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MEKELLE, Tigray – “We tried to flee on the back of a truck, but they caught us. They took me away, raped me and left me in the bush.” Mahlet* was just 17 when she fled her home in November 2021 to escape the conflict raging in Ethiopia’s northern Tigray region.

She didn’t regain consciousness until the next day. Alone, terrified and in pain, she said, “There was no one around to help me.”

Grinding conflict and insecurity in Ethiopia have decimated the health system, with most hospitals and medical centres either looted or destroyed in the fighting.  Without access to sexual and reproductive – or any – health care, by the time she chose to speak with UNFPA, Mahlet was seven months pregnant by her rapist.

“I kept it a secret because if one of the community leaders had found out, they would be shocked and I would be discriminated against,” she said.

The crime of sexual violence is hugely under-reported on a global scale, but in conflicts the obstacles to seeking and receiving help can become insurmountable. Few survivors ever speak of their ordeal, for fear of being stigmatized by their families and communities – and in the stinging awareness that justice will anyway likely elude them. Constrained by a culture of silence, they don’t dare to ask for the humanitarian assistance they should be prioritized for, as many are scared of being discovered should they try to seek help.

A crisis hiding in plain sight

Mahlet found her way alone to the Sabacre 4 camp in Mekelle for internally displaced people, having lost her family in the chaos of the hostilities. Malnourished, exhausted and consumed with anxiety for the future that now lay ahead of her, she said she was relieved to be able to tell her story to a counsellor at a UNFPA-supported friendly space for women and girls.

Friendly spaces are centres where survivors can access psychosocial support, dignity kits containing health and sanitary items, and referrals to safe shelters. The centres offer food, medical care, legal advice, psychosocial support and life-skills training, as well as a space for survivors to heal and begin the long process of rebuilding their lives.

Mahlet is just one of an unknowable number of young girls desperately trying to navigate a situation they had no hand in creating, forced to endanger their lives in order to stay alive. “This isolation is common among survivors of sexual violence,” said Senait Geber, who manages gender-based violence cases at one of the friendly spaces. “They become invisible in the camp and resort to commercial sex and other activities just to survive.”

Almost 4 million people in Tigray and an estimated 10 million in the Amhara region need life-saving health services, including sexual and reproductive support: More than 80 per cent of remaining health facilities in Tigray don’t have maternal health capacity, while in the Afar region only 1 in 5 facilities is currently functional. The UN humatitarian coordination office reports that protection from gender-based violence is almost nonexistent, with rape survivors having little to no access to clinical management of rape or other core services.

Providing a safe haven for recovery and healing


Women and girls who have been displaced by the conflict in northern Ethiopia wait at a UNFPA-supported centre that provides them with psychosocial support, dignity kits containing health and sanitary items, and referrals to safe shelters. © UNFPA/Paula Seijo

Sexual violence can lead to a lifetime of physical and mental health anguish. Those who become pregnant and give birth often face social exclusion, abandonment and poverty. “Many survivors say they would rather die than endure such trauma,” said a nurse at a UNFPA-supported one-stop centre, another kind of facility that brings together various forms of reproductive health, medical and other assistance.

Some 70 per cent of women in humanitarian settings report experiencing sexual violence, compared to around 30 per cent globally. As an unaccompanied, displaced adolescent girl, Mahlet is among the most vulnerable in this dangerous and devastating crisis.

Across northern Ethiopia, UNFPA supports 11 friendly spaces, which have assisted more than 15,000 women and girls so far this year, and 20 one-stop centres. In the Tigray and Amhara regions, UNFPA also works with three shelters to enable survivors to recover through intensive counselling and support. To date, nearly 25,000 people in conflict-affected areas of northern Ethiopia have been reached through UNFPA-supported psychosocial counselling programmes.

There are some 130 children living in the Sabacre 4 camp without any family: Most are teenagers like Mahlet. As Ms. Senait indicated, some are resorting to transactional sex in exchange for food or a meagre amount of cash. “How can I carry on with this baby when I have to beg just for clothes and food?” Mahlet said. “I can’t even meet my own daily needs.”

Of the 26 million people in Ethiopia in need of urgent humanitarian assistance, nearly three quarters are women and girls. The UNFPA Humanitarian Response Appeal 2022 is calling for nearly $30 million to respond to the urgent protection and health needs of women and girls in eight crisis-affected regions in Ethiopia.

*Name changed for protection purposes.