Although the area has traditionally been witness to tribal violence, the ferocity and scale of attacks are now causing serious concern.
Just two months ago, at least 40 people were killed in a refugee camp. Now the United Nations Emergencies Unit for Ethiopia (EUE) is urging action to try and break the ever-growing cycle of violence.
Much of the fighting has been between two ethic groups - the Nuer who live close to the Ethio-Sudan border and are pastoralists - and the Anyuaa, or Anuak, tribe.
In a detailed study of the region, the EUE blamed several factors for the increase in attacks which culminated in the massacre at Fugnido refugee camp - one of three in the area.
"These include control over scarce natural resources such as water and grazing land, the question of majority population in the region and what language should be taught in school, and, a general feeling or apprehension among Anyuaa that they are being dominated by the pastoralist Nuers who enter Anyuaa territory in search of grazing land and water," the UN unit said.
But, it recognised that without peace in war-torn southern Sudan, the conflict in Gambella was likely to continue.
"As a long-term solution throughout Gambella region, it is of paramount importance that peace and stability be re-established in southern Sudan," author Abraham Sewonet added in the report, released after a six-day field visit in late December.
"Development initiatives along the Ethio-Sudanese border would contribute to minimising uncontrolled influxes of people from Sudan into Gambella town," he said. "Meanwhile, strict arms control along the Ethio-Sudanese border could be an important factor in minimising conflict and causalities in the future."
Clashes, which have seen thousands forced from their homes, have been breaking out with increasing regularity over the last year.
The EUE has also called on aid agencies helping victims of the conflict to ensure that any food or non-food support is totally transparent to avoid accusations of bias.
The Ethiopian Human Rights Council (EHRCO) has also expressed concern over the fighting in the region.
It argues that the federal government in Ethiopia should step in to ensure that tribes gain some kind of political representation in Gambella. It also calls for local officials, who are found to be complicit in the violence, to be brought to justice.
The EUE likewise argues for local organisations to play a role in securing peace and breaking the ever-increasing cycle of violence.
"Traditional conflict resolution mechanisms should be included in the peace talks and processes," the EUE report said.
Around 182,000 people live in Gambella Region. The Anuak make up some 27 percent with the Nuer representing the majority group, with 40 percent of the population.
But the Anuak question the legitimacy of the Nuer who they say are usurpers who have crossed the border form Sudan.
Clashes between both tribes were usually resolved through village elders who would arrange for blood money to be paid in the form of cattle if villagers had been killed.
"Gradually, however, these traditional conflict resolution mechanisms have started to erode for various reasons," the EUE said.
In schools, the Nuer language is no longer taught sparking further resentment among the ethnic groups. A ready supply of arms from the civil war in Sudan and arms dumps left over from the former Ethiopian regime have exacerbated the scale of the violence.
Attempts have been made to try and disarm groups, but it has proved difficult with the Nuer as they are pastoralists.
The EUE argues that under the next census, which is due to take place in 2004, the various tribes in the region should be clearly identified. It may then become easier to determine what languages is taught in schools.
But until a long term solution is found the violence is likely to continue.
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