Introduction: Chairman Menendez, Ranking Member Risch, distinguished members of the Committee: thank you for this opportunity to discuss the humanitarian crisis in Ethiopia, how the U.S. Agency for International Development (USAID) is providing life-saving assistance, and the ongoing challenges that impact our response efforts. I also want to thank the committee for its attention to and continuous engagement on this crisis and, in particular, Senator Coons for his travel to Addis Ababa at the request of President Biden and his continued advocacy on behalf of the humanitarian community and the people of Ethiopia.
The gravity of the situation is clear. It is also time sensitive. Without an immediate cessation of hostilities, improved humanitarian access, and an immediate scale-up of life-saving humanitarian assistance, we could see widespread famine occur in Ethiopia later this year一a situation the country has not faced since the 1980s.
Overview of Humanitarian Situation
Over the years, Ethiopia has struggled with a confluence of recurring acute shocks: drought, seasonal flooding, pest and disease outbreaks, and above-average food prices. These ongoing challenges have led to chronic and sustained humanitarian needs, which are further exacerbated by ongoing conflict.
In this year alone, nearly 24 million Ethiopians will likely require humanitarian assistance - more than 20 percent of the country's population一with 13 million needing emergency food assistance through July due to ongoing conflict and displacement, the compounding effects of severe drought, desert locust infestations, and the COVID-19 pandemic. Escalating violence in southern Amhara, along the Afar-Somali border, and in parts of Oromiya in recent months has resulted in significant population displacement and hundreds of civilian deaths.
The scale of humanitarian need in Ethiopia's Tigray region is particularly staggering. After more than six months of hostilities between multiple armed actors, including the Tigrayan People's Liberation Front (TPLF), Ethiopian National Defense Forces (ENDF), Eritrean Defense Forces (EDF), Amhara regional forces, and others, approximately 5.2 million people are in need of humanitarian assistance, out of a total population of around 6 million. The food insecure population is spread over hundreds of rural communities across rugged terrain that is larger than the state of Maryland, with significant clusters of displaced people among peri-urban and urban centers seeking assistance.
As striking as these numbers are, even more striking are the lived experiences of the people in the region. I want to take a moment to share some of their stories. When the conflict started, Elias's office was looted and most of his belongings were taken. He made the decision to flee with his wife and children to find safety. They arrived in Mekelle with only what they could carry in a single bag. Mariam tragically lost 25 of her family members and friends since the conflict broke out, including her brother and her five month-old baby boy who succumbed to malnutrition. Mariam now suffers from eating disorders due to the trauma she experienced. Elias and Mariam both found shelter and refuge in centers supported by U.S. partners. The grim reality is that there are almost two million other stories of displacement like Elias and Mariam's.
Agriculture and Livelihoods
In early April, USAID completed a rapid agricultural livelihoods assessment and found that the conflict has severely impacted rural communities by eliminating many primary sources of food and income. The majority of poor households feed their families through at-home crop production, purchasing food at local markets, and the Government of Ethiopia's (GoE) Productive Safety Net Programme (PSNP). However, our analysis shows that conflict is preventing people from accessing markets, farmland, and many services, which limits their ability to feed themselves and their families. Traditional casual labor opportunities that many people rely on for income, such as on farms or construction sites, are virtually non-existent, and income-generating activities, like the sale of crops, milk, and livestock, have been severely disrupted. The bottom line is that millions of Ethiopians cannot feed their families.
Additionally, because the ongoing conflict has had a devastating impact on the agriculture sector more broadly (including through the loss of animals for plowing and destruction of nurseries for seeds and stores for agricultural inputs), we fear those families will be without food for years to come. We are in the middle of the traditional planting season. However, many farmers are not able to obtain seeds and tools, or have been driven from their land and will not be able to plant before the rains come. If the upcoming season is lost, the more than 5 million people currently in need of food assistance will need help until the October 2022 harvest. Providing this life-saving food assistance could cost the humanitarian community upwards of one billion dollars.
