Protecting health-care workers in the firing line

Abstract

“In Syria, having a medical kit visible on your car seat can be more dangerous than having a Kalashnikov”, s a y s B r u c e E s h a y a C h a u v i n , medical adviser to the International Committee of the Red Cross (ICRC). “Health-care workers in confl ict zones are literally being hunted down.” Eshaya-Chauvin was talking at an ICRC conference about violence against health-care workers in London, UK, on Dec 3. The ICRC, along with key players in global health such as the World Medical Association (WMA), the British Medical Association (BMA), and Medecins Sans Frontieres (MSF), is spearheading a project called Healthcare in Danger to raise awareness of the way that medical workers in war zones are targeted. The Geneva Conventions and human rights laws to protect sick people during conflict state that all wounded and sick must have access to medical assistance, but this international framework is frequently fl outed. For many in the humanitarian community, this situation is reaching a crisis point that requires urgent action both internationally and on the ground. A 2011 report by the ICRC recorded violent acts in 16 countries and gives some insight into the perpetrators and the victims, and shows how indiscriminate this violence is. The state was responsible for a third of the events, and armed groups for another third. A point worth highlighting, says Eshaya-Chauvin, is that attacks are not just aimed at international humanitarian workers—in many situations, local medical staff bear the brunt of the attacks. Indeed, international non-governmental organisations (NGOs) were aff ected in 34·5% of attacks, and local health-care workers in 25·6%. The violence is often brutal. Healthcare workers might be beaten severely, kidnapped and tortured, or shot at by snipers. Those seeking health care might be killed on their way to hospitals, and those hospitals themselves might be the target of gunfi re and bombing. Armed forces on either side of the confl ict regularly block ambulances or destroy medical supplies. Providing health care in confl ict zones is obviously inherently dangerous, but sometimes the level of violence aimed at health-care workers—irrespective