Global health centre
15 June 2018

Health care in conflict zones - still under attack

Under international humanitarian law (IHL) hospitals and other medical facilities, medical personnel and medical transport must be respected and protected at all times, while attacks targeting them are prohibited. However, in many current armed conflicts this principle is not adhered to, resulting in loss of life of not only health workers and other medical personnel, but also impacting on patients because they cannot access healthcare facilities due to the destruction of this infrastructure. Both state and non-state actors involved in the conflicts are conducting attacks and other violence towards healthcare. This complicates the national and international response to provide healthcare.  

Majority of the international community remembers the airstrike in Kunduz, Afghanistan, while attacks on healthcare personnel and facilities occur in many countries, almost every day. In particular the Eastern Mediterranean region continues to experience volatility, wide-spread and systematic attacks and in other conflict regions attacks on healthcare are also becoming more common.

International human rights law also stipulates that everyone has the right to the highest attainable standard of physical and mental health without discrimination. Intentionally directing attacks against medical facilities and personnel, wilful killing or harming of sick or wounded people may constitute war crimes. However, bringing violators to justice is difficult in the multifaceted and prolonged conflicts because in these situations not only healthcare is under threat but also many other human rights violations occur. The Human Rights Council in its 38th session in early July condemned the continuous attacks on healthcare within the Syrian Arab Republic, while also noting other issues including arbitrary detention, chemical weapons use and the overall grave humanitarian emergency, as well as the resource constraints to address them.

In order to discuss these complexities and seek ways forward, the Global Health Centre and the International Peace Institute organised a one-day workshop for policy makers on 8th June 2018 on the current governance and policy mechanisms for protecting health workforce, facilities and the patients in war zones. The workshop featured speakers with diverse and extensive field experience in conflict locations and highlighted the crude realities of providing health care in war zones.  The discussion also sought to rethink and redefine existing collaboration models, governance structures and accountability mechanisms for international health and humanitarian actors in order to ensure the adequate delivery of health services in conflict settings. The participants identified accountability, or the lack thereof, as a key issue in current health governance systems. Read more about the discussions of the workshop here.  

Following this theme, the GHC together with the Centre for Strategic and International Studies hosted a screening of the CSIS film The New Barbarianism, which wants to create awareness and address what is necessary at international level to prevent the silent acceptance and normalisation of these IHL violations and the abhorrent loss of lives. The panellists from ICRC, WHO and the Permanent Mission of Canada highlighted the need to protect IHL and not give into the rhetoric predicting the downfall or undermining the law, in order to maintain its position as a respected international set of rules of war.

As with most long-term ongoing health emergencies in conflict settings, the public attention, as well as the resources and capacity of aid organisations, tend to divert and reduce. Therefore, it is even more important to continue drawing attention to the issues and ongoing human suffering. The events held at Maison de la paix in June did exactly this and reinvigorated the political and public awareness of the ways healthcare facilities and personnel continue to be under attack.