Conflict in the Tigray region has also forced almost two million people from their homes and communities. Around two million people are displaced within Tigray, and some 63,000 people have fled across the border as refugees into Sudan. Many internally displaced people are relying on host communities for basic necessities like food and water, further straining already limited resources. One of the cities experiencing the biggest influx of people displaced by the conflict is Tigray's capital city of Mekelle. During recent visits to Mekelle, USAID staff noted overcrowded conditions where these displaced populations were living, and irregular and uncoordinated assistance. Some sites did not have any food, health, gender-based violence prevention and response, other protection, or water, sanitation, and hygiene (WASH) services. Many of the centers that did have these services were experiencing shortages of medicines, food, and supplies due to the sheer volume of people in need. If hostilities continue, and available food and jobs remain absent in rural areas, we fear that even more people will be displaced and need help.
Earlier, you heard me note how food security and resources in Ethiopia have been long-term challenges. The recent conflict has pushed the people of Tigray to desperate levels of hunger. Many areas of Tigray are currently facing Emergency--Integrated Food Security Phase Classification (IPC) 4--levels of food insecurity, and at this level we not only expect but are also hearing confirmed reports of Tigrayans dying as a result of food insecurity, malnutrition, disease, and starvation. USAID analysis, in line with UN reporting, suggests that the crisis is at a critical tipping point: Famine--IPC 5--could occur in 2021 in areas of Tigray if sustained, large-scale, multi-sector humanitarian assistance does not reach people in time, and if conflict between armed actors continues to disrupt agricultural production and livestock and labor markets, which are critical for poor households to make ends meet. IPC 5 may in fact have already begun, but the lack of access has limited the data collection necessary to make an accurate assessment. However, let me be clear that food assistance alone will not avert a famine in Tigray. Famine prevention requires integrated public health, nutrition, and WASH services. Without enough food, clean water, and access to basic health and nutrition services, malnourished bodies are not able to effectively use nutrients or fight disease. The international response must be multi-sectoral and robust if it is to be truly effective against the threat of famine.
But, as I sit here with you today, people in Tigray do not have those life-sustaining resources they need. Due to the ongoing conflict and looting, Tigray's health system has collapsed, with only around 16 percent of hospitals and health centers functioning fully. The rest of Tigray's health facilities were looted or occupied by armed actors, denying people the basic care they need. This lack of health resources not only heightens the risk of famine, it also gravely impacts the ability of people in Tigray to receive treatment for illnesses and limits health officials' ability to control the spread of infectious diseases, including COVID-19.
In addition to the significant impact on the Tigrayan health infrastructure, the conflict has also resulted in the destruction of critical safe water and community hygiene infrastructure. Relief actors estimate that around 250 motorized water pumping systems in towns are out of order due to lack of fuel and electricity, damage, looting, or vandalism. The status of approximately 11,000 hand pumps in various rural areas is unknown because of ongoing access constraints. As a result, many people lack access to clean water and adequate sanitation services.
In addition to lack of food, medical care, and clean water, we have also heard devastating reports of abuses by armed actors across Tigray. The severity of abuse is among the absolute worst I have seen in nearly two decades of humanitarian work. The reports not only speak to widespread incidents of rape and other gender-based violence against women, but of systematic attempts to dismantle society and destroy families. For example, some perpetrators are targeting the wives of priests, abusing women in front of their families, or using a level of violence so brutal that women are left with organ damage.
We at USAID condemn these abuses to the strongest degree possible, and we are prioritizing support to survivors in our humanitarian response. While the full scale of abuses and GBV incidents in Tigray may never be truly known, Ethiopian health officials recorded at least 950 cases of reported sexual assault in the region in March and April alone, according to Save the Children, while the UN Population Fund (UNFPA) projects that approximately 22,500 survivors of sexual violence in Tigray will seek clinical care in 2021. Unfortunately, the actual numbers are likely far higher than those recorded by health authorities due to persistent barriers to accurate reporting, including scarce health and legal services, limited staff capacity to dedicate to reporting, fear of stigmatization, and risk of further harm.
