UNITED NATIONS (AP) — The heads of nine U.N. agencies and other officials demanded a halt to attacks against civilians in Ethiopia’s embattled Tigray region, “including rape and other horrific forms of sexual violence.”

They called for an independent investigation into “conflict-related sexual violence in Tigray” that involves the Office of the U.N. High Commissioner for Human Rights.

In a joint statement, the U.N. agencies, the U.N. special investigator on the human rights of internally displace people, and two umbrella organizations representing non-governmental groups doing humanitarian work also called on all parties in Tigray to explicitly condemn all sexual violence and ensure their forces “respect and protect civilian populations, particularly women and children, from all human rights abuses.”

No one knows how many thousands of civilians or combatants have been killed since months of political tensions between Ethiopian President Abiy Ahmed’s government and the Tigray leaders who once dominated Ethiopia’s government exploded in November into war. Eritrea, a longtime Tigray enemy, is accused of teaming up with neighboring Ethiopia in the conflict, which Abiy’s government has denied.

The region remains largely cut off from the world, with few journalists allowed in, and only now are steps being taken to allow the United Nations human rights office into Tigray to help investigate allegations of atrocities.

The dozen signatories, including U.N. human rights chief Michelle Bachelet and U.N. humanitarian chief Mark Lowcock, urged the warring parties to take action to bring perpetrators of abuses to justice.

They stressed that “humanitarian access is essential” and aid workers need to reach all regions affected by conflict and violence, including major towns and rural areas.

“Women and children in affected areas are reporting significant challenges in accessing health, social welfare and justice services,” they said.

“Initial assessments of 106 facilities in Tigray between December 2020 and March 2021 show that nearly 70% of facilities were looted, 30% damaged, and only 13% in Tigray were functional,” the officials said. “Further health service availability assessments of over two-thirds of the total 264 facilities in the region report large and widespread disruptions of services,” including child vaccinations in just 28% of facilities and nutrition services only in approximately 29% of functioning facilities.

They said: “Only one facility provides the full range of services for clinical management of rape survivors, and emergency contraception is fully available in less than half of the facilities assessed.”

Many displaced people are living in unfinished or damaged buildings without separate spaces and latrines for women and men, girls and boys, “thus increasing risks of gender-based violence and the spread of certain infectious diseases,” the officials said.

U.N. deputy spokesman Farhan Haq said Monday the conflict continues to drive massive displacement, with tens of thousands of people arriving into Shire, Axum and Adwa, most fleeing fighting in Western Tigray in the last few weeks. There are also reports of people uprooted by violence in the northwest and central areas, he said.

“According to our humanitarian colleagues, people arriving in towns from the rural zones of Tigray are visibly malnourished and in desperate need of life-saving support, after enduring 4 1/2 months of conflict with little access to vital supplies,” Haq said.

He called the humanitarian situation “extremely dire” and continuing to deteriorate, though aid workers have provided food baskets to more than one million people, emergency shelter and relief items to nearly 140,000, and clean water to more than 630,000.

“We urgently need more funding,” Haq said. “We want $1.3 billion for Ethiopia, and we have received $738.8 million.”