Doctors Without Borders says three of its staff were “intentionally” killed in 2021 during the fierce fighting in Ethiopia’s Tigray region.

The organisation, known by its French initials MSF, on Tuesday published the findings of its internal review into the killings of Maria Hernandez, a Spanish national, and Ethiopians Yohannes Halefom Reda and Tedros Gebremariam Gebremichael.

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The northern region of Tigray erupted in a brutal civil war against the federal government from 2020 and 2022 that killed some 600,000 people.

The conflict prompted a humanitarian disaster, leaving a million displaced, and a fragile peace deal has caused simmering resentment.

MSF accused the Ethiopian government of failing to “fulfil its moral obligations” to conclude investigations. “The review confirmed that the attack was an intentional and targeted killing of three clearly identified aid workers,” says its statement.

Hernandez was one of MSF’s emergency coordinators in Tigray, while Reda and Gebremichael were a coordination assistant and driver for the NGO. All three employees of MSF-Spain were shot dead on June 24, 2021, in southern Tigray.

The NGO said they and their vehicle were all clearly identified. According to the medical charity, a convoy of Ethiopian soldiers was present at the time of the attack.

MSF said despite numerous follow-ups with the federal authorities in Addis Ababa, they had not received “any credible answers” and the government had “failed to fulfil its moral obligations to conclude an investigation into the attack”.

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“This was not the result of crossfire, nor was it a tragic mistake. Our colleagues were killed in what can only be described as a deliberate attack,” said Paula Gil, president of MSF-Spain.

The report follows from an international investigation in 2022 when the NGO said the three aid workers had been killed “intentionally,” without providing further details.

The New York Times newspaper claimed in a 2022 investigation that an Ethiopian army officer had given the order to kill the three aid workers.

But Raquel Ayora, director-general of MSF-Spain, said on Tuesday, “We cannot confirm that or go that far.”

The report’s findings were presented to authorities, who did not respond, the NGO said. Ethiopian authorities refused to meet the president of MSF-Spain to discuss the MSF investigation into the killings.

The 2020-2022 war pitted federal forces, supported by local militias and the Eritrean army, against Tigrayan rebels. All of the warring parties have been accused of war crimes.

However, an NGO called The Sentry said in June that, while all sides perpetrated war crimes, the nature of the atrocities committed by the Eritrean army was “unmatched in scale and premeditation”.

Ethiopia, Africa’s second-most populous country with nearly 130 million inhabitants, has been led by Prime Minister Abiy Ahmed since 2018.