In Ethiopia's Tigray region, Humanity & Inclusion has identified an urgent need for mental health and psychosocial support as the crisis continues.

People are isolated, facing food insecurity and have spent months living under the constant threat of violence. Stress levels are high, and the population is experiencing widespread psychological trauma.

More than 5,400 children have lost or been separated from their families. With nearly 2 million people forced to flee their homes, shelters are often overcrowded and there have been increased reports of sexual violence against women and girls. Unaccompanied children and girls with disabilities are at even greater risk of harm. The UN Population Fund estimates that more than 22,500 victims of sexual violence will seek clinical support this year. The number of unreported assaults remains unknown, as widespread fear and stigmatization prevent many from coming forward.

At this time, only a fraction of the region’s care services is active or able to respond. Many have been forced to close indefinitely due to the crisis and others are overwhelmed by the Covid-19 pandemic.  

Along with rehabilitation and inclusive initiatives, Humanity & Inclusion has listed mental health support and protection among the top priorities for its emergency intervention plan in Tigray. Mental health specialists will be mobilized to access people in remote and isolated areas as well as dozens of camps housing internally displaced people. Teams will provide psychosocial support and refer individuals in need of additional care, including those with new or pre-existing disabilities, to appropriate resources. Group therapy sessions will also be implemented alongside recreational activities such as sewing, beading and art therapies to improve mental health and wellness.

“In times of crisis, people are in dire need of mental health and psychosocial support. Emergencies eliminate sources of support and care that are normally available and they increase the risk of developing psychological distress while also amplifying pre-existing ones. Crises like this can have long-term impacts on the development and well-being of an entire population, create psychosocial disabilities, and overall, negatively impact physical health and social cohesion. HI’s mental health and psychosocial support (MHPSS) activities promote optimal mental health and social participation which takes into account the social and psychological aspects of support and access to medical care.” — Chiara Beguin, mental health specialist for Humanity & Inclusion

Widespread starvation and volatile conditions continue to overwhelm the people of Tigray, Ethiopia. Humanity & Inclusion reveals its four-sector intervention plan. 

With each passing day, the crisis in northern Ethiopia weighs more heavily on the people of the Tigray region. An alarming 5.5 million people are now in need of humanitarian assistance, as people experience widespread hunger and malnutrition, ever-present security risks, and extremely limited resources. 

Hunger and malnutrition

At least 4 million people, representing more than 90% of the population, are facing alarming levels of food insecurity. According to the Integrated Food Security Phase Classification, 1.8 million are facing emergency levels of hunger and over 350,000 people have reached the “catastrophic phase,” defined by an extreme lack of food, evident starvation, destitution and critical acute malnutrition. 

Children make up more than 2.2 million of those experiencing acute food insecurity and severe malnutrition, which can lead to serious delays in child development and even to lifelong disabilities. Without urgent intervention, millions are at alarmingly high risk of developing permanent disabilities or starving to death.  

Protection

Persistent danger in the region continues to threaten the safety of Tigray’s most vulnerable people. In the month of May alone, more than 500 cases of gender-based violence and sexual assault were reported, including around 70 offenses against children. Schools and shelters that are currently used to house thousands of internally displaced people have been repeatedly looted and damaged, raising further security concerns for those already forced to flee their homes. Some areas have become completely inaccessible due to safety risks, further isolating the inhabitants, who are in critical need of food, supplies and protection. 

People with disabilities are most at risk

In an already devastating humanitarian context, people with disabilities and older people are at even greater risk of harm. So far, Humanity & Inclusion teams have identified more than 4,650 people with disabilities or special needs. Always disproportionately affected in times of crisis, these populations are more likely to experience isolation, reduced access to basic care, and mobility limitations, which could prevent them from fleeing dangerous areas. 

HI’s intervention plan

"The need for basic supplies and services grows each day,” says Jeff Meer, U.S. Executive Director for Humanity & Inclusion. “Our colleagues in Ethiopia see it as people flee their homes and seek refuge in larger cities. They see it among people living in rural, isolated areas, which are dangerously cut off from assistance. Funding needs are high, to enable our teams to safely and effectively work alongside affected communities. Our priority is to see people with disabilities and individuals in vulnerable situations safely accessing basic and specific aid.”

