Effects of violence on health care

April 24, 2014

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Between January 2012 and December 2013, the International Committee of the Red Cross (ICRC) studied the effects of violence on health care during armed conflict and other emergencies in 23 countries. Information was collected, through various sources, on 1809 violent incidents that involved the use or threat of violence against health-care personnel, the wounded and the sick, health-care facilities and medical transports. 

The second interim report,* Health Care in Danger. Violent incidents affecting the delivery of health care, was published in early April. One of the health workers interviewed in this study was Liana Kakesa, the ICRC’s assistant medical coordinator in Bangui, Central African Republic, where it has been extremely unsafe lately. “We were threatened by armed men who insisted on getting in the car and making us take them where they wanted to go. When we tried to explain our work to them they became angry and threatened us with machetes and rifles.”

This report analyses the main patterns of violence:

  • Local, far more than international, health-care providers, bear the brunt of violence, as was the case in 2012.
  • State armed forces and security forces, and armed non-State actors, are the main perpetrators, each of them being responsible for approximately one-third of all the recorded violence against the delivery of health care.
  • The report on health-care facilities shows that they are affected mainly by looting, direct attacks, and disruptive armed entry.

As the report says, providing health care has remained as dangerous as ever over the last two years. In addition to reporting on attacks, the study highlights lesser-known types of incident, such as armed personnel disrupting hospital services by forcing their way in, or sexual violence against health personnel.

“Media reports only highlight violence affecting health services in just a few conflict-stricken countries, such as Syria,” said Pierre Gentile, head of the ICRC-led Health Care in Danger project on the dangers facing health-care services. “However, the ICRC report shows that the violence occurs in other countries too. It is therefore urgent that governments, armed forces and the health-care community step up their efforts to make health-care delivery safer all over the world.”


Access Health Care in Danger. Violent incidents affecting the delivery of health care, ICRC, 2014

* The first ICRC report on this issue, published in May 2013, was titled Health Care in Danger. Violent incidents affecting health care.