The United Nations General Assembly and Human Rights Council should act on the report by the UN special rapporteur on the right to health about attacks against health workers and services, the Safeguarding Health in Conflict Coalition said today. The report, by Anand Grover, the special rapporteur, was presented to the General Assembly on October 24, 2013. It describes a wide range of abuses occurring against health workers and highlights the need for better monitoring and accountability.
“The Special Rapporteur’s report shows how attacks on health workers and medical facilities imperil health workers and disrupt access to health care,” said Leonard Rubenstein, chairman of the coalition, which contains human rights, health, health professional, and other nongovernmental groups. “This is a call to action for the General Assembly and Human Rights Council to press governments to put a stop to these attacks and punish those responsible.”
The special rapporteur’s report is the first UN human rights analysis to describe comprehensively the responsibilities of countries to provide and protect health workers and services in conflict. The report also addresses the practice of using criminal laws and other punitive measures to threaten or arrest health workers for providing care to disfavored groups.
Recent examples of attacks against health workers and facilities by government and non-state armed groups include:
- In Syria, 32 of the country’s 88 public hospitals have closed because of the ongoing conflict, and government and pro-government forces have arbitrarily detained, tortured, and killed hundreds of health workers and patients.
- In Turkey and Bahrain, state security forces have harassed, detained, and physically assaulted physicians providing care to antigovernment demonstrators.
- In the Central African Republic, non-state armed groups and fleeing government forces have systematically targeted health facilities and medical nongovernmental organizations.
- In Nigeria and Pakistan, armed Islamist groups are alleged to have targeted and killed polio vaccinators.
“The deliberate and systematic attacks on health workers and facilities by Bahraini security forces not only harmed medical professionals, but the people of Bahrain,” said Rula al-Saffar, president of the Bahrain Nursing Society. “Governments should respect the proper functions of health systems so that we can provide care for all those in need, no matter their political affiliation.”
Health workers and healthcare services are increasingly under attack by non-state armed groups, the coalition said. The special rapporteur highlighted the decisions of the Security Council and other entities to make clear that non-state armed groups need to respect human rights. The rapporteur also said that even when resources are constrained by conflict, governments are responsible for assuring accessible, affordable, quality, and non-discriminatory health services. It says they have a special responsibility to provide services to groups made vulnerable by conflict, including women, children, displaced populations, older people, and people with disabilities.
In some cases, the special rapporteur said that denying health services, obstructing humanitarian aid, or interfering with the underlying conditions that affect health may be “a strategy to target specific communities” based on their ethnic, religious, or political affiliation.
“During fighting in Burma in the past, government forces arrested health workers, burned clinics, and obstructed patient care,” said Saw Poe Say, documentation manager at the Karen Human Rights Group, a coalition member. “We hope the special rapporteur’s report will encourage the government not to attack or interfere in health care in any future conflicts.”
The special rapporteur also criticized the use of checkpoints and roadblocks that restrict access to aid or health care. Any restrictions on movement for people in conflict areas need to be legitimate and essential, and provide exceptions for access to health facilities, goods, and services that can be exercised with minimal delays. Accountability is key to ending unlawful restraints on access to health care, the coalition said.
“What we have witnessed in Syria during the past 31 months is frequent, systematic and deliberate attacks on medical professionals by the government,” said Dr. Zaher Sahloul, president of the Syrian American Medical Society, a coalition member. “Doctors are harassed, detained, tortured, and killed just because they are doing their humanitarian and professional duties. The perpetrators should be held accountable in a court of law.”
The special rapporteur criticized the lack of thorough investigation when attacks occur, and the absence of systematic data collection to determine the global frequency of attacks. He recommended using all remedies available in human rights enforcement, including the repeal of discriminatory laws, compensation, and restitution for victims, and, where warranted, prosecution.
“This report provides an important roadmap for increasing accountability, so that doctors can continue treating the sick and wounded, even in dangerous situations,” said Donna McKay, executive director of Physicians for Human Rights.
The coalition urged the UN high commissioner for human rights to support expanded monitoring and reporting of attacks on health workers and services, and for the Human Rights Council to pass a resolution reaffirming the obligations of countries never to attack health workers and to ensure that they are protected.
“Too often, when health workers, ambulances, or hospitals are attacked, there is no accountability,” said Joe Amon, health and human rights director at Human Rights Watch, a member of the coalition. “The special rapporteur’s report should shame governments into ending impunity for these outrageous and unlawful attacks.”