So much of our energy in global health is directed toward creating vibrant health systems that can serve everyone. But violence against and insecurity of health care undermines all our best efforts to achieve universal health coverage, immunize all children, assure safe childbirth, and develop the health workforce countries need.
As the report issued today by the Safeguarding Health in Conflict Coalition shows, attacks on hospitals, clinics, ambulances, and health workers take place throughout the world—in countries at war and countries at peace, in middle-income countries as well as poor ones. Just this past week we’ve heard reports of police storming a hospital in Bujumbura, shooting patients lying in the emergency room waiting to be treated. Aside from such targeted attacks, armed groups and government forces interfere with access to health care by setting up road blocks or restricting movement in circumstances of insecurity.
Why do these attacks occur? There are myriad reasons. As our report shows, health facilities or workers are targeted to gain military or political advantage, to demoralize opponents, to further an ideology, to deprive opponents of health care by making its provision a criminal act, as part of a counter-terrorism strategy, by sheer ignorance of what international law requires, or, as in Syria, as part of a wholesale assault on civilian populations that has included use of barrel bombs against hospitals.
These attacks impede access to essential services, including mental health, and can and do devastate health systems. They undermine health systems resilience. Liberia had so few health workers to confront Ebola because so many had fled when under attack during the civil war. The chief impediment to eradication of polio, especially in Pakistan, is relentless violence against vaccinators. In Afghanistan, huge investments have gone into health care, but in many places people cannot access clinics because it is too dangerous to reach them.
Some believe we are powerless to stop them. But these assaults are not inevitable. They can be prevented. Dr. Chan has spoken powerfully and passionately against them, and the World Health Organization is incorporating advocacy for safer health care in its core work. The WHO also must fulfill the mandate of a 2011 resolution to provide leadership on data collection and dissemination regarding attacks on health care so that we can understand them and protect health care from attacks.
States have to act as well. A resolution sponsored by the global health and foreign policy group and passed by the UN General Assembly in December 2014 identified concrete steps they can and should take. These include repealing laws that make the provision of health care a criminal act; training police, soldiers, and paramilitary groups in their obligations under the law; aiding health workers in understanding their rights and responsibilities; assuring protection from third parties; and collecting data so we can be more sophisticated in our strategies.
Accountability is essential, too, to end impunity.
The roadmap to protection is before us. We can work together to protect health workers and their patients from attack. It is time to act.
Read the report: http://www.safeguardinghealth.org/sites/shcc/files/attacks-on-health-global-report-2015.pdf