These terrible attacks and their long-lasting effects underscore our particular concern about the negative effects of the conflict on women and children writ large. Women are facing increased safety risks, loss of livelihoods, and restrictions on their movement. As the number of female-headed households rises and social support networks break down due to the conflict, women are also facing increased childcare responsibilities. Children are also experiencing rising levels of violence and abuse as part of the conflict, suffering from higher rates of malnutrition and other health concerns, and around 5,000 of them have been separated from their families.
Scaling Up the U.S. Government Response
USAID's longtime and robust presence in Ethiopia implementing one of the largest and most complex portfolios in Africa has enabled a swift response to this crisis. In Fiscal Year (FY) 2020, USAID provided a total of $716 million in assistance to the people of Ethiopia across sectors like agriculture, education, global health, and women's empowerment. USAID funding also supports programming to protect human rights; promote accountability; counter disinformation, misinformation, and hate speech; mitige conflict in Tigray and other at-risk areas; prevent gender-based violence, and promote inclusive governance and political processes. However, the crisis threatens the gains that Ethiopia has made across these sectors in the last 20 years.
In the face of staggering humanitarian need due to recurrent acute shocks and conflict, the United States has responded with significant support and advocacy. In FY 2020, USAID provided more than $650 million in humanitarian assistance in Ethiopia, and we anticipate that the FY 2021 figure may be more than 40 percent higher due to needs stemming from the Tigray crisis and ongoing conflict within Ethiopia.
As soon as the conflict in Tigray started, USAID immediately began providing life-saving assistance. The United States is the largest humanitarian donor to the Tigray response, providing nearly $305 million since the conflict began, of which $193 million is for food and nutrition assistance. We used our existing programs, including rapid response mechanisms, while also adapting to access and logistical constraints by pre-positioning in-kind commodities and working with our partners to pivot other resources as needed. However, the sheer level of the needs and ongoing nature of the crisis necessitated a scale-up and additional resources.
On March 1, USAID deployed a Disaster Assistance Response Team (DART) to scale up the U.S. humanitarian response efforts to the conflict in Ethiopia's Tigray Region. This expert team has been building upon existing USAID humanitarian programs that were in place prior to the conflict, and is focused on rapidly scaling our life-saving efforts to reach even more people. The DART works with other humanitarian organizations, international donors, and local community groups to assess needs and coordinate assistance to those who need it most. USAID's robust and holistic response has focused on nine priority sectors: food assistance; WASH; health; nutrition; protection; shelter and emergency supplies; emergency agriculture and livestock interventions; humanitarian coordination; and logistics support.
In response to acute food needs across Tigray, USAID is supporting the Catholic Relief Services-led Joint Emergency Operations Program (JEOP), the United Nations World Food Program (WFP), and other humanitarian partners to provide emergency food assistance (including U.S.-sourced agricultural products like cereals, pulses, and vegetable oil) and U.S.-made specialized emergency nutritious products to vulnerable people across the region. USAID has ramped up food assistance and is providing more than 206,000 metric tons of food--enough to feed 4 million people and treat more than 400,000 women and children suffering from malnutrition for three months.
As I noted earlier, the continued conflict impacts the children of Tigray in the most acute and heartbreaking ways. Since February, our partners' health facilities have admitted more than 3,400 children suffering from wasting--a life-threatening form of malnutrition. And as of mid-April, WFP and its sub-partners reached more than 51,000 children and pregnant and lactating women with emergency nutrition assistance. With USAID support, the United Nations Children's Fund (UNICEF) is also distributing nutrition commodities to displaced populations--including High Energy Biscuits and ready-to-use therapeutic foods (RUTFs). These specialized high-calorie foods are sufficient to meet the daily needs of up to 27,000 children younger than five years of age who are at risk for malnutrition.
In an environment of ongoing conflict that has devastated all basic resources and services, our response must utilize integrated, flexible, and mobile service delivery. Over the next nine months, our humanitarian health partners (FHI360, GOAL, IRC, Samaritan's Purse, and World Vision) will operate nearly 60 mobile health and nutrition units that can be deployed to populations in need throughout Tigray. They will also support the operation and rehabilitation of 300 static clinics, many of which were damaged or looted during the conflict. We are also providing hygiene kits with soap, toilet paper, and sanitary products, and supporting hygiene promotion campaigns to help prevent the spread of diseases, including COVID-19. FHI 360 programming will also promote community organization and outreach focusing on disease prevention and other key health messaging.
Safe shelter and places for displaced families to live are critical issues as the conflict continues. Our partners, such as IOM and the Ethiopian Red Cross Society, are constructing emergency shelters for displaced people. On April 12, USAID airlifted 1,500 rolls of heavy-duty plastic sheeting from our warehouse in Dubai to contribute to emergency shelter efforts. This plastic sheeting will be used to create needed walls and roofs of temporary structures, keeping more than 18,000 people safe from the elements, rather than sleeping outside or in crowded community shelters. USAID's partner, the Relief Society of Tigray or REST, also provided sleeping mats, blankets, and basic household items, including kitchen sets with pots, pans, and cooking utensils to assist displaced populations.
Gender-based violence (GBV) has been one of the most egregious weapons of this conflict. USAID has been attuned to this need and prioritized protection from the initial days of our response. Our current programs include funding for four partners to implement protection programming in the region, including GBV prevention and life-saving response services to survivors and vulnerable women and girls. Specifically, our funding provides psychosocial support for women and girls, safe spaces for women and girls, case management for survivors, and training for social workers and community case workers. We also include programming to address other protection needs brought on by the conflict, including community-level psychosocial support to address widespread distress and loss, family tracing and reunification for separated children, and support to first responders.
Despite the extensive assistance and resources provided to date, the ongoing fighting means that we cannot access many areas where we know the needs are the greatest. When security conditions allow and armed actors withdraw, USAID is ready to respond to identified needs. Our decades of working in Ethiopia, experienced partners and staff on the ground, significant assets in the region, and deep relationships underpin our readiness and ability to respond. But, although the humanitarian response resources remain at the ready, the problems of unending conflict, proliferation of armed actors, and restricted access make the work incredibly difficult. This crisis highlights the need to get ahead of the recurring humanitarian crises in Ethiopia-- whether caused by conflict, climate, or disease outbreaks一and compels us to work with our partners on the ground to anticipate, plan for, mitigate, and respond to disasters, but also to address the grievances and triggers that can lead to violent conflict.
In the last six months, USAID has scaled up its response and reached millions with live-saving assistance. However, this expansion will not be enough to avert famine if insecurity and access restrictions continue to significantly hinder our partners' ability to reach people in need, and the ability of people in Tigray to resume the activities on which they rely for their livelihoods.
The U.S. Government and its partners recognize the severity of the situation. This is why unhindered humanitarian access to populations in need has been at the center of ongoing engagement from Senator Coons, Senator Van Hollen, Special Envoy Feltman, Secretary Blinken, U.S. Ambassador to the United Nations Thomas-Greenfield, and other Administration Leaders , as well as Ambassador Pasi's leadership in-country. It has also underpinned our discussions with the GoE, humanitarian partners, fellow donors, and other like-minded countries. However, many challenges remain.
Currently, over one million people in need of life-saving humanitarian assistance are inaccessible to humanitarians.
The biggest challenges to reaching people in need are the ongoing conflict between armed actors, and obstruction of humanitarian operations by armed actors, especially the Eritrean Defense Forces. Our implementing partners are also reporting increased hostility toward and requirements for humanitarian actors at checkpoints run by EDF, ENDF, and Amhara regional forces. For example, we have recent reports of armed actors blocking key roads to main population centers like Shire town, which hosts nearly half a million internally displaced people. Not only are these armed actors preventing assistance to towns like Shire, but also further impeding access to more isolated rural areas as well. The decrease in the number of food distribution points has resulted in people having to travel greater distances to get food, with some people walking up to 25 miles to receive food for their families.
By blocking food assistance deliveries and preventing farmers from accessing their agricultural land to plant and harvest, the armed actors are actively exacerbating the risk of famine in Tigray. The U.S. Government continues to call for an end to these abuses, unimpeded humanitarian access, and the full withdrawal of Eritrean and Amhara forces from the area. These incidents highlight the need for improved civil-military coordination across federal, regional, and local levels of Ethiopia, which is key to enabling the safe movement of humanitarian supplies and personnel on the frontlinesーand getting life-saving aid to the people who need it most. The GoE's recent designation of the TPLF as a terrorist organization is expected to further negatively impact already challenging humanitarian operations in TPLF areas, even if the GoE grants full exceptions for humanitarian activities. Already, our partners have reported security incidents where armed actors have accused them of providing assistance to the TPLF. Targeting humanitarian workers providing life-saving aid is unacceptable, and we fear that our partners will have to limit operations in order to protect their staff. USAID is particularly concerned for the food security impacts of this decision, especially in remote inaccessible areas that are already at greater risk of famine.
Other access constraints for scaling up the response are due to bureaucratic restrictions. The GoE is currently only granting one-month visas for humanitarian workers. This is a major challenge because humanitarian staff require extended visas in order to serve in a sustained response scale-up. Furthermore, the multiple military actors have each implemented their own authorization letter requirements, decreasing our partners' ability to get through check-points and easily operate across regions. When responding in such rural and insecure environments, humanitarian operators require telecommunications equipment (including satellite phones and VSATs) to communicate with one another, establish distribution sites, or call for help in an emergency. Despite five months of requests, the GoE has not permitted humanitarians to import their own equipment, despite a significant shortage in-country. Reliable telecommunications equipment is critical for our partners' security and ability to safely expand operations into insecure and rural areas, where humanitarian needs are likely to be the greatest.
Communications across Tigray continue to be poor, which limits actors' ability to obtain real-time information and increases insecurity for everyone.
Despite growing humanitarian need across sectors, the Tigray response continues to be underfunded by the international community. We project that there are hundreds of millions of dollars in unmet needs. The United States funds a majority of the humanitarian response in Tigray. USAID is working with the Department of State to urge other donors to rapidly scale up their assistance to support a multi-sector response to prevent famine. USAID welcomes recent steps to scale-up operations and is further advocating for the United Nations (UN) to commit additional funding and expert staff to lead and coordinate for the duration of the response.
I am honored to be here today to discuss our work and underscore that the United States remains committed to helping the people of Ethiopia. However, while our humanitarian assistance will help alleviate urgent needs, it will not address the root causes of the ongoing conflict and human rights violations and abuses in Ethiopia. Rather, in order to stop the suffering in Tigray, we need an immediate end to armed actors obstructing humanitarian access, a cessation of fighting, and establishment of dialogue, reconciliation, and accountability measures.
We owe it to women like Haben, who was a sesame seed farmer in Western Tigray before she was forced to leave her home with her husband and three children due to the conflict. She now lives in an overcrowded room within a school with 24 other women and their children, with no privacy whatsoever. She told our partners that without food donations from individuals and local churches, she and her family would have starved.
Despite the ongoing heroic efforts of the international humanitarians and the local communities, the trajectory of the crisis in Tigray is clear: current extreme levels of food insecurity and malnutrition could turn into widespread famine later this year. But this can be prevented with an immediate cessation of hostilities, an increase in humanitarian access, and the immediate scale-up of more life-saving humanitarian assistance. The people of Ethiopia can wait no longer for the international community and the GoE to scale up assistance and provide unhindered humanitarian access to people in need immediately.
Thank you for the opportunity to speak with you today, and I welcome your questions.
Humanitarian Situation in Ethiopia
Committee on Foreign Relations