People's Stories Wellbeing

Attacks on health care have a devastating impact on people already suffering from war
by Safeguarding Health in Conflict Coalition
June 2023
A new report published by the Safeguarding Health in Conflict Coalition (SHCC) documents 1,989 attacks and threats against health care facilities and personnel across 32 countries and territories in armed conflict and situations of political violence throughout 2022.
The reported figure represents the most severe year of attacks against health care in the last decade globally. Over half of all attacks were reported in just two countries, Ukraine and Myanmar. The report identifies more than 750 attacks perpetrated by the Russian Federation on health care in Ukraine alone–the most committed in a single year in one country.
“Over the last year, we identified a 45% increase in reported incidents of violence against or obstruction of health care in conflict zones as compared to 2021,” said Christina Wille, director of Insecurity Insight, which led the data collection and analysis for the report.
“Health workers have been systematically targeted with violence, killed, arrested and kidnapped while health facilities have been destroyed with explosive weapons and robbed of essential medicine and equipment.”
Of these violent incidents, the report identifies: 1,989 total reported incidents of violence against health facilities and health workers; 704 incidents where health facilities were destroyed or damaged; 232 health workers killed; 298 health workers kidnapped; 294 health workers arrested.
Despite the alarmingly high global rates of reported attacks on health, the number of violent incidents documented in the report is likely an undercount due to difficulties of data collection given insecurity, communication blockages, and fear of retaliation for reporting.
“Some of these assaults are well-known and frequently reported, especially the bombing and shelling of hospitals and clinics,” said Leonard Rubenstein, chair of the Safeguarding Health in Conflict Coalition (SHCC) and professor at the Johns Hopkins Bloomberg School of Public Health, “But less visible acts, like attacks on vaccinators in seven countries, deprive millions of children protection from measles, polio and other diseases, as vaccination campaigns have to be suspended.”
Following Russia’s invasion of Ukraine in February 2022, the report documents 782 violent incidents against health throughout the first 10 months of the conflict alone, many attributed to the destruction of the health infrastructure, shooting at ambulances and deaths of health workers.
In Myanmar, at least 271 violent incidents have been reported since the February 2021 coup d’etat by Myanmar’s junta, in which health workers were arrested or brutally killed for caring for wounded and bombing of health facilities.
“The assaults have a devastating impact on the availability of health care to people already suffering from war. As health systems are destroyed, health workers flee, and essential supplies and medication are looted, severing access to health for years after attacks take place,” added Wille.
“The far-reaching impacts of attacks on health are as disturbing as their frequency. Health workers were arrested and killed in countries where political instability has endured, including Iran, Myanmar and Sudan.
In protracted conflicts in Afghanistan, the Democratic Republic of the Congo, Nigeria, South Sudan, the occupied Palestinian territory and Yemen, the report found severely high rates of attacks on health. Across the wider Sahel, the report also reveals how insecurity for health care providers has been growing as the humanitarian space has been shrinking.
“The suffering patients and health workers endure from these war crimes cannot be undone, but accountability for the attacks can bring them a measure of justice. Global attention to Russia’s atrocities in Ukraine must become an inflection point in prosecuting the perpetrators of these crimes there and everywhere,” added Rubenstein.
The report makes a series of pointed recommendations to the UN Security Council, the International Criminal Court (ICC), UN Secretary General, legislators of UN member states, the World Health Organization (WHO), and medical, nursing, and public health organizations. Specifically, the Coalition calls on these entities to:
End impunity through prioritizing prosecutions of war crimes and attacks on health. Strengthen prevention against the obstruction and prevention of the delivery of health care through reform of law and military doctrine and training and restrictions on arms transfers.
Reform the World Health Organization’s system for collecting and disseminating data on attacks on health care. Strengthen global, regional and domestic leadership on the protection of health care across states and UN bodies. Support health workers through ministries of health, UN member states, donors, and health organizations.
“When one doctor is killed or a hospital bombed, thousands of patients are deprived of health care,” said Erika Dailey, director of advocacy and policy at Physicians for Human Rights.
“The way to protect the right to health is to ensure that these critical civilian resources are fully protected under the law. If these devastating, cascading harms are to be stopped, perpetrators must be held criminally accountable.”
* The Safeguarding Health in Conflict Coalition is a group of more than 40 organizations working to protect health workers and services threatened by war or civil unrest.


