The protection of health services (comprising health care personnel, medical vehicles and medical facilities) is vital for universal health care. If the delivery of health care is disrupted through direct or threatened violence, access to health care is restricted.
Violence against patients and health-care workers is one of the most overloaded humanitarian issues today. Medical doctors have a moral, humanitarian and most importantly professional obligation to deliver best possible health care to all in need. Fulfillment of this obligations is under threat, medical professionals health and life is under threat, and the respect to medical ethics is in jeopardy. This violence towards health workers and facilities have become recognized as a effect we peon in conflicts. We need to improve security and delivery of impartial and efficient health care in armed conflict and other emergencies. The topic Healthcare Under Attack was extensible addressed during the 67th World Health Assembly (WHA67), Geneva May 2014; a Technical Briefings. a side event by The World Health Professions Alliance, and in addressed in the progress report WHO’s response, and role as the health cluster lead, in meeting the growing demