A new report issued by Physicians for Human Rights (PHR) and the Organization for Justice and Accountability in the Horn of Africa (OJAH) has exposed the widespread use of mass rape, forced pregnancy and sexual torture by Ethiopian and Eritrean forces during the Tigray conflict—actions which the report brands as crimes against humanity and possibly genocide.
Drawing on medical records from more than 500 survivors of conflict-related sexual violence including mass rape and interviews with around 600 health workers, the investigation describes horrific patterns that persisted even after a formal ceasefire was agreed in November 2022. Survivors reported mass rape involving multiple perpetrators, forced impregnation, and extreme sexual torture. In many cases, foreign objects—ranging from rusted screws and metal spikes to plastic rubbish and threatening notes—were inserted into women’s reproductive organs, clearly intended to inflict permanent psychological and physical injury, and deny them the capacity to bear children. These methods were described by doctors and witnesses as deliberate efforts to inflict reproductive trauma and undermine Tigrayan ability to reproduce. The notes wrapped in plastic explicitly referenced historical border disputes and threats to prevent future generations of Tigrayan births.
Children and the elderly were among the victims: health workers indicated that over 20 percent of reported survivors were infants or children under age 12, and 63 percent were under 17. Doctors at Ayder hospital in Mekelle treated thousands of rape survivors, sometimes admitting more than 100 in a week during the worst months. Forced pregnancies and delivery occurred in captivity settings where women were held for extended periods. Medical tests revealed that 27 percent of survivors tested were pregnant at time of examination, and around 11 percent also tested positive for HIV. Meanwhile, long‑term physical consequences included reproductive injuries, fistulas, incontinence, chronic pain and mental health disorders such as PTSD and depression.
Despite the Pretoria peace deal that formally ended hostilities, survivors told reporters and researchers that such sexual violence continued—particularly in areas still occupied by Eritrean troops. Efforts to prosecute or hold perpetrators to account have largely stalled. Eritrean officials have denied wrongdoing and largely refused cooperation with international investigators. Meanwhile, survivors report severe cuts to international aid for treatment and psychosocial support, compounding trauma and hindering recovery and justice efforts.
The scale and nature of the abuses have drawn international condemnation. Medical professionals and human rights experts describe these acts as among the most extreme forms of wartime sexual violence documented, especially the intentional targeting of fertility as a tactic of ethnic destruction. Amnesty International previously detailed systematic rape and sexual slavery by Eritrean Defense Forces and Ethiopian troops, noting forced sterilization and strong evidence of genocidal intent. The International Commission of Human Rights Experts on Ethiopia (ICHREE) and bodies like the UN Human Rights Council have called for preserving evidence and renewing mandates to pursue accountability.
Victims continue to face profound stigma within their communities, cultural silence, limited support and fear. One health provider described survivors presenting for care long after traumatic events—some after several suicide attempts—once they could no longer endure alone. Many survivors have still not received mental health or legal services, while communities remain deeply fractured. Experts warn that without justice, these crimes risk being repeated across other conflict zones in Ethiopia. Evidence also indicates that sexual and reproductive violence occurred in neighbouring Amhara and Afar regions, potentially driven by impunity in Tigray.
The report concludes by stressing urgent international intervention. Worldwide human rights organizations, UN agencies and the African Union are being urged to take strong measures: enable unrestricted access for investigators, provide comprehensive care and reparations for survivors, and ensure prosecutions under international law to interrupt cycles of violence and prevent future atrocities.
