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“The situation [in our village] was very bad,” said Saudia Idris, a refugee from Blue Nile State. “There was no relief. The planes were constantly bombing us and the militia were attacking us. It was no way to live,” she told Human Rights Watch. “Disease began to spread, but we couldn’t get any medication because the militia were always attacking.” The Sudanese government’s indiscriminate aerial bombardment and shelling in Blue Nile and Southern Kordofan states has killed and injured scores of civilians since the conflict began more than a year ago, Human Rights Watch said in a report, Under Siege.
Mali is currently experiencing the most severe crisis of its existence. When heavily armed Tuareg rebels and Islamist rebel groups poured in from Libya on January 17, 2012, they quickly defeated the underequipped, disorganized Malian army. Now they have seized the country’s vast northern regions and are working to force sharia—or Islamic law—on the people there. The most visible rebel chief is not Malian—he is from Pakistan—and he often appears on TV to say that sharia is good for Mali. That if Mali accepts Islamic law, the rebels will help the country to get funds from other Islamic countries. We never thought something like this could happen in Mali. It still feels like a dream, like it’s not reality.
In Bahrain, health workers have been drawn into the conflict that began in February 2011 when protesters called for reform and the government responded with violence. By treating wounded civilians, frontline health workers witnessed the effects of the government crackdown—and quickly became targets themselves. One health worker recently told news outlet RT of her experience. “As a punishment for not obeying the authorities to abandon these patients, all the doctors who were involved in treating these patients, they were arrested. Myself personally, I was abducted from my house at 3 am in the morning, and I was badly mistreated… I was tortured. Later on, after being jailed for almost two months, I was prosecuted, tried in a military court and was sentenced to 15 years imprisonment,” said Dr. Nada Dhaif.
The World Medical Association revised its Regulations in Times of Armed Conflict and Other Situations of Violence, endorsing collection of data and including a code of conduct for physicians in conflicts. In May 2012 at the World Health Assembly, member states of the World Health Organization passed a resolution requiring the WHO to lead international data collection of attacks on health workers, facilities, transports, and patients.
In his New York Times blog, Nicholas Kristof wrote about the horrific attack on Dr. Denis Mukwege, a doctor in the Democratic Republic of the Congo who advocates for women’s health and does fistula repair. “Dr. Mukwege presumably was targeted because of a strong speech he gave at the United Nations last month denouncing mass rape in Congo and the impunity for it,” Kristof noted. This important blog depicts a sad incident in a much larger problem, which is widespread violence against health workers and health facilities under conditions of armed conflict.
The Democratic Republic of the Congo’s Sud Kivu province has been an area of armed conflict for many years, with various rebel factions fighting for control over the resource-rich region. The continued fighting has disrupted health services — which were weak to begin with — due to geographic isolation and poorly supported health workers.
Lack of access to health care facilities, for both patients and health care providers, is one of the main obstacles to the provision of health care. There are severe staffing shortages in hospitals and other health facilities, especially in areas experiencing high levels of violence.
Leonard S. Rubenstein of the Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Public Health took part in the 65th World Health Assembly in Geneva last month. Upon his return, he told the magazine of the Johns Hopkins Bloomberg School of Public Health about the new resolution requiring the World Health Organization to lead international data collection of attacks on health workers, facilities, transports and patients.
The Safeguarding Health in Conflict coalition commends the World Health Assembly—the governing body of the World Health Organization (WHO)—on its unprecedented step to protect the lives of health workers and patients in humanitarian crises by spearheading global efforts to document the number of attacks on medical services. In violent conflicts, where health needs are most urgent, health workers are at risk of assault, arrest and sometimes kidnapping and death, compromising their ability to deliver care and remain on the job. But such attacks usually go unreported; with a body of evidence, the global community can better protect fragile health systems and those on the frontlines.
If you’ve been following international news for the past year, you are most likely aware of the recent developments and political movements in the Middle East. While the Arab Spring has opened the possibility for a new wave of democracy in several Middle Eastern countries, an unfortunate new wave of crime and violence toward health facilities, doctors, and patients has emerged. This issue did not arise from the Arab Spring, nor is it a new issue, but recent events have propelled this violence into the international spotlight.