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Civilians are #NotATarget
by OCHA, ICRC, IFRC, MSF, agencies
2:10pm 4th Aug, 2018
Aug. 2018
Every year World Humanitarian Day brings citizens of the world together to rally support for people living in humanitarian crises and to pay tribute to the aid workers who help them. This year, World Humanitarian Day builds on the momentum created by the 2017 #NotATarget campaign, which saw more than 2 million people take actions urging global leaders to do a better job of protecting civilians, humanitarians and health workers in conflict zones.
Civilians in conflict zones are routinely killed or maimed in targeted or indiscriminate attacks. Last year, the United Nations recorded the deaths or injuries of tens of thousands of civilians in attacks in just six conflict-affected countries: Afghanistan, the Central African Republic, the Democratic Republic of the Congo (DRC), Iraq, Somalia and Yemen.
The failure of parties to conflict to protect civilians cannot go unchallenged. Around the world, conflict is exacting a massive toll on people's lives. People in cities and towns struggle to find food, water and safe shelter, while fighting drives millions of people from their homes.
Children are recruited by armed groups and used to fight, and their schools are destroyed. Women are abused and humiliated.
As humanitarian workers deliver aid and medical workers treat the sick and wounded, they are directly targeted, treated as threats, and prevented from bringing relief and care to those in desperate need.
Conflict has forced record numbers of people to flee their homes, with over 65 million people now displaced, most of them within their own borders.
Humanitarians and health workers are frequently targeted in attacks and prevented from carrying out impartial humanitarian or medical activities. Since 2003, over 4,000 humanitarians have been killed, injured, detained, kidnapped and prevented from responding to those in need. That is an average of 300 cases a year. In 2017, WHO recorded 322 attacks across conflict-affected countries including Afghanistan, CAR, DRC, Iraq, Libya, Mali, Nigeria, Somalis, South Sudan, Sudan and Syria. These resulted in 242 deaths of and 229 injuries to medical personnel and patients.
There are rules governing fighters' behaviour in war. Every time those rules are broken, human suffering intensifies. States and armed groups have clear and long established international legal obligations in conflict, including to protect civilians from harm, to spare schools and hospitals, and to ensure the safe and unimpeded passage of aid workers and supplies. Leaders and fighting forces must take active steps to spare civilians and the infrastructure they rely on.
Conflict increasingly takes place in towns and cities, injuring tens of thousands of civilians every year and laying waste to homes and vital infrastructure, including hospitals and schools, and water and power systems. More than 50 million people are currently affected by conflict in urban areas. Our global capacity to respond to these crises is increasingly overstretched.
Conflict-driven food insecurity and the potential for famine have left millions of lives hanging in the balance. Conflict is one of the main drivers of global food insecurity, in addition to climatic shock.
World leaders must ensure violators are held accountable. In his report this year on the Protection of Civilians in conflict, UN Secretary-General Antonio Guterres called on countries to undertake credible and effective investigations into allegations of serious violations of international humanitarian law and to hold perpetrators to account, with the support of the United Nations as necessary.
At the World Humanitarian Summit in 2016, global leaders made commitments to uphold the norms that safeguard humanity - to undertake actions to protect civilians and civilian infrastructure in armed conflict.
This year once again, millions of citizens from around the world are demanding that world leaders and non-state actors take action to protect people caught in armed conflict.
We demand that world leaders do everything in their power to protect civilians in conflict. Civilians are #NotATarget
* Agenda for Humanity: Respect the Rules of War:
* Report of the UN Secretary-General on the protection of civilians in armed conflict:
* States must act to fulfil famine victims right to food, UN Special Rapporteur on the right to food:
* Monitoring food security in countries with conflict situations (FAO/WFP) Aug. 2018:
June 2018
We are seeing an utter disregard for the protection of children in conflict - UNICEF Executive Director Henrietta Fore.
I have recently returned from a trip to Mali with the Secretary General, where children are suffering in silence, and are the missing face of the crisis.
More than 850,000 children under the age of five are at risk of malnutrition this year, including 274,000 who face severe malnutrition and are at imminent risk of death. This represents a 34 per cent increase over our initial estimates for the year.
