At least 18 people were killed in southern Ethiopia in days of clashes between soldiers and protesters agitating for the creation of a breakaway state, hospital officials said Monday.
The unrest stems from efforts by members of the Sidama ethnic group, the largest in the southern region, to establish a new semi-autonomous state -- a project that put them on a collision course with the government of Prime Minister Abiy Ahmed.
Ethiopia is already partitioned into nine semi-autonomous regions.
The Sidama are part of the diverse Southern Nations, Nationalities, and Peoples' Region.
The constitution requires the government to organise a referendum for any ethnic group that wants to form a new entity within a year of them requesting it.
The Sidama Liberation Movement, a political party that had been leading calls for the new state, last week accepted government demands for a delay pending a plebiscite before the end of the year.
But not everyone was happy with the new timeline, and protesters started lobbing stones at security forces and burning tyres once it became clear that a state declaration was not imminent.
Hospital officials in Hawassa, the regional capital, confirmed last Friday that four people were killed in protests there.
Security forces including soldiers managed to quickly assert control over the city, which has been calm for the past few days.
But violence in towns outside Hawassa continued over the weekend and on Monday morning, upping the death toll considerably.
A hospital official in Woreta Rassa, located about 30 kilometres (18 miles) outside Hawassa, said Monday that 12 people had died after being shot by soldiers late last week.
"Twelve people from the community were killed and 19 were injured," said the official, who spoke to AFP on condition of anonymity because he was not authorised to reveal casualty totals.
"They were fighting the military."
In Yirgalem, around 40 kilometres south of Hawassa, two people died out of 10 who were admitted to the local hospital, said Gudura Funte, the hospital's CEO.
"One patient was shot at 4am today. He was admitted in the morning and then he died. The rest came on Friday, Saturday and Sunday," Funte said.
He added that the security situation had largely stabilised by Monday afternoon.
The numbers provided Monday by hospital officials are likely incomplete, as violence was also reported in other areas.
Some Sidama activists have put the death toll at higher than 60, though their reports have not been possible to verify.
Derese Desalegn, the head of the Sidama health department, said he planned to dispatch officials to affected areas on Tuesday to begin gathering comprehensive casualty figures.
At least 150 people had been arrested in connection with the violence as of Friday, Hawassa Mayor Sukare Shuda told regional state media.