UNITED NATIONS (AP) — A U.N. humanitarian official warned Thursday of an ongoing crisis in Ethiopia’s conflict-torn Tigray region, pointing to targeted civilian killings, over 500 recent rape cases, an increasing number of people fleeing violence, 4.5 million people needing food, and children on the brink of starvation.

Wafaa Said, the deputy humanitarian coordinator for Ethiopia who spent 2 1/2 months in Tigray, said in a virtual briefing to U.N. members that the impact of the crisis isn’t fully known because of communications blackouts in large parts of the region and lack of access to vast areas, especially rural areas. “Yet what is already known is quite alarming,” he said.

The U.N.’s humanitarian partners continue to receive corroborated reports of targeted civilian killings, sexual and gender-based violence, forced displacement, restricted movements of civilians and extensive looting of civilian property, Said noted.

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, teamed up with neighboring Ethiopia in the conflict.

As fierce fighting reportedly continues between Ethiopian and allied forces and those supporting the now-fugitive Tigray leaders who once dominated Ethiopia’s government, alarm is growing over the fate of Tigray’s 6 million people.

In terms of access for humanitarian staff, Said said, it is hindered by insecurity and clashes that continue in many parts of the region involving Ethiopian forces, Eritrean forces, the Tigray People’s Liberation Front, and forces from the neighboring Amhara region.

While it’s impossible to identify the full scale of displacement, Said told the diplomats local officials currently estimate that around 950,000 people fled their homes, most with just the clothes they were wearing.

“They are generally traumatized and tell stories of the difficult journey they took in search of safety,” Said reported. “Some reported walking for two weeks and some as far as 500 kilometers. Of the people who traveled with them, some were reportedly killed, particularly youngsters. People were reportedly beaten. Women were subject to rape. Some were pregnant and delivered on the way losing their babies.”

He said five medical facilities recorded 516 rape cases in mid-March, and given that most health facilities aren’t functioning and the stigma associated with rape, “it is projected that the actual numbers are much higher.”

“Women say they have been raped by armed actors, they also told stories of gang rape, rape in front of family members and men being forced to rape their own family members under the threat of violence,” Said told the diplomats.

Even before the conflict, he said Tigray was facing a deteriorating socio-economic situation because of the COVID-19 pandemic and an infestation of desert locusts. When fighting began, the “harvest was lost or burned, existing food stocks were looted or destroyed.” Food security was also impacted by the disruption of commercial supplies and failure to pay civil servants salaries for past months, he said.

The famine early warning system projected in early February that an emergency was expected across extensive areas of central and eastern Tigray, Said reported. And a rapid nutrition assessment in the first week of March indicated that among screened children under the age of 5, the proportion affected by acute malnutrition “greatly exceeded the emergency threshold of 15%” in all six areas assessed.

Said cited estimates that 82% of the 229 health centers in Tigray are not functioning, or no communication has been established with them.