No Respite: Violence Against Health Care in Conflict
by Safeguarding Health in Conflict Coalition
5:14pm 31st May, 2021
Today, the Safeguarding Health in Conflict Coalition released its eighth annual report, documenting the global incidence of attacks and threats against health workers, facilities, and transport around the world. The report cites 806 incidents of violence against or obstruction of health care in 43 countries and territories in ongoing wars and violent conflicts in 2020, ranging from the bombing of hospitals in Yemen to the abduction of doctors in Nigeria.
Attacks – including killings, kidnappings, and sexual assaults, as well as destruction and damage of health facilities and transports – compounded the threats to health in every country as health systems struggled to prepare for and respond to the outbreak of the COVID-19 pandemic.
The findings reveal that, on the fifth anniversary of the UN Security Council’s Resolution 2286 on protection of health care in conflict, acts of violence against health care have not been curbed and impunity for those who commit them has remained a constant.
In an introduction to the report, Coalition Chair Leonard Rubenstein notes, “The reasons for violence are variable and sometimes complex, but the explanation for continuing impunity is not. States have failed to fulfil their commitments to take action – individually or as part of an international effort – to prevent such violence or hold the perpetrators accountable.”
The report, “No Respite: Violence Against Health Care in Conflict,” documents at least 185 health workers killed and 117 kidnapped. Countries sustaining the highest number of attacks included Afghanistan, the Democratic Republic of the Congo (DRC), Libya, the occupied Palestinian territories (oPt), Syria, and Yemen.
Although these figures (806) represent a modest decline compared to the overall number of reports identified by the Coalition in 2019 (1,203), the number of killings showed a 25 percent increase, and kidnappings, a 65 percent increase.
At the same time, during the COVID-19 pandemic, there were more than 400 acts of violence against health care.
“Violence against health workers has taken many horrific forms: ambulances shot at, hospitals bombed, and even snipers targeting medics,” said Christina Wille, director of Insecurity Insight, who guided the data collection.
“The true extent of the violence remains unknown, as many countries, health facilities, and organisations do not report their experiences. Yet we need to remember that each incident is a tragedy in its own right and represents the loss of a family member and a colleague.’
The full 2020 data cited in the report can be accessed via Attacks on Health Care in Countries in Conflict on Insecurity Insight’s page on the Humanitarian Data Exchange (HDX).
The data and analyses for 17 countries and territories with the highest numbers of incidents is made available as individual datasets on separate factsheets included in the report.
A related interactive map and report issued by Coalition member Insecurity Insight in March 2021 pinpoints an additional 412 incidents of violence against health, such as attacks on testing facilities and the targeting of health workers directly related to the COVID-19 pandemic.
During the five years since Security Council Resolution 2286 was adopted, people in 14 conflicts have experienced more than 50 reported incidents of violence against health care, eight conflicts have seen more than 100 such incidents, five more than 200, and four more than 300 incidents.
The report notes that states failed to take actions they agreed to in the resolution and were urged by the UN Secretary-General in his recommendations for implementation. They included:
Ensuring that militaries integrate practical measures for the protection of the wounded and sick and medical services into the planning and conduct of their operations;
Adopting domestic legal frameworks to ensure respect for health care, particularly excluding the act of providing impartial health care from punishment under national counterterrorism laws;
Engaging in the collection of data on the obstruction of, threats against, and physical attacks on health care;
Undertaking “prompt, impartial and effective investigations and accountability processes within states’ jurisdictions with respect to violations of international humanitarian law” in connection with health care;
Referral by the Security Council in cases where there is evidence of war crimes in connection with violence against health care, such as in Syria, to the International Criminal Court;
Listing of states found by the Special Representative of the Secretary-General for Children and Armed Conflict to have engaged in violence against hospitals in the annex to the Secretary-General’s annual report on children in armed conflict; Ceasing the sale of arms that have been used to inflict violence on health care.
In issuing the report, the Coalition called on the UN Secretary-General to report on the actions and inactions of member states with respect to the commitments made five years ago and recommended the appointment of a special rapporteur or special representative to report on countries and themes as a step toward accountability, to ensure that protection of health in conflict is more than hollow words.
“As if the COVID-19 pandemic and other health threats are not enough, every day, health workers face the risk of violent attack,” said Joe Amon, director of Global Health at Drexel University’s Dornsife School of Public Health, a Coalition partner.
“We need an emergency response that targets not a virus but our collective failure to protect workers, facilities, and ambulances and ensure that no matter the context, access to health care, and all health workers, is protected from harm.”
