Violence Against Health Care In Conflict Zones Now Common, Red Cross

Violent acts against health care that injure and kill health care workers and patients, damage and destroy facilities, are now a common feature of conflict zones throughout the world, according to a new report from the International Committee of the Red Cross (ICRC).

The Health Care in Danger report, due to be issued today, 10 August on the ICRC website, documents one of today's much overlooked, yet crucial humanitarian issues: the perpetration of deliberate acts, many of them illegal and violent, that prevent the delivery of health care, and stop injured people from getting help, in armed conflicts and other situations of violence.

Despite numerous efforts by the International Red Cross and its partner, the Red Crescent Movement "over decades to put an end to these acts, the problem nonetheless continues", says the ICRC.

The ICRC has been gathering information on violence against health care facilites and workers, and against patients, since 2008.

It defines "health care" as including:

• Health care personnel working in medical facilities, ambulances and also practising independently.
• Hospitals clinics, ambulances, first aid posts, and all the people in them, including health workers, maintenance staff, patients and their relatives.
• All Red Cross and Red Crescent staff and volunteers involved in delivering health care, and similarly health-oriented non-governmental organizations (NGOs).
• Military health-care facilities and personnel.

The report itemizes 600 attacks worldwide. It covers 16 countries where the ICRC is working, including Somalia, where hospitals have been shelled, Libya where ambulances have been fired on, Bahrain, where doctors who treated protesters are facing prosecution, and Afghanistan, where wounded people wait for hours in vehicles held up at checkpoints.

In a statement to the press, the ICRC says the report describes how there is a:

" ... lack of respect for the neutrality of health-care facilities and personnel, and medical vehicles, among both those attacking them and those who misuse them for military gain."

The report shows there is a pattern of violence that hinders the safe delivery of health care. This ranges from attacks on patients, health care workers and facilities, including looting and kidnapping, to arrests and deliberately obstructing access to medical help.

While the number of acts is striking, it is only the tip of the iceberg, says the ICRC. It does not reflect the full cost of the violence which causes doctors and nurses to leave their posts, hospitals to run out of drugs and supplies, and vaccination campaigns to grind to a halt.

The knock-on effects can prevent entire communities from getting the health care they need, many of whose members may be suffering from long-lasting and war-related injury.

For example, after six ICRC and Red Cross nurses were killed in Chechnya in December 1996, an estimated 2,000 war-wounded per year went without surgical care.

These acts of violence and deliberate attacks on health care nearly always contravene international law, as enshrined in the Geneva Conventions and their Additional Protocols. These assert the right of sick and wounded people, whether they be soldiers or civilians, to receive help and be spared further injury during armed conflict. They give health care facilities and workers, and their medical vehicles, protected status, as long as they remain neutral and treat all patients equally, regardless of their ethnic, political and religious affiliations.

These international laws also oblige all parties to look for and collect the wounded after battle, and to help get access to the health care they need.

The ICRC is launching a global Health Care in Danger campaign, starting with the publication of the report today, that will last for four years. The campaign's aim is to raise global awareness and "mobilize a community of concern" about violence against healthcare.

The campaign will include expert workshops, organized in partnership with national societies, states, health care communities and NGOs, to come up with tangible and practical solutions. These will end in 2014 with an inter-governmental conference to look at the conclusions and recommendations and encourage nations to adopt them.

One solution, for example, might be to cover hospital windows with transparent sheeting to protect the people inside from blasts. Another could be to encourage nations to integrate international humanitarian law (IHL) into their national legislation and military doctrine, says the ICRC on its FAQ page about the campaign.

Other major Red Cross and Red Crescent events will also be organized to get support for the Health Care in Danger project.