Attacks on health-care facilities and workers in emergency settings killed 959 people and injured 1561 between 2014 and 2015. For the first time, the World Health Organization (WHO) has gathered data to quantify the scope of a problem that has gathered wider attention over the past year. It will now maintain a database to keep up with attacks, an important nod to those pressing on governments to protect the vital services of health workers during war and emergencies.
“The most disturbing challenge for health-care providers during emergencies is when they themselves are the victims of attacks – real or threatened, targeted or indiscriminate,” according to the report’s introduction. “Yet we witness with alarming frequency a lack of respect for the sanctity of health care, for the right to health care, and for international humanitarian law: Patients are shot in their hospital beds, medical personnel are threatened, intimidated or attacked, hospitals are bombed.”
A total of 594 attacks were recorded in 19 countries experiencing acute or protracted emergencies over the two-year period. Nearly two-thirds of the attacks were directed at health-care facilities. This is all based on what the WHO could gather from secondary sources. It is all but certain that there were many more undocumented attacks over the same period. With more than 60 percent of the recorded attacks determined to be intentional, groups and governments are violating international laws without recourse.
(WHO)
The lack of accountability was at the heart of why Doctors Without Borders, also known as Médecins Sans Frontières (MSF), pulled out of last week’s World Humanitarian Summit. Following attacks on medical facilities it supported in Afghanistan, Yemen and Syria, the medical aid group is pressing for better protection of humanitarian professionals and civilians. It succeeded in the passage of a U.N. Security Council resolution that reaffirmed the protection of health workers and accountability for perpetrators.
“When so-called surgical strikes end up hitting surgical wards, something is deeply wrong,” said U.N. Secretary-General Ban Ki-moon in a statement supporting the resolution. “Explanations ring hollow to parents burying their children and communities pushed closer to collapse. All too often, there is no respect for the sick and no sanctity for those who provide care.”
What remains unchanged is the mechanism to punish the people or groups who carry out the attacks. The WHO report finds that more than half of the recorded attacks were at the hands of government forces. Syria’s government is one of the biggest offenders. The 135 attacks on health care in the country last year were more than half of the recorded total for 2015. And the civil war continues, meaning health workers and patients are still at great risk.
Wreckage smoulders in part of the MSF hospital in Kunduz on Oct. 3, 2015, after it was hit by an air strike. (Credit: MSF)
“This is a huge problem. Attacks on health workers are not isolated, they are not accidental and they are not stopping,” Bruce Aylward, the head of emergency response at WHO, told the Associated Press.
Better data collected by one of the most important international health bodies may help prevent and prosecute attacks. At the very least it is an important nod by the WHO to the campaigners trying to keep health workers and civilians safe during emergencies. With the WHO collecting data and refining categories, we will gain a better record of the attacks themselves and who is behind each attack.
“Make no mistake: We will relentlessly denounce attacks on healthcare. We will speak out loudly and with force about what we witness in the field. Medicine must not be a deadly occupation. Patients must not be attacked or slaughtered in their beds,” said Joanne Liu, head of Doctors Without Borders, to the U.N. Security Council in early May.