"No patient should worry about safety when seeking care or have to live with fear on top of the vulnerability imposed by illness. Health care providers should never have to put their lives on the line while fulfilling their moral obligations. Violations of the right to safe access to health care cannot continue to be the norm, and violators should be held accountable for these crimes," said Houssam al-Nahhas, a medical doctor from Syria who is Middle East and North Africa researcher at Physicians for Human Rights.
International Council of Nurses CEO Howard Catton said, “This report is a clear indictment that the global effort to protect our healthcare workers on the front lines of care in conflict zones is falling far short. The violation of health worker rights is both a health and humanitarian crisis. Our nurses, whether in conflict areas or on the global COVID frontline are particularly at risk of violence.
International humanitarian law must not only be respected but applied on the ground to protect nurses and other health workers at the heart of our healthcare systems.
http://www.safeguardinghealth.org/no-respite-violence-against-health-care-conflict http://www.hhrjournal.org/2021/06/five-years-after-security-councils-resolution-to-protect-health-care-in-conflict-still-at-zero/ http://www.msf.org/attacks-medical-care
Killed and Maimed: A generation of violations against children, report from Save the Children International
Today millions of children are on the frontlines of conflict. Despite progress in some areas, the trends over recent years are of increasing violations, increasing numbers of children affected by conflict and increasingly protracted crises.
Over the past decade we have witnessed the outbreak of conflict in Syria and Yemen, two waves of horrifying violence in Myanmar, and protracted conflicts in Afghanistan, Nigeria, Somalia, the Democratic Republic of Congo (DRC) and Iraq. The conflict in Ukraine has escalated, and the situation for children in the occupied Palestinian territory has continued to deteriorate. Despite a peace accord in 2016, violence in Colombia persists.
As we write, children are at the forefront of the conflict in Nagorno-Karabakh and the Sahel. As this litany of conflict suggests, the overall trajectory of violations against children is cause for great alarm. The world must take notice – and act.
While 2020 has been dominated by the COVID-19 pandemic, that should not be allowed to mask the red flags signalling the devastation conflict is having on children’s lives.
This report highlights some of the impacts of the war on children:
• Since 2005, more than 250,000 violations against children have been verified in the UN’s annual reports on the situation of children in armed conflict. Of these, 106,000 (42%) related to the killing and maiming of children.
• Since 2010, the equivalent of 25 children a day have been killed or maimed in conflict.
• The number of children living in high-intensity conflicts in 2019 rose by 2% from 2018 to stand at 160 million. A total of 426 million children were found to be living in conflict zones overall in 2019 – the second highest total ever recorded.
• The number of children living in close proximity to the most intense conflict zones rose significantly – up from 4 million to 9 million in 2018–19.
• Explosive weapons accounted for 37% of the 10,294 incidents of killing and maiming of children in 2019 – with the proportion much higher in Afghanistan, Syria and Yemen.
The world must act to stop the war on children. And there’s no excuse not to. In 2021 there will be critical opportunities for states and parties to conflict to take concrete actions to better protect and support children in conflict.
Governments will be able to lend their support to a declaration avoiding the use of explosive weapons in populated areas. Donors can ensure that child protection work in conflict is funded in line with other life-saving interventions. UN Security Council members can use their power to hold perpetrators of grave violations to account.
Save the Children calls on states to:
• uphold standards and norms in the conduct of conflict – including protecting education from attack, avoiding the use of explosive weapons in populated areas, and enabling unimpeded humanitarian access
• hold perpetrators of violations against children to account – including through resourcing international investigative mechanisms, supporting the Monitoring and Reporting Mechanism for grave violations against children, and consistently applying political, legal and financial sanctions on perpetrators
• take practical action to protect children and support their recovery – including adequate funding for child protection work, ensuring children have access to quality mental health and psychosocial support and education, and embedding child rights expertise within peacekeeping and political missions: http://bit.ly/3fgz2Ay
http://resourcecentre.savethechildren.net/library/killed-and-maimed-generation-violations-against-children http://reliefweb.int/report/world/stop-war-children-killed-and-maimed-generation-violations-against-children-conflict http://www.unicef.org/children-under-attack#HACappeal http://alliancecpha.org/en/series-of-child-protection-materials/prevention-initiative
* Note: As the World Food Programme and many other agencies underline, conflict directly impacts hunger, nutrition and the health and life chances of millions of children and people worldwide.
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