Attacks on Health Care

What are the problems with regards to attacks on health care?

Data collected by the United Nations has indicated that a significant rise in armed conflict has occurred over the last few years.[1] According to the International Committee of the Red Cross (ICRC), violence disrupts health-care services when they are needed most.[2] The ICRC has confirmed that a huge number of people die unnecessarily because they cannot receive health services.[3] After conducting a 16-country study, the ICRC found that the key cause of preventable mortality is the widespread lack of respect for the law by parties to conflict and other armed groups.[4]

Aside from the devastation experienced by individual victims of attacks on healthcare, these attacks have disastrous consequences on the health of the community. According to the Center for Public Health and Human Rights, research has shown the maternal mortality increases and access to treatment for diseases and other health conditions decreases after attacks on health workers, patients, or facilities.[5]

Why are attacks on health care a human rights issue?

As stated in the Alma Ata Declaration on Health for All, the right to health is a human right. Unfortunately, attacks on health workers and facilities violate the right to health by depriving patients of the care they need. In November 2013, the global health and human rights community convened to discuss attacks on health workers, patients, and facilities.[6]The ICRC and others have documented attacks on health facilities, which have been shelled, tear-gassed, looted and occupied.[7] Examples of attacks against health workers and patients include harassment, physical abuse, torture, murder, sexual assault, disappearance, detention, and prosecution. Victims have included patients, physicians, nurses, ambulance drivers, and community health workers.

What are the relevant sources?

Major international human rights laws and treaties protect health workers, patients and facilities. These laws include: the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment; the International Covenant on Economic, Social, and Cultural Rights (ICESCR); and the Convention Against Torture (CAT). In December 2014, the UN passed a resolution on global health and foreign policy, that also pays attention to attacks on health workers. This resolution urges States to take immediate steps to ensure health workers in all countries are protected from violence, whether in armed conflict or in times of peace.[8]

According to Physicians for Human Rights, attacks on healthcare and health workers directly violate international law, which requires “the protection of medical personnel, patients, facilities, and transport from attack or interference”.[9] In addition to violating international human rights laws, attacks against health care also violate the principle of medical neutrality which applies during peacetime and during instances of armed conflict.[10]

How can the situation be improved?

At the international level, PHR states that the international community can create a Special Rapporteur on Medical Neutrality that would chronicle and document violations of medical neutrality.

At the national and local level, the Center for Public Health and Human Rights has called on health professional organizations to promote universally accepted standards of professional conduct among health workers that includes training on human rights and medical ethics as well as advocacy for the protection of health workers and patients.

What can health workers do to improve the situation?

One way individual health workers can improve the situation is by participating in global partnerships such as the Health Care in Danger (HCiD) Network, which is a web-based interactive platform that gathers organizations and individuals working to improve safe access to health care in armed conflict and other emergencies. It allows members to access and contribute to a resource centre. They can also exchange practical experiences, share a community calendar and follow on recommendations developed during the Health Care in Danger workshops.[11] To join the HCiD or to learn more about this network, please contact the HCiD Information and Community Manager Chiara Zanette (czanette@icrc.org).

Health workers may also find it useful to subscribe to the monthly updates released by the Safeguarding Health Coalition, a group of international nongovernmental organizations working to protect health workers, services, and infrastructure.  Details on how to sign up for the updates and other opportunities can be found here: www.safeguardinghealth.org/take-action.

This page was written by Tara Ornstein and last updated in February 2015.

Notes

[1] http://www.unhcr.org/539809d4b.html

[2] https://www.icrc.org/eng/what-we-do/safeguarding-health-care/index.jsp

[3] http://www.icrc.org/eng/what-we-do/safeguarding-health-care/index.jsp

[4] http://www.icrc.org/eng/resources/documents/report/hcid-report-2011-08-10.htm

[5] http://www.jhsph.edu/research/centers-and-institutes/center-for-public-health-and-human-rights/_pdf/BellagioReport-03192014.pdf

[6] http://www.jhsph.edu/research/centers-and-institutes/center-for-public-health-and-human-rights/_pdf/BellagioReport-03192014.pdf

[7] http://www.icrc.org/eng/what-we-do/safeguarding-health-care/index.jsp

[8] http://www.un.org/ga/search/view_doc.asp?symbol=A/69/L.35

[9] http://physiciansforhumanrights.org/library/multimedia/principle-of-medical-neutrality.html

[10] http://physiciansforhumanrights.org/library/multimedia/principle-of-medical-neutrality.html

[11] http://www.icrc.org/eng/what-we-do/safeguarding-health-care/solution/2013-04-26-hcid-expert-consultations.htm

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Resources

Topics:
Type of resource: Books and reports

Impunity Must End: Attacks on Health in 23 Countries in Conflict in 2016 (2017)
The Safeguarding Health in Conflict Coalition

Open resource
Topics:
Type of resource: Books and reports

Changes in medical practice in Syria (2016) - Justin Armstrong
MSF

Open resource
Topics: ,
Type of resource: Books and reports

Armed conflict does not justify violations. In: Human rights for human dignity: A primer on economic, social, and cultural rights (2014)
Amnesty International, pp. 89-93, July

Open resource
Topics:
Type of resource: Books and reports

Call to Action: Bellagio Conference on Protection of Health Workers, Patients, and Facilities in Times of Violence (2014)
Center for Public Health and Human Rights of Johns Hopkins University

Open resource