foreign objects – including metal screws, stones and other debris – into women’s reproductive organs. In at least two cases, the soldiers inserted plastic-wrapped letters detailing their intent to destroy Tigrayan women’s ability to give birth.

View image in fullscreen In attacks designed to destroy fertility, foreign objects such as these nail clippers were inserted into women’s wombs, usually after rape. Photograph: Ximena Borrazas

The new research included interviews with a number of healthcare workers who independently reported treating victims of this kind of attack.

Many of the survivors said soldiers expressed their desire to exterminate the Tigrayan ethnicity – either by destroying Tigrayan women’s reproductive organs, or forcing them to give birth to children of the rapist’s ethnicity.

One psychologist who treated a teenage girl said: “Her arm was broken and became paralysed when the perpetrators tried to remove the Norplant contraceptive method inserted in her upper arm, and this was aimed to force pregnancy from the perpetrator. [They said]: ‘You will give birth from us, then the Tigrayan ethnic[ity] will be wiped out eventually.’”

Other women were held at military camps, some for months or years, and gave birth to the children of their assailants while in captivity.

Legal analysis of the medical record data and health worker testimony found conclusive evidence of crimes against humanity, including mass rape, forced pregnancy, and enforced sterilisation, Shah said.

Women were frequently assaulted in public, by multiple attackers, and in front of family. The attacks included significant breaches of taboo in Tigray, including anal rape and attacks on menstruating women. The resulting stigma meant that some survivors were divorced by their husbands, rejected by families, or socially excluded.

“This form of violence is being imparted in a way that is intended to cause trauma, humiliation, suffering and fracture and break communities,” Shah said. “This is going to have generational impacts.”

View image in fullscreen Most survivors of sexual violence during Tigray’s war have not received any medical or psychological assistance due to a lack of facilities. Photograph: Nariman El-Mofty/AP

Many survivors are still living in displaced persons’ camps. A number of clinics providing for survivors have shut due to the closure of USAID.

“The very fabric of these women’s personalities and sense of self has been shattered,” one psychiatrist said.

A significant portion of health workers had treated children. Many were too young to understand what had happened, one nurse said: “Most of them don’t know what rape is. They do not know what the consequence is.”

For girls who became pregnant, some as young as 12, the health risks were significant. “Their bodies are not fully developed to handle the demands of pregnancy,” a reproductive health coordinator working with child survivors said.

Ayder hospital treated a number of children, Abraha said, many of whom developed long-term conditions, including fistula.

As well as direct victims of sexual attacks, health professionals described treating children who had experienced “forced witnessing”, where they were made to watch parents and siblings being raped or killed, causing severe psychological trauma.

View image in fullscreen Then-13-year-old Esther shows her scar. A few weeks after the war began in November 2020, four soldiers raped her mother. Esther began screaming for help; to silence her, the men stabbed her and threw boiling water on her. Photograph: Ximena Borrazas

Health workers in Tigray face significant risk for speaking publicly about sexual violence by government-affiliated forces. One surgical worker, who spoke on condition of anonymity, told the Guardian that the youngest patient he had treated for sexual attacks was three years old.

“It is very difficult to think of the worst [cases],” he said. At Ayder hospital, Abraha said medical staff experienced acute psychological distress and nightmares as a result of what they had witnessed.

“We hope that many people will hear [about this] across the surface of the Earth. If justice can be served, maybe consolation will follow.”

The report covered the conflict and post-conflict period to 2024, and concluded that weaponised sexual violence has continued since the ceasefire, and expanded to new regions.

“The perpetrators must be punished, and the situation must be resolved,” one health worker said. “True healing requires justice.”

Anbassa*, a human rights worker in Ethiopia who helped conduct the surveys, said: “No one is accountable.” The failure to hold perpetrators to account meant human rights abuses continued, he said, with atrocities now being committed in the nearby regions of Amhara and Afar.

“If this conflict continues, this impunity that happened in Tigray, the aftermath of this one will continue, [and] conflicts are going to erupt to other regions.”

In the UK, Rape Crisis offers support for rape and sexual abuse on 0808 802 9999 in England and Wales, 0808 801 0302 in Scotland, or 0800 0246 991 in Northern Ireland. In the US, Rainn offers support on 800-656-4673. In Australia, support is available at 1800Respect (1800 737 732). Other international helplines can be found at ibiblio.org/rcip/internl.html