Humanity & Inclusion teams are on-site and preparing to provide vital assistance to the population. Staff has assessed the situation and humanitarian needs by meeting with impacted community members, other INGOs, and experts in security and logistics. Humanity & Inclusion, which has been working in Ethiopia since 1986, has developed an emergency intervention plan in the sectors of Mental Health and Psychosocial Support, Rehabilitation, Inclusive Humanitarian Response, and Protection. These include: 

• Psychological first aid through individual and group counseling sessions and trauma-informed training for aid and health workers;
• Quality rehabilitation services, including physical therapy sessions, training of health care workers and mobility aids for people with disabilities, those facing complications after injuries and over 300,000 internally displaced persons;
• Inclusive humanitarian response that focuses on people with disabilities, unaccompanied children, women at-risk of violence and exploitation, and vulnerable populations; and
• Child protection initiatives in refugee camps and sites hosting internally displaced people.

Image: Humanity & Inclusion teams drive to the Tigray region of Ethiopia to begin crisis intervention efforts. Copyright: J. Avery/HI

Over a million people in Ethiopia's Tigray region are suffering in the midst of a violent crisis. Humanity & Inclusion teams are on-site providing aid and support to those most affected.

The humanitarian crisis is worsening each day in Ethiopia’s Tigray region. People are facing death, injury and trauma. Women and children are reporting instances of violent sexual assault. Health facilities, schools and other public infrastructure have been destroyed, looted or are being used as shelter for internally displaced persons. 

It’s estimated that 1.3 million people need humanitarian aid, ranging from health services to food and shelter to basic hygiene items. Forced to flee dangerous areas or left without access to necessities, 735,000 people have left their homes across the region, migrating primarily to the northern city of Shire. On top of that, thousands of Ethiopians have sought refuge in neighboring countries, while nearly 100,000 Eritrean refugees living in Tigray have been relocated to other camps. The circumstances are only exacerbated by the Covid-19 pandemic and food insecurity caused by extreme floods, droughts and locust infestation affecting the region.

The need for basic supplies and services grows each day as people flee their homes and seek refuge in larger cities. Humanity & Inclusion teams on-site say this is particularly true for people living in rural, isolated areas, which are dangerously cut off from assistance. Funding needs are high, to enable them to safely and effectively work alongside affected communities. Their priority is to see people with disabilities and individuals in vulnerable situations safely accessing basic and specific aid.

Humanity & Inclusion’s teams have assessed the situation and humanitarian needs by meeting with impacted community members, other INGOs, and experts in security and logistics. Humanity & Inclusion, which has been working in Ethiopia since 1986, is forming emergency intervention and protection plans that include:

• Psychological first aid through individual and group counseling sessions and trauma-informed training for aid and health workers;
• Quality rehabilitation services, including physical therapy sessions, training of health care workers and mobility aids for people with disabilities and those facing complications after injuries;
• Inclusive humanitarian response that focuses on people with disabilities, unaccompanied children, women at-risk of violence and exploitation, and vulnerable populations; and
• Storage, transportation and coordinated distribution of humanitarian aid supplies with partner INGOs.

Image: A fleet of Humanity & Inclusion vehicles travel into Ethiopia's Tigray region to provide humanitarian aid. Copyright: HI

Nyaduoth, 16, has newfound freedom with her tricycle, along with the chance to go to school. She serves as a shining example to her fellow Nguenyyiel refugee community that with access, anything is possible. 

"My life was bad before I met the Humanity & Inclusion team," Nyaduoth says. In fact, she doesn't really like to think about it.

The young girl could not move on her own, was not allowed to go to school, and her own mother believed her disability was a curse from God. Nyaduoth comes from Ochom, a town in South Sudan, and has been living in Ethiopia’s Nguenyyiel refugee camp for several years. 

Her life changed when she first got a wheelchair from Humanity & Inclusion and then a tricycle—finally she could move around freely. The Humanity & Inclusion team later convinced her mother that children with disabilities should enroll in school. Thanks to psychosocial support, Nyaduoth has gained more confidence. She's also made friends. She helps her church community and, to her mother’s delight, is a diligent student. 

Nyaduoth participates in all of Humanity & Inclusion’s community awareness raising events for disability rights and inclusion, where she boldly shares her own experience. She also works in community outreach for another organization, teaching people in the camp best hygiene practices.

Equal rights

She could only crawl across the floor, whether it was dry as dust or muddy. Going to the bathroom was especially difficult. Nyaduoth’s father died when she was 3, and her mother felt her child was a burden. The local school did not accept her either. Nyaduoth had no opportunity to interact with other children, to learn or to make friends. 

A wheelchair from Humanity & Inclusion was her first step toward independence. Next, was training her family and community in understanding that Nyaduoth has the right to choose her path in life, and that children with disabilities must have equal rights, not be discriminated against. Nyaduoth received psychosocial support, a barrier-free toilet and a hand tricycle, with which she can be mobile all by herself. 

“Thanks to the tricycle and the support of Humanity & Inclusion, I developed my self-confidence and can now ignore the barriers of my disability,” Nyaduoth explains. 

Today, she is a role model for anyone living with a disability. She appears at events and shows that education with a disability is possible. And, her mother no longer equates disability with incapacity.

"I am so happy when I see my daughter moving independently from one place to another," says the mother of seven children.

Her daughter is growing just like all the other girls in the camp. Nyaduoth has a boyfriend, and the young couple has promised to get married and take care of one another.

Image: Nyaduoth sits in her hand-operated tricycle outside her home in a refugee camp in Ethiopia. Copyright: Till Mayer/HI

To mark International Women's Day on March 8, we talked to Reiza Dejito, a strong woman who is deeply committed to both her family and her role at Humanity & Inclusion. Currently serving as the Program Director for Nepal, India and Sri Lanka, Reiza has worked in numerous countries affected by humanitarian crises for two decades.

Why did you decide to join Humanity & Inclusion?

I graduated in science and physical therapy, and I earned diplomas in teaching and then management. I also completed several volunteer missions in the Philippines (my home country) and Ethiopia. And then, three months after leaving Ethiopia, I joined Humanity & Inclusion as a victim assistance project manager in Bor, South Sudan. Since then, I have worked in Kenya, Bangladesh, the Philippines and now Nepal.

Is there one experience that really stands out?

Working with Rohingya refugees in Bangladesh. They’ve suffered so much. One woman told me how she watched helpless as her husband was murdered and her house was burned down. A 9-year-old child, who was injured in the arm by a bullet after being caught in the crossfire, told me he’d forgiven the attacker for hitting the wrong target. Men, women and children walked for days and days to cross the border with little food and water. Awful. 

As a director in the Philippines, I joined the emergency team to help the victims of Super Typhoon Goni. I was extremely impressed by the resilience and generosity of Filipinos. And the commitment of my team and partner organizations to provide assistance to those who needed it most.

What’s the hardest part of your job?

As Program Director, I’m responsible for the security and protection of my teams and ensuring they are safe and sound, and in good health, especially during emergencies, crises and conflicts. In 2016, I had to manage the evacuation of Humanity & Inclusion’s teams in South Sudan following a series of deadly clashes between armed groups. It was the most trying experience of my career.

What's really important when it comes to working with your team?

Trust. Transparency. Empathy. And being able to laugh together.

Humanitarian and mother: how do you strike the right balance?

For many women, achieving this balance is a huge challenge and often prevents them from taking on more responsible positions. I’m extremely fortunate to have a supportive family and a husband who takes care of our child when I’m working. Thanks to their support, I can do the job I do. My family is my biggest incentive. They really inspire me to do better every day.

Is gender equity a challenge in the humanitarian sector?

I’ve been personally fortunate to work with male colleagues and team leaders who are advocates for women's leadership. But while many women work in the humanitarian sector, there are still too few in senior positions. Many organizations have made a lot of progress, but not enough. There is a great deal of work to do before we achieve greater equity. It’s not an easy task, because these inequalities run deep. They’ve been entrenched in cultural, social, financial and political life for generations. It’s not simply a question of empowering women and advancing their rights, but of changing corporate cultures. Men also have a role to play here. I want to see women access positions of responsibility just like men. I think we'll get there...slowly but surely.

Header image: A Filipino woman named Reiza (wearing the blue visor) and another woman carry a tub of supplies after Typhoon Goni in the Philippines. Copyright: HI

Inline image: Reiza squats down to talk with a girl who has an artificial leg at a refugee camp in Kakuma, Kenya, in 2015. Copyright: Xavier Bourgois/HI

Mohamed Badal is a 45-year-old father of 10, living in Fafan, a rural city in the Somali region, southeast Ethiopia. He is an owner of an electronic maintenance business. Like many small businesses, income has been deeply hit by the lockdown, causing him a lot of stress. Our team recently checked in with Mohamed to see how he was doing. Here’s what he told us:

How COVID-19 changes daily life

I work as electronic maintenance technician. My wife has a small restaurant. We were all doing ok before COVID-19, but now our daily income from the restaurant and electronic maintenance business is at risk. Demand from customers has rapidly declined, and our daily income is impacted. Customers who were traveling from surrounding villages are unable to come due to travel restrictions. I am really worried about my family’s future. 

Living in isolation

Everyone is living in in isolation for fear of contracting the coronavirus . And due to travel restrictions, it’s difficult to reach social or heath services. When I needed treatment for tuberculosis, I was not able to go to the Jijiga Karamarda Hospital. Nobody wanted to take me there. There is so much fear among the community, so social cohesion is affected.

Living in fear

I fear the virus. It is currently a stressful living condition and I am worried about the impact for the future if COVID-19 continues to spread. If the virus hits the area hard, life will be even more difficult.

Impact for the future

I would like our easy daily life back, with a daily income, free movement and social interaction. I like my job of maintaining electronics, and I would also like to a become role model to show other community members that people with disabilities are capable and strong enough to manage their daily life.

Staying informed about COVID-19

I am well informed. I’ve obtained prevention information from Humanity & Inclusion and the government. Some of the information is about washing hands with soap and water, and to avoid touching your eyes, nose and mouth before hand washing. It’s also recommended not to shake hands.

I also received hygiene kits from Humanity & Inclusion. COVID-19 can be prevented by following the instruction provided by health professionals like maintaining physical distancing and avoiding mass gatherings.

I am personally able to implement these prevention measures, but physical distancing is difficult, because for the community here, being together is very important and people are not very disciplined, it isn’t easy to learn new practices.

Humanity & Inclusion works to protect the most vulnerable 

As of May 7, we count 141 new projects that aim to protect our beneficiaries and staff from the virus, and to help them during their countries' lock downs. As COVID-19 takes aim at our planet's most vulnerable neighbors, we're ensuring that people with disabilities, people with injuries from conflict, children, women, and especially older people have the information--and even the soap--to stay healthy. Learn more about our COVID-19 response.

Begin a monthly gift today to help sustain this work and reach as many people as possible.

Meryam is a 40-year-old mother of 10, living in Ethiopia. After being injured in a car accident, she now walks with crutches. Meryam runs her own peanut trade business in Fafan, in southeast Ethiopia. But the lockdown due to COVID-19 has put a stop to all trading activities. Our team recently checked in with Meryam to see how she was doing. Here’s what she told us:

Business has come to a halt

I use to sell peanuts for a living. Last month’s profit was approximately 500 Birr (15 USD) and that was rather good. My elder daughter sometimes tailors and sews which generates between 150 and 200 Birr. My husband is a daily labourer, but I bring in the main income for the family. We used to have just enough to cover household expenses like food.

Due to COVID-19, the transport of groundnuts from the production sites to my home has stopped due to a national ban on travel. I have no source of income apart from my daughter, who still has some sewing orders, and support from one of my sons. Mutual assistance is really the key to cope with such a crisis in order to survive.

Hygiene kits & awareness from Humanity & Inclusion

Humanity & Inclusion has provided us with COVID-19 hygiene kits and awareness information. I have also received public awareness notifications via mobile and on our local TV about COVID’s origin, transmission and preventive measures. I have changed my habits. I used to wash my hands with water only but now I am now using soap, like the rest of my family.  

We have understood the main messages: frequently wash your hands with soap, no hand shaking when greeting and avoid public gatherings.

Education & health care

Like in most countries around the world, school teaching programs have ceased. Two of my children are still in primary school and one is in junior school. 

I need regular rehabilitation care for my legs, but it is currently impossible due to the limitation of movement. Plus, medical teams are mainly focusing on the COVID crisis. A few days ago, my daughter had a severe stomach ache and it took a long time to reach a professional because the few professional health physicians were already engaged in COVID prevention. 

Reduced social contact

I am a member of the local businesswoman’s group and I am used to participating in discussions on a weekly basis with other members about business and other social issues. But the group is smaller than usual. We are not allowed to gather all 25 members at once. For those that do come, we practice social distancing. 

I am really sad to see that traditions have been suspended. Last week we were informed that we would not be able to attend funerals. In this time of crisis, we really need strong social cohesion.

I want this crisis to pass as quickly as possible, so we can all be back to normal life.

Begin a monthly gift today to help sustain this work and reach as many people as possible.

Violence affects one in three women in their lifetime. Globally, women with disabilities are ten times more likely to experience sexual violence. Over the next three weeks, Humanity & Inclusion will address the violence against women with disabilities at the 71st session of the Committee[1] on the Elimination of Discrimination against Women, organized by the United Nations in Geneva from October 22 through November 9.

25 years of work

Humanity & Inclusion implements projects to address violence in six countries around the world[2] by raising women's awareness of their rights and helping them build self-reliance. In Rwanda, HI provides psychological support to victims of physical and sexual violence, including women, and organizes discussion groups. In Rwanda, Burundi, and Kenya, our team works to combat sexual violence against children, including children with disabilities, who are three to four times more likely to be at risk of violence.

Making it Work

HI launched the Making it Work Gender and Disability project to promote good practices in order to eliminate violence against women and girls with disabilities. The aim is to ensure that women's voices are heard and that the risks they face (violence, abuse, and exploitation) are taken into account in the projects implemented by other organizations in the fields of humanitarian action, human rights, feminism, and gender-based violence.

Publications

Gender and disability intersectionality in practice: Women and girls with disabilities addressing discrimination and violence in Africa

In June 2018, Humanity & Inclusion's Making it Work project published the report, “Gender and disability intersectionality in practice: Women and girls with disabilities addressing discrimination and violence in Africa,” which presents nine best practices for women’s organizations in six African countries. Women leaders with disabilities presented the report at the Conference of States Parties to the Convention on the Rights of Persons with Disabilities in New York. 

Protection Against Violence Based on Disability, Gender, Age (2018)

Humanity & Inclusion works to prevent violence based on disability, gender and age and its disabling consequences in development and fragile settings, as well as to provide holistic care for survivors of violence, exploitation and abuse. HI’s goal is to ensure that people with disabilities and other at-risk groups are less exposed to violence and can live in dignity, independently, and with control over their own lives. View the flier here.

[1]This committee is the body of independent experts that monitors implementation of the Convention on the Elimination of All Forms of Discrimination against Women

[2] Kenya, Ethiopia, Rwanda, Burundi, Pakistan, and Bangladesh.

The children I recently met in Ethiopia changed me forever. For the past three years, working at HI has allowed me to witness firsthand the impact our projects have made in the lives of millions worldwide. From visiting our projects in Morocco, to my most recent life-changing trip visiting inclusive schools and refugee camps in Ethiopia, I can confidently say to you today, our donors’ support truly makes a difference.

In May, I visited some of HI’s inclusive schools, which were supported by USAID, in Dire Dawa, Ethiopia. There, I met children filled with smiles and excitement, grateful for the opportunity to learn. I saw wheelchair users zip from one class to the next using the ramps we built and teacher’s aides translating the day’s lesson in sign language while students attentively listened and responded, approaching the chalkboard with their answers. It was incredibly beautiful to see the teacher and students working together to mold the future leaders of tomorrow.

While there, I met with 14-year-old Yabsera (pictured left) during his recess break. Yabsera told me, “I’m really happy at this school, especially seeing children like me.” Born with a disability affecting his legs, Yabsera rarely left his family home and only knew life through the experiences of others. Mobility was a major issue for him. He was often carried around by a family member or crawled across the floor at home. That all changed when he met Humanity & Inclusion. Our team provided him with his very first wheelchair, giving him the independence to move around and attend school.

When I asked him about his goals, he told me that he hopes more kids like him can have the opportunity to attend school. When Yabsera sees other children with disabilities in his community, he tells them, “You can have a future, too.”

Globally, 32 million children with disabilities are not in school – children longing to have a future. With support from our donors, we’re working to change this injustice and open the world to children in countries like Ethiopia, Nepal, Burkina Faso, and Laos through our #school4all campaign. Learn more about #school4all and help us send more children like Yabsera to school today.

Written by Reisa V. Tomlinson, U.S. Development Officer

The grazing regions of Oromia and Somali in southern and eastern Ethiopia have witnessed an escalation in inter-ethnic violence in recent months. Since last September, more than one million people have fled their villages and been displaced to hundreds of reception areas. HI is working to protect the most vulnerable individuals, primarily women and children. Fabrice Vandeputte, HI’s head of mission in Ethiopia, explains the causes of the crisis and how our team is responding.

How did the crisis begin?

For years, ethnic groups have been fighting over natural resources, especially water and pasture land in the regions of Somali and Oromia in southern and eastern Ethiopia. But the conflict has intensified due to long periods of drought and the famines that have followed them. A disagreement over where the border lies between the two regions also recently turned violent, when hundreds of thousands of people from Oromia living in Somali and even in neighboring Somaliland were forcibly removed to Oromia. The Oromia authorities expelled the Somali population in reprisal.

Where are the displaced people living?

More than one million displaced people, mostly women and children, are currently living in 400 reception areas, such as schools and public buildings, but also with families and the like, on a north-south line from the towns of Jigaga to Moyale, on the border between the Somali and Oromia regions. These population movements are putting a lot of pressure on host communities. For example, one woman we met recently has taken in 50 or so members of her close or extended family. You can imagine the day-to-day problems that causes in terms of sanitary facilities, food, and so on.

What are conditions like for displaced people?

They’re exhausted. Think about it: you’re walking down the street, minding your own business, when you’re suddenly surrounded by police who load you onto a vehicle, and transport you hundreds of miles away from your home region. That’s what’s happened to most displaced people. They’ve lost everything they own. A lot of children even get separated from their parents. Many suffer serious psychological distress.

What are NGOs doing?

Unfortunately, very few humanitarian actors are supported by funding bodies or are able to implement emergency programs. NGOs in the field are finding it hard to launch a response because displaced people are spread across lots of different sites, and you have to find them. Organizing aid for people scattered over a large area is not easy.

What is HI doing?

We’ve set up a program to protect women and children. When people are suddenly displaced in large numbers, and forced together in very poor conditions, it leads to tension and violence, and women and children are usually worst affected. There’s also a heightened risk of rape and child trafficking. In Babile and Kersaa, where we work, we’ve formed mobile teams whose job is to spot risky situations and vulnerable individuals and to refer them to the right services, such as health centers, social services, NGOs, and the like. We’re also opening areas for women and children where they can play or get psychosocial support.

How do you think the crisis will develop over the coming months? 

Some observers estimate the number of people who could need humanitarian assistance, displaced people and host communities included, at five to seven million. Very few people are paying attention to this crisis and not enough money has been allocated to it. The basic need for water, food, hygiene and facilities are only just being met. The support provided by funding bodies falls short of what’s needed.

Humanity & Inclusion in Ethiopia

Present in the country since 1986, our team is working to provide support to the displaced as well as improve the quality of and access to physical rehabilitation and orthopedic-fitting services, livelihoods facilities for families of children with disabilities, and assistance for refugees and displaced people, and more.