Partnering with community groups and health workers during civil war

Ethiopia

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Against the backdrop of a brutal civil war, Ipas Ethiopia supports health facilities to provide sexual and reproductive health services, including abortion, and to re-establish those services where they have been disrupted. Use of rape as a weapon of war has created a crucial need for care that is trauma-informed and centers the needs of survivors. In partnership with humanitarian agencies, Ipas provides trainings in abortion and contraceptive care for health workers. Ipas also collaborates with pharmacists and mobile health units to ensure women can access abortion pills without needing to go to a health facility.

Photography by Martha Tadesse for Ipas

One in five refugee and displaced women experience sexual violence in humanitarian settings.

Ipas gathered stories in war-torn regions of Ethiopia that demonstrate the rampant sexual violence and crucial need for sexual and reproductive health care, including abortion. Those interviewed chose to remain anonymous.

“We fled to the nearby forest when the war started, and that’s where they raped me. I was anxious the entire five months. There were no other place to go. I was very concerned about my status. I went through a difficult time. But praise God, I was glad to go to the hospital at last, get my infection treated, and also get a negative blood test.”

“I survived rape during the occupation. Until I went to the hospital, I was restless and nervous. I went three months without seeing a doctor since everything was shut down due to the war. The test result made me feel a lot better, and the therapy sessions we had were also beneficial because I met so many other women who were also survivors. But more tragic than surviving rape is the shame in my community.”

“I had an extremely hard time. In my home, I was sexually assaulted. What a difficult period. I was worried about whether or not I was pregnant for weeks. After that, I worried about getting HIV for months. At that time, clinics were closed, which made my pain worse. I was able to get tested after four months. I was told that I was negative.”

“Clinics were all closed due to the fighting, so I didn’t visit one during my entire pregnancy. When the conflict began, I was seven months pregnant and was taken away from my home. I was raped. I wasn’t sure if I would give birth to a healthy child. With my sister’s assistance, I gave delivery at home, and was happy to discover that my child was well. Well, we are here now. We survived. We received counseling and when we got back, they told us to get tested and we did that. They told us we are free of HIV.”

“I was kidnapped and sexually assaulted a few months ago. There was no way for me to get help because everything was shut. I worried about my health for two months and stayed at home. Even though it’s still a challenging period, finding other survivors like myself has been very helpful.”

Reaching women displaced by conflict

Ipas supports health providers who help women access abortion with pills through a partnership with the New Millennium Women Empowerment Organization. Focused on reaching women displaced by conflict, New Millennium is also setting up referral systems to connect women and girls with facilities or mobile clinics where they can get sexual and reproductive health care.

Mearegu Gede is a health officer with Ipas partner New Millenium Women Empowerment Organization, working in Gidan, Walda and Lasta kebeles (neighborhoods) to train health extension workers in reproductive health and raise community awareness of services. “Due to the war, all the health facilities were affected,” he says. “There was no health facility where pregnant women could give birth. Women who survived rape were also exposed to various injuries because they could not get direct services. There were no contraceptive methods and health centers could not perform a safe abortion.”

Bizuye Habte is a health extension worker in the Amhara Region who received training through New Millenium Women Empowerment Organization.

“For nearly six months, our community lacked access to health care,” she says. “We have lost numerous children as a result of many mothers giving birth at home. I recently reopened the center, and each day I see a lot of families.”

Many women who experience sexual violence during the war then suffer from the stigma associated with that violence in their communities. “We raised awareness among the community because mothers have been stigmatized,” Bizuye says. “They have been isolated and felt shame.”

Working with the Bureau of Women and Children, Bizuye and other health workers are reaching out in communities to ensure women know where to come for care. “That has helped them to come forward and access different treatments,” she says. “We provided counseling, and we did pregnancy and HIV tests.”

Ipas gratefully acknowledges the support of Canada’s Department of Foreign Affairs, Trade and Development in the collection of these stories.

Every crisis is different. Our varied solutions recognize that.

Through a variety of different programs and approaches, we’re proving that reproductive health care can be made accessible during an acute crisis and in the years that follow.