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Health Care in Danger: Safeguarding Medical Access in Conflict

27 May 2014
Natalya Wells
Source:© ICRC/Isaac Griberg
The ICRC commissioned an art installation representing a bombed ambulance to promote the Health Care in Danger campaign. It was displayed in Sydney at the International Red Cross and Red Crescent Movement’s statutory meetings in November 2013 and at the military practices expert workshop in December 2013. A report from the workshop will be published later this year.

The serious issue of attacks against health care personnel was on the agenda of the World Health Organisation’s 67th World Health Assembly (WHA) last week. Ahead of the WHA, Human Rights Watch and the Safeguarding Health in Conflict Coalition released a joint report, Under Attack: Violence against Health Workers, Patients and Facilities. The report called on states to promote safe access to health care and to strengthen accountability for attacks on patients, health care personnel and facilities that contravene International Humanitarian Law (IHL).

Dr Peter Maurer, President of the International Committee of the Red Cross (ICRC), joined Ms Valerie Amos, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, and Dr Margaret Chan, Director-General of the World Health Organisation, to provide a technical briefing to the WHA on ‘health care under attack’. Dr Maurer talked about the International Red Cross and Red Crescent Movement returning to its roots of protecting the wounded on the battlefield through the ICRC-led Health Care in Danger campaign.

The four-year Health Care in Danger project draws attention to the consequences of the lack of respect for the neutrality of health care and advocates that states and armed actors protect health care and those who seek or provide it. Under IHL, parties to a conflict must ensure the respect and protection of the wounded and sick, as well as health care facilities, personnel and transportation.

Last month, the ICRC released its latest Health Care in Danger publication, Violent Incidents Affecting the Delivery of Health Care, which documents violence against health care personnel and facilities in 23 countries in 2012-2013. The report identified a worrying trend of increased health care attacks related to vaccination programs. The consequences of interrupted vaccination schemes are far-reaching and have serious ramifications for global public health. The UN was forced to discontinue its polio eradication program in Pakistan just as hope was appearing that polio might finally be extinguished around the world. Last week the White House acknowledged and complied with a plea from US public health school deans to refrain from using humanitarian and health programs for covert purposes. Compromising the neutrality of health care can endanger health care personnel and patients, and indeed polio vaccination workers in Pakistan and Nigeria have been attacked and killed as they went about their humanitarian work.

To compound this backwards step in the battle against polio, the disease has made a comeback in the Middle East due to the collapse of the health system in war-torn Syria. Access to medical care cannot be assured when health care personnel are arrested, kidnapped, tortured, killed or driven out of the country, hospitals are bombed and looted, medical supplies are blocked from delivery, roads are too dangerous to travel on, water and sanitation systems are destroyed and ambulances are fired upon or stopped at checkpoints. All combatants in the Syrian conflict must respect IHL and the right for all individuals to access impartial and adequate health care.

Australia is a strong supporter of the Health Care in Danger project. The Australian Government co-hosted a military experts’ workshop in Sydney where participants discussed measures that can be incorporated into military doctrine to protect health care in the context of military operations. This is a significant element of safeguarding health care; ICRC’s data shows that state armed and security forces and non-state armed actors are the two main perpetrators of violence against health care with each responsible for approximately one-third of the recorded incidents. Recent violent events, such as attacks this year on hospitals from both government and opposition forces in South Sudan, highlight this trend and demonstrate the need for the ICRC constantly to engage in dialogue with and educate all parties to conflicts on their IHL obligations.
Natalya Wells is a Policy & Political Affairs Officer with ICRC Australia