Caught in the Crossfire: Understanding the Impact of Conflict on Young People’s Lives in Ethiopia

When the Ethiopian Government and Tigray People's Liberation Front shook hands in November 2022, to end two years of devastating conflict, few doubted the enormity of the task to rebuild people’s lives and ensure a lasting peace. According to UN agencies, over 20 million people are being targeted for food assistance, and 3.5 million people are currently internally displaced. While it is unclear exactly how many people have died as a result of the conflict, researchers from Ghent University estimate there have been between 385,000 and 600,000 civilian deaths resulting from famine, lack of healthcare, and direct killings.

Getting behind the headlines to really understand how the conflict has affected young people’s lives, however, is not easy.

The Young Lives study has followed the lives of 3,000 young people in Ethiopia, from infancy and early childhood since 2001, who are now aged 22 and 29 years old.  At the start of the conflict in 2020, Young Lives was one of the only longitudinal studies able to collect data in Tigray and conflict-affected areas in Amhara through our COVID-19 phone survey, before disrupted communications and the intensity of fighting made it impossible to continue. With the peace agreement still in place, we are now planning to return in-person to all of our study sites for our next comprehensive survey round (‘Round 7’), including those sites that were caught up in the conflict. Our survey interviews, in six regions of Ethiopia, are due to begin in October 2023.

Asking young people how deeply traumatic experiences have affected their day to day lives needs to be approached with the utmost care and sensitivity. In preparation, we completed a short pilot survey interviewing 139 young people living in 10 sites close to our main Young Lives sample (and representing similar social and economic backgrounds).  Our pilot tested both the validity and robustness of new survey modules designed to capture experiences and consequences of the conflict, while minimising any undue distress for participants completing the survey.

This blog presents initial findings from our pilot survey data, highlighting some of the devastating impacts of conflict on young people living in the conflict-affected regions of Tigray and Amhara, as well as in Oromia and the capital city Addis Ababa. While our findings cannot be considered representative of all young people living in these regions, they indicate that many have suffered multiple traumatic experiences during the conflict, including shocking levels of violence and loss of life, frequently running out of food, significant financial loss and destruction of property. These experiences are likely to have profound impacts and setbacks on young people’s life trajectories, including their mental health and well-being, which our forthcoming Round 7 survey will investigate in detail. 

While overall levels of violence have recently declined, the situation in Amhara remains unstable. Individual experiences of violence were shockingly high during the conflict, particularly in Tigray, and among those living in poor and rural households.  Many of the young people in our pilot survey reported witnessing - and in some cases experiencing - several forms of harrowing violence, including sexual violence, being attacked with a weapon, being chased or shot at. 

In Tigray, 63% of young people said they had witnessed someone being killed, with over 60% reporting that a friend or family member had been seriously injured, had disappeared, or had died as a result of the conflict.

Reported sexual violence was particularly high in Amhara, with almost one in three (29%) of our pilot respondents saying they had witnessed sexual violence and 11% reporting they had been subject to sexual violence themselves.

Over half (55%) of our pilot sample in Tigray, and 38% in Amhara, reported that their households did not have enough food during the conflict; high rates were also experienced in Oromia (31%) and even Addis Ababa (25%). As is often the case, those living in the poorest households have been hardest hit. 

These alarming levels of food insecurity are likely to have been caused by multiple factors, including inflation, rising food prices and income shocks; crop failures due to repeated droughts; and the disruption of markets and distribution of food aid during the conflict.

Nine out of 10 young people in our pilot survey reported that their day to day lives had been affected by significant price increases, which is not surprising given spiralling inflation of between 20 - 35% in Ethiopia since 2020.  Just over half of those surveyed had also suffered a major income shock, either due to loss of jobs, family enterprises, or other sources of income.  In Tigray, seven out of 10 young people in our pilot study were unable to find jobs or continue working during the conflict.

Young people living in the conflict-affected regions of Tigray and Amhara reported experiencing up to four times as many shocks as those living in areas not directly affected by the conflict.  Shocks included loss of communication and access to utilities, and disruptions to education and healthcare, while reduced access to markets and banks impacted almost all of our pilot participants in Tigray.

Our pilot data also indicated significant changes in how young people spent their time during the conflict, with clear gender differences. Young men spent more time either socialising, doing nothing or sleeping, while young women spent more time on child care and domestic work responsibilities.

Almost half (47%) of young people in our pilot in Amhara and a third (33%) of those living in Tigray reported symptoms associated with Post Traumatic Stress Disorder (PTSD). This is compared to 15% in Addis Ababa and none in Oromia.  The prevalence of PTSD symptoms seems to be directly linked to young people’s exposure to the conflict and their experience of shocks, with ongoing insecurity in Amhara also likely to be a contributing factor.  

Previous Young Lives research shows that global crises are exacerbating many of the triggers of mental health issues, particularly in relation to rising levels of poverty and inequality, food insecurity and job losses. In Ethiopia, our evidence shows that the outbreak of conflict in 2020 led to a significant decrease in mental health in Tigray, with young men experiencing increased symptoms of anxiety, and young women experiencing increased symptoms of depression.

Witnessing and experiencing violence can have profound effects on young people’s mental health and overall well-being, alongside other known risk factors including food insecurity and job losses, with interrupted education and increased domestic work likely to have a disproportion impact on women and girls.

Gathering data about the impacts of conflict comes with significant practical and ethical risks, not least safeguarding the health and well-being of Young Lives respondents and staff. It is a huge responsibility. With this in mind, our pilot study enabled us to pioneer an innovative survey method used to ask highly sensitive questions about the impact of conflict (including personal experiences of different types of violence), drug and alcohol use, and sexual and reproductive health.

The Young Lives audio self-administered questionnaire (ASAQ) allows participants to respond to questions using pre-programmed tablets, in private and without an interviewer’s involvement, to minimise distress in recalling traumatic events. Individuals are able to listen to (rather than read) survey questions and to answer by touching the screen; our audio function is particularly important in Ethiopia where many of our participants have low levels of literacy. By comparing data with a control group who answered the same questions in face-to-face interviews, our pilot study also confirmed that the ASAQ reduces the risk of participants under- or mis-reporting distressing experiences.

Previous Young Lives evidence has shown how the impact of conflict in Ethiopia is exacerbated and intensified by other global crises, including severe food insecurity (particularly in drought-affected southern regions), climate change, and crippling inflation (especially in urban areas). The economic and social impacts of the COVID-19 pandemic have also taken their toll, with significant job losses, service disruptions, and insufficient social protection undermining an already overwhelmed humanitarian system.

With over two decades of longitudinal research, Young Lives has built a unique body of data with huge potential for understanding how conflict and compounding global crises are affecting the lives of young people, particularly those from poor and marginalised backgrounds.

Building on the lessons we have learnt from our pilot study, our forthcoming Round 7 survey will enable a much deeper understanding of how conflict and multiple shocks are affecting young people’s mental health. This will include in-depth analysis of anticipated increases in symptoms of anxiety and depression, alongside new Young Lives data on experiences of stress and PTSD.  This knowledge is crucial for informing policy, designing targeted interventions, and improving young people’s mental health in Ethiopia.