Bloodied young soldiers with babies strapped to their backs and desperately seeking medical treatment is an all-too familiar image for Ethiopia-based Australian nurse Valerie Browning.
Having provided medical support in Afar, in northern Ethiopia, for more than 27 years, she is calling on Australia to help the region's helpless who are in urgent need of assistance of every kind.
Browning runs the Afar Pastoral Development Association (APDA) which works to improve literacy, promote maternal and child health, eradicate harmful traditional practices such as female genital mutilation and tackle the spread of HIV and AIDS.
"We have a massive, full scale war in northern Afar affecting five districts and close to half a million people," she tells AAP.
"There are at least 300,000 displaced people walking for days to find food, water or medical attention."
The crux of the conflict is a dispute between Prime Minister Abiy Ahmed and the Tigray People's Liberation Front, who ruled Ethiopia for almost 30 years.
Abiy came to power in 2018 and there were simmering tensions between the two until war erupted last year when the TPLF were accused of attacking army bases.
The conflict in Tigray, Afar and Amhara has isolated people from food, knocked out water reserves and destroyed medical clinics.
The United Nations says the most recent hostility has triggered wider humanitarian crisis, with some 5.2 million Ethiopians in need of urgent help and thousands feared dead after more than two million were forced to flee their homes.
Killings, looting and destruction of health centres and farming infrastructure, including vital irrigation systems, have intensified a truly desperate situation, the UN says.
UNICEF has demanded an immediate ceasefire and called for both parties to adhere to international human rights and laws to ensure the protection of children.
Five days before speaking to AAP, Browning visited the frontline herself.
What she witnessed was a thing of nightmares: child soldiers and mothers with young ones strapped to their backs sent into battle with little chance of return - all because of a lust for power.
"I am hearing the stories of soldiers as young as 14 being drugged with marijuana and pushed out stoned to fight other young fit men from government forces," Browning says.
"It is heart wrenching to see. These boys, who should be at school, instead are being killed or captured and their dead bodies have hashish on them - sometimes tied to their neck and spare supplies around a leg."
The casualties are extreme, with hundreds dying every day.
"There are 2.5 million people in Afar put on the planet for the same reasons as you or I ... and apparently it's okay to obliterate them for the sake of power," Browning says.
For now, all she and her team can do is focus their attention on those who are suffering, injured or in grave danger.
She spoke by phone with AAP while loading a truck headed to the frontline with supplies.
"As an organisation we are buying up food that we can, like dates and ground barley, and sending trucks with water containers to other areas in need," she says.
ADPA is in desperate need of money for food, blankets, cooking pots, water containers, soap and medicine. The organisation's teachers are using camels to reach displaced students.
ADPA is still working to change the way locals think of traditions that are not good for women, getting equal justice for men and women and education - but its role has grown to take on much more.
"We're working to ensure the Afar people have basic human rights - we're working to get the market back again because people are very, very hungry," Browning says.
"We need to restock goats that were slaughtered and homes that need to be repaired."
She admits seeing so much suffering is "extraordinarily emotionally draining" and says she could not do it without the support of her seven brothers and sisters back in Australia or her belief in God.
She is desperate for it not to all be in vain.
Browning grew up in Armidale, NSW and was awarded an Order of Australia for her humanitarian work.
She first moved to Africa in 1973 as a 21-year-old and stayed on permanently in 1989.
Late last year Australia joined the US and UK in warning citizens it wasn't safe to stay in the region but asked if she would ever leave, Browning laughs off the suggestion.
"I was amazed at the Western response that I had to return home, to save myself," she recalls of a phone call from Foreign Affairs in Canberra telling her it was time to come home.
"I thought to myself that I wasn't above the people of Afar, that I'm not something different.
"It's how I live. I've been in the Horn of Africa for 33 years and I'm not about to leave.
"While there is breath in my body, a bit of energy to do what I can, I will be here in the Afar."
Australian Associated Press
Sign up for our newsletter to stay up to date.