More than a million children are out of primary school and another million are out of secondary school. At least 750 primary schools remain closed in the northern and central parts of the country due to insecurity.
Mali is also one of the top 10 countries in the world with the highest rates of newborn and maternal mortality, with 1 in 28 babies dying in the first month of life and 1 in 27 women likely to die from pregnancy-related causes.
Mali is one of many countries around the world where children are suffering greatly because of conflict.
Yemen has the highest number of children in need at 11.3 million, followed by Syria with 8 million children and the Democratic Republic of the Congo with 7.9 million.
These are vast numbers, and the number of children affected by conflict is on the increase. It's an issue that UNICEF is hard at work on, and we very much appreciate Sweden's long standing interest and leadership on the issue of children and armed conflict. It is an issue the world needs to pay more attention to. Children are bearing the brunt of most of these conflicts.
What we are seeing around the world is an utter disregard for the protection of children.
In Syria, over 300 education facilities have been attacked since the beginning of the conflict 7 years ago. Schools should always a be a place of safety. Schools should always be protected.
In South Sudan, around 19,000 children continue to serve as fighters, messengers, porters, cooks and even sex slaves for the warring parties.
Conflicts are increasingly taking place in urban settings, causing significant damage to civilian infrastructure and damaging social protection systems.
Water systems are being damaged: In Yemen, between August 2017 and May 2018, there were 5 verified attacks by the Coalition forces on water reservoirs and pipes, namely in Sa'ada and Amran governorates, affecting over 90,000 people.
Hospitals and medical staff have frequently come under direct attack. In Syria alone, 92 attacks have been documented over the first four months of this year, involving 89 deaths and 135 injuries. In 2017, the World Health Organization recorded 322 attacks resulting in 242 deaths among medical personnel and patients.
Hard won gains on education are being reversed. In Mali, the number of children out of primary school increased by 30 per cent since 2009. In Afghanistan, the number of children out of school increased for the first time since 2002, with 3.7 million children - nearly half of all children between ages 7 and 17 - now missing out on school.
Harrowing violence inflicted on women and girls, often with life-long consequences and in complete impunity.
In Cox's Bazar, nine months after Rohingya refugees fled brutal attacks that included killings, burnings and rapes, women are facing the stigma of sexual violence and the horror of delivering and raising babies in appalling conditions.
The longer the conflict, the deeper the impact.. We see this in the long unresolved conflict between Israelis and Palestinians, from the hundreds of Palestinian children who are detained in Israeli prisons each month, to the children in southern Israel who live under the threat of mortars or rockets landing in their homes and schools.
We also see it in the Democratic Republic of the Congo where ethnic violence in the Kasai region has led to a massive increase in child recruitment, and where decades of war have weakened health systems, making the country vulnerable to disease outbreaks. An ongoing Ebola outbreak is the latest addition to the woes of the country and its children.
In all these countries, UNICEF's dedicated teams are working to deliver for children, often in extremely complex environments and sometimes at great risk.
Examples of this work since the beginning of the year include:
In Cox's Bazar, diphtheria vaccination for more than 400,000 children and psychosocial support for 140,000 children. In South Sudan, measles vaccination for 460,000 children and release of more than 800 child soldiers. In Syria, access to safe water for 13 million people and polio vaccination for 3.3 million children. In Yemen, severe malnutrition treatment for over 61,000 children and access to safe water for close to 4 million people.
We need access to the populations we serve. We urge parties to the conflicts to allow humanitarian organizations to have unimpeded, unconditional and sustained access so that we are able to save lives.
We need funds. Of the $3.7 billion we need for humanitarian programmes this year, we have only received 900 million or 24 per cent in 2018.
Children need peace, but meanwhile, parties to conflict have an obligation to respect the rules of war - rules that prohibit the unlawful targeting of civilians, attacks on schools or hospitals, the use, recruitment and unlawful detention of children, and the denial of humanitarian assistance. When conflicts break out, these rules need to be respected and those who break them need to be held to account.
June 2018
As the Yemeni port city of Hodeidah faces the threat of an assault, I am extremely concerned about the impact it will have on children in this port city and beyond.