Every day, people flee conflict and disasters and become displaced inside their own countries
by NRC, Internal Displacement Monitoring Centre
May 2023
The number of internally displaced people (IDPs) around the world reached 71.1 million as of the end of 2022, an increase of 20 per cent from the previous year, according to the Internal Displacement Monitoring Centre’s flagship annual report.
The number of movements in which people fled in search of safety and shelter, sometimes more than once, was also unprecedented in 2022. The conflict in Ukraine triggered nearly 17 million displacements as people fled repeatedly from rapidly shifting frontlines, and monsoon floods in Pakistan triggered 8.2 million, accounting for a quarter of the year’s global disaster displacement.
“Today’s displacement crises are growing in scale, complexity and scope, and factors like food insecurity, climate change and escalating and protracted conflicts are adding new layers to this phenomenon,” said IDMC’s director, Alexandra Bilak. “Greater resources and further research are essential to help understand and better respond to IDPs’ needs”.
Internal displacement is a global phenomenon, but nearly three-quarters of the world’s IDPs live in just 10 countries - Syria, Afghanistan, the Democratic Republic of the Congo (DRC), Ukraine, Colombia, Ethiopia, Yemen, Nigeria, Somalia and Sudan - many as a result of unresolved conflicts that continued to trigger significant displacement in 2022.
Conflict and violence triggered 28.3 million internal displacements worldwide, a figure three times higher than the annual average over the past decade. Beyond Ukraine, nine million or 32 per cent of the global total were recorded in sub-Saharan Africa. DRC accounted for around four million and Ethiopia just over two million.
The number of disaster displacements rose by nearly 40 per cent compared to the previous year, reaching 32.6 million, largely the result of the effects of La Nina which continued for a third consecutive year. South Asia recorded the highest regional figure, surpassing East Asia and the Pacific for the first time in a decade.
In the Horn of Africa, the worst drought in 40 years triggered 2.1 million movements, including 1.1 million in Somalia alone, while fuelling acute food insecurity across the region.
The secretary general of the Norwegian Refugee Council, Jan Egeland, described the overlapping crises around the world as a “perfect storm”.
“Conflict and disasters combined last year to aggravate people’s pre-existing vulnerabilities and inequalities, triggering displacement on a scale never seen before,” he said. “The war in Ukraine also fuelled a global food se- curity crisis that hit the internally displaced hardest. This perfect storm has undermined years of progress made in reducing global hunger and malnutrition.”
Three-quarters of the countries that face crisis levels of food insecurity are also home to IDPs. Shining light on this connection is key to understanding how IDPs are affected by disruptions to food systems, but also how future investments in food security will be essential to reaching solutions.
“There is an increasing need for durable solutions to meet the scale of the challenges facing displaced people,” Bilak said. “This spans the expansion of cash assistance and livelihood programmes that improve IDPs’ economic security, through to investments in risk reduction measures that strengthen their communities’ resilience.”
World’s most neglected displacement crises. (NRC)
For the first time, Burkina Faso tops the list of the world’s most neglected displacement crises, according to a new report from the Norwegian Refugee Council (NRC). Redirection of aid and attention towards Ukraine has increased neglect of some of the world’s most vulnerable people.
The annual list of neglected displacement crises is based on three criteria: lack of humanitarian funding, lack of media attention, and a lack of international political and diplomatic initiatives. The crisis in the Democratic Republic of Congo ranks second, having appeared first or second on the list every year since its inception seven years ago. Colombia, Sudan, and Venezuela follow in this grim ranking.
“Neglect is a choice – that millions of displaced people are cast aside year after year without the support and resources they so desperately need is not inevitable,” said Jan Egeland, NRC’s Secretary General.
“The powerful response to the suffering inflicted by the war in Ukraine demonstrated what the world can deliver for people in need. Political action for Ukrainians has been impactful and swift, borders kept open, funding plenty, and media coverage extensive. Those in power need to show the same humanity towards people affected by crises in places such as Burkina Faso and the Democratic Republic of the Congo.”
More than five times more articles were written about the Ukrainian displacement crisis last year than about all the world’s ten most neglected crises in total. For every dollar raised per person in need in Ukraine in 2022, just 25 cents were raised per person in need across the world’s ten most neglected crises.
The repeated warnings of increased disparity due to the reallocation of resources to the Ukraine response have now become reality. The redirection of a large amount of aid money towards Ukraine and towards hosting refugees in donor countries means that many crises have seen a drop in assistance, despite growing needs. Total aid to Africa, where we find seven out of the ten most neglected crises, was 34 billion USD in 2022, representing a drop of 7.4 per cent compared to 2021.
The Ukraine crisis also contributed to an increase in food insecurity in many of the countries featured in the report, worsening already dire crises, and increasing the number of people in need.
“The world has failed to support the most vulnerable, but this can be reversed. The lives of millions of people suffering in silence can improve, if funding and resources are allocated based on need, not geopolitical interest, and media headlines of the day,” said Egeland. “Last year the gap between what was needed and what was delivered in humanitarian assistance was 22 billion USD. This is a huge sum of money, but no more than Europeans spend on ice cream a year. We need donors to increase support and new donor countries to step up to share responsibility.”
Burkina Faso’s decline since the crisis broke out five years ago has been swift and devastating. More than 2 million people have been forced to flee their homes, and nearly a quarter of the population now requires humanitarian aid. Across the country, 800,000 people are living in areas under blockade by armed groups where they have no access to even basic services. The situation is increasingly dire with some people forced to eat leaves to survive.
“We must do more to end the suffering in Burkina Faso before despair becomes entrenched and it is added to the growing list of protracted crises. That this crisis is already so deeply neglected shows a failure of the international system to react to newly emerging crises, as it also fails those lost in the shadows for decades. Ultimately, greater investment in diplomatic solutions is needed if we hope to pull crises off this list,” said Egeland.
The world’s most neglected displacement crises highlights Burkina Faso, DR Congo, Colombia, Sudan, Venezuela, Burundi, Cameroon, Mali, El Salvador, Ethiopia.

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