Abstract
Among the many crimes committed during the Tigray war from 2020 to 2022, the systematic destruction of health care has been extensively documented and contributed to the suffering and death of hundreds of thousands of civilians. Despite the direct harm that Tigray's health care workers experienced and their role in sustaining care under siege, these professionals have been excluded from a transitional justice process that remains performative rather than substantive. We argue that this exclusion represents a violation of international legal obligations and a failure of both the Ethiopian government and the multilateral organizations involved through financing and diplomacy. Despite their marginalization, Tigrayan health workers have continued to exercise agency through sustained grassroots advocacy, documentation, and collective action. In this case study, we amplify the voices of these professionals as they assert their rights, record unacknowledged harms, and demand meaningful participation in the very mechanisms intended to deliver justice. Their experience demonstrates that truly centering victims requires centering health workers as well-addressing their material, legal, and psychological needs as part of any effort to uphold health as a human right.