UNICEF estimates that at least 300,000 children currently live in and around Hodeidah city - boys and girls who have been suffering for so long already.
Millions more children throughout Yemen depend on the humanitarian and commercial goods that come through that port every day for their very survival. Without food imports, one of the world's worst malnutrition crises will only worsen. Without fuel imports, critical for water pumping, people's access to drinking water will shrink further, leading to even more cases of acute watery diarrhea and cholera, both of which can be deadly for small children.
There are 11 million children in need of humanitarian aid in this war-torn country. Choking off this lifeline will have devastating consequences for every one of them.
UNICEF teams delivered antibiotics, syringes, IV fluid, ready-to-use therapeutic food and hygiene kits to our local partners in Hodeidah just two days ago. But this will only last so long. Should the security situation worsen, our capacity to respond will be severely hampered.
We urge all parties to the conflict and all those who have influence over them to put the protection of children above all other considerations. Every effort must be made to keep children safe and to provide them with the health, protection, water, sanitation, nutrition and education services they desperately need. Aid distribution should continue unimpeded and civilians wishing to move to safe areas should be allowed to do so.
May 2018
Attacks on children in conflict continue unabated, by UNICEF Executive Director Henrietta Fore.
From the Central African Republic to South Sudan, and from Syria to Afghanistan, attacks on children in conflict have continued unabated during the first four months of the year.
"With little remorse and even less accountability, parties to conflict continue to blatantly disregard one of the most basic rules in war: the protection of children.
"No method of warfare has been off-limits, no matter how deadly for children: Indiscriminate attacks on schools, hospitals and other civilian infrastructure, abductions, child recruitment, besiegement, abuse in detention and denial of humanitarian assistance were all too commonplace.
"In Yemen, for example, more than 220 children were allegedly killed and over 330 were injured since the beginning of the year as a result of the conflict. Nearly 4.3 million children are now at risk of starvation, a 24 per cent increase over 2017 levels. An acute watery diarrhoea and cholera outbreak which killed more than 400 children under the age of five last year is threatening to claim even more young lives as the rainy season begins and hygiene conditions deteriorate further.
"In Syria, hopes for peace remain dim. More than 70 attacks on hospitals and health facilities were verified during the first three months of the year, denying children and families vital health services. Over 300 education facilities have been attacked since the beginning of the conflict. Some 5.3 million children have been internally displaced or became refugees, and nearly 850,000 children continue to live in besieged or hard-to-reach areas.
"In Gaza, we have seen children killed and injured in protests since early March, with reports on Monday of more child casualties in what is said to be the deadliest day of violence since the 2014 Gaza war.
In Bangladesh, more than 400,000 Rohingya refugee children who survived recent atrocities in Myanmar need humanitarian assistance. As the monsoon season approaches, the risk of cholera and other waterborne diseases is higher than ever.
"In South Sudan, the first country I visited as UNICEF Executive Director, at least 2.6 million children have been forced to flee their homes. More than 1 million children are acutely malnourished including over 250,000 severely so and at increased risk of death. Although close to 600 children have been released from armed groups so far this year, around 19,000 continue to serve as fighters, messengers, porters, cooks and even sex slaves for the warring parties.
"In Afghanistan, more than 150 children were reported killed and over 400 injured during the first three months of the year because of the conflict.
"In the Central African Republic, renewed violence over the past few months has forced nearly 29,000 children to flee their homes, bringing the total number of internally displaced children close to 360,000. More than 2 in 5 children under the age of five suffer from chronic malnutrition and one third of school-aged children are now out of school.
"In all these countries and many more, committed teams from UNICEF and partners are doing all they can to alleviate the suffering of the most vulnerable, those separated from their families, terrified and alone, those getting sick in densely populated refugee camps, those on the move in monsoon and unrelenting dry seasons, those who are starving.
Despite funding shortfalls we have only received 16 per cent of our funding needs for this year we are resolutely committed to serving the most vulnerable. We are vaccinating children, treating them for malnutrition, sending them to school, providing them with protection services, and trying to meet their basic needs.
Humanitarian aid alone is not enough. Children need peace and protection at all times. The rules of war prohibit the unlawful targeting of civilians, attacks on schools or hospitals, the use, recruitment and unlawful detention of children, and the denial of humanitarian assistance. When conflicts break out, these rules need to be respected and those who break them need to be held to account. Enough is enough. Stop attacks on children."
Feb. 2018
Humanitarian Action for Children 2018 Appeal
UNICEF appealed today for $3.6 billion to provide lifesaving humanitarian assistance to 48 million children living through conflict, natural disasters and other emergencies in 51 countries in 2018.
Around the world, violent conflict is driving humanitarian needs to critical levels, with children especially vulnerable. Conflicts that have endured for years - such as those in the Democratic Republic of Congo, Iraq, Nigeria, South Sudan, Syria and Yemen, among other countries continue to deepen in complexity, bringing new waves of violence, displacement and disruption to children's lives.
Children cannot wait for wars to be brought to an end, with crises threatening the immediate survival and long term future of children and young people on a catastrophic scale, said UNICEF Director of Emergency Programmes, Manuel Fontaine.
Children are the most vulnerable when conflict or disaster causes the collapse of essential services such as healthcare, water and sanitation. Unless the international community takes urgent action to protect and provide life-saving assistance to these children, they face an increasingly bleak future.
Parties to conflicts are showing a blatant disregard for the lives of children. Children are not only coming under direct attack, but are also being denied basic services as schools, hospitals and civilian infrastructure are damaged or destroyed. Approximately 84 per cent ($3.015 billion) of the 2018 funding appeal is for work in countries affected by humanitarian crises borne of violence and conflict.
The world is becoming a more dangerous place for many children, with almost one in four children now living in a country affected by conflict or disaster. For too many of these children, daily life is a nightmare.
The spread of water-borne diseases is one of the greatest threats to children's lives in crises. Attacks on water and sanitation infrastructure, siege tactics which deny children access to safe water, as well as forced displacement into areas with no water and sanitation infrastructure - all leave children and families at risk of relying on contaminated water and unsafe sanitation.
Girls and women face additional threats, as they often fulfil the role of collecting water for their families in dangerous situations.
117 million people living through emergencies lack access to safe water and in many countries affected by conflict, more children die from diseases caused by unclean water and poor sanitation than from direct violence, said Fontaine. Without access to safe water and sanitation, children fall ill, and are often unable to be treated as hospitals and health centres either do not function or are overcrowded.
The threat is even greater as millions of children face life-threatening levels of malnutrition, making them more susceptible to water-borne diseases like cholera, creating a vicious cycle of undernutrition and disease.
As the leading humanitarian agency on water, sanitation and hygiene in emergencies, UNICEF provides over half of the emergency water, sanitation and hygiene services in humanitarian crises around the world.
When disasters strike, UNICEF works with partners to quickly provide access to safe drinking water, sanitation services and hygiene supplies to prevent the spread of disease. This includes establishing latrines, distributing hygiene kits, trucking thousands of litres of water to displacement camps daily, supporting hospitals and cholera treatment centres, and repairing water and sanitation systems.
These measures save lives, have long-term impact and pave the way for other important services like health clinics, vaccination programmes, nutrition support and emergency education.
The largest component of UNICEF's appeal this year is for children and families caught up in the Syria conflict, soon to enter its eighth year. UNICEF is seeking almost $1.3 billion to support 6.9 million Syrian children inside Syria and those living as refugees in neighbouring countries. Working with partners and with the support of donors, in 2018 UNICEF aims to:
Provide 35.7 million people with access to safe water; Reach 8.9 million children with formal or non-formal basic education; Immunize 10 million children against measles; Provide psychosocial support to over 3.9 million children; Treat 4.2 million children with severe acute malnutrition.
In the first ten months of 2017, as a result of UNICEF's support:
29.9 million people were provided with access to safe water; 13.6 million children were vaccinated against measles; 5.5 million children accessed some form of education; 2.5 million children were treated for severe acute malnutrition; 2.8 million children accessed psycho-social support.
For hundreds of millions of people, conflict is a profoundly negative determinant of health, by Diane Misenga Kibeya. (ICRC)
In an urbanizing world, armed conflict and violence are urbanizing too.
Increasing numbers of people around the world are living through armed conflict in towns and cities, or experiencing chronic urban violence. This affects their health severely.
Armed conflicts are increasingly taking place in cities and towns. Urban space is fought over in ways not widely known for decades - since the Second World War and the wars in South East Asia.
The experience of cities like Mosul, Mogadishu, Aleppo, Juba, Bangui, Sirte and Hodeidah now typify contemporary urban warfare and its intense civilian suffering.
I would like to set the scene of modern urban warfare and chronic urban violence. Then I would like to focus on three things: the impact of conflict and violence on health; the ICRC's expanding humanitarian response in urban areas and call for greater respect of international humanitarian law (IHL) in urban armed conflict and the priority of safe access to resilient health services in armed conflict and urban violence.
War destroys and degrades urban life and space
Many urban communities in conflict today are forced to live under repeated bombardments from the air and from artillery. The use of explosive weapons with a wide area impact in densely populated areas is highly destructive of people, property, livelihoods and essential services.
Cities are often divided for months and years in stalemates between opposing forces. Battles to take and re-take towns and cities often leave much of them completely destroyed.
Millions of people have also experienced terrible conditions of life under protracted sieges or in "hard-to-reach" urban areas across Middle East wars, with their labyrinthine networks of checkpoints and frontlines that cross and confuse modern urban space.
Health care personnel, facilities, and transports as well as the wounded and sick are also frequently subject to acts of violence in conflicts today, very often in violation of the Geneva Conventions, so further degrading available health services.
The direct and indirect damage as well as gradual degradation of health services in conflict leads to situations like that in Yemen today where only 40% of the country's health services are functioning.
War destroys urban space but it also creates new urban spaces as people are forced to flee within and across State borders. This is because they have fled there from unsafe rural areas to swell population levels in cities like Mogadishu and Maiduguri, or because they have moved within a city to find relative safety as frontlines change.
Most of the world's internally displaced people (IDPs) now live in cities - many of them by staying with host families or by occupying abandoned and damaged buildings, construction sites or unbuilt ground. In the process they shape new informal settlements and slums.
Many others flee across borders to transform the urban space and demography of neighbouring or distant countries.
In the Middle East, urban space in Lebanon and Jordan has been transformed by millions of Syrians. In Uganda and Ethiopia, new urban space and informal settlements have been created by millions of South Sudanese fleeing conflict in their country.
Displaced people are often changing cities and making new cities in weeks, without any of the planning and services to accompany managed urbanization or urban growth.
Urban Violence
In other towns and cities across the world, chronic urban violence rooted in organized crime and gangs is entrenched, often in extremely concerning conditions of high homicide rates and the creation of large "ungoverned" urban spaces where essential services in health and education are eroded at best and failed at worst.
Urban armed conflicts and the almost epidemic spread of chronic urban violence pose a humanitarian crisis of safety and security that often exposes millions of people in towns, cities and informal settlements to serious protection risks.
These protection risks can dramatically change people's levels of health and their access to health services.
The Impact of Conflict and Violence on Health
Armed conflict and violence are major determinants of health for people all around the world. We in the ICRC see this effect in peoples lives every day.
Conflict and violence cause ill-health directly by physical wounding, injury, sexual violence, or psycho-social stress which in turn may even result in mental health conditions.
Violence and conflict also lead indirectly to ill-health because of the spread of deprivation, impoverishment, displacement, destitution, hunger and disease they cause in people's lives.
People's health also deteriorates from conflict and violence because of the damage and gradual collapse of health services, and other essential systems and services that determine health like livelihoods, social protection, water systems and education.
Many of today's conflicts last for decades as "protracted conflicts" in countries across Africa, Europe and the Middle East, and urban violence also overshadows people's lives year after year especially in Latin America but also increasingly in Africa, Asia and Europe.
In a recent study on protracted conflict, the ICRC estimated that we have been operating in our top ten emergency operations for an average of 36 years.
This means that for many millions of people around the world, armed conflict is a multi-generational experience. Not surprisingly, its damage and duration has a deep and enduring impact on health and access to health services.
For hundreds of millions of people, conflict and violence are an entrenched and a profoundly negative determinant of health.
The ICRC has dramatically expanded its urban response in the last 15 years. Our humanitarian operations have undergone "an urban revolution" as we respond to people's needs for protection, food, water, health, livelihoods and education in urban areas.
This sees us working across large and densely populated areas at a new scale - often supporting water and electricity supplies to millions of people across a country''s urban areas.
It also involves levels of technological sophistication and urban complexity unprecedented in our history as we work to ensure continuity and resilience in urban infrastructure of essentially middle income countries like Syria, Iraq and Ukraine.
To meet urban people's immediate health needs and to counter erosion in the positive determinants of their health, we engage simultaneously on protection, water, sanitation, livelihoods and education to achieve health impact.
Doing this well means working closely with all parties to conflict, relevant authorities responsible for essential services and with technical partners from national and municipal government, Red Cross and Red Crescent Societies and business contractors with the skills to ensure service continuity in electricity, health, water, sanitation infrastructure.
Our work always carries a strong preventive purpose. In Maiduguri - a city rapidly expanded by internal displacement - only 30% of people have access to clean water services. This is a major challenge to health which we are working to correct.
Working in towns and cities has also brought us into contact with the widespread challenges of non-communicable diseases (NCDs) and mental health and psycho-social support (MHPSS), in addition to the disease burden from infectious diseases.
These bring new operational dilemmas of health equity, and ICRC is re-shaping its health programming to a more holistic approach. We are expanding in community-based MHPSS services and strengthening our system of referrals for NCDs.
For example, in several cities, the ICRC ensures cold chain management for insulin and vaccines where the lack of electricity risks the safe delivery of medicines; and we strengthen health system resilience against the background of outbreaks and emergencies.
Safe access to healthcare remains a huge problem for people enduring urban warfare and urban violence. Safe movement and clear communication are critical here.
Often it is not safe to move freely in conflicted urban space and patients and health staff cannot reach health services, or fear to try. This is especially true if health services are perceived as being deliberately targeted by parties to conflict.
Knowledge about health services is another major break on access. A recent ICRC study found that people's knowledge of available services is the main gatekeeper to accessing healthcare. Communities often don't know about the health centre one block away, the nature of its services, who provides them, if they are eligible for them, and if they are free of charge. Communicating health service availability is a priority in contested urban space.
A call for greater respect for International Humanitarian Law (IHL)
The rules of international humanitarian law (IHL) are clear about the need to protect the civilian population and to prioritize and protect health services for the wounded and sick, whether wounded and sick combatants or fighters or wounded and sick civilians.
In urban warfare today, the ICRC calls on all States and all parties to conflict to respect IHL. It also calls on all States supporting parties to conflict in various ways to ensure that their partners respect IHL. And we urge all parties to pay particular attention to the following three priorities:
Stop and prevent attacks against healthcare - protect healthcare facilities, transport, personnel and patients from all forms of violence and attack.
Avoid the use of explosive weapons with a wide impact area in densely populated areas, where they can bring about indiscriminate civilian harm and destroy, damage and disrupt critical infrastructure on which essential services depend.
Actively support the continuity of resilient urban services on which civilian populations depend by facilitating the provision of relief and humanitarian action, and ensuring people''s safe access to these services.
Although IHL does not apply to cities affected by chronic urban violence, the challenge of safe access to health services and other essential services that determine health - like water, electricity and education - are equal priorities in parts of towns and cities affected by chronic urban violence.
I hope I have shown how urban warfare and urban violence are major and negative determinants of health for many millions of people around the world. The vital humanitarian agenda to protect these people is clear.
The importance of ensuring safe and effective health services in armed conflict and chronic urban violence and the other essential services which determine people's health is also essential if there is to be any chance of delivering on Sustainable Development Goal 3 for the world's poorest people who live in fragile and conflict affect areas.
(Address by Diane Misenga Kibeya, Deputy Head of Delegation of the International Committee of the Red Cross to the African Union to the 15th International Conference on Urban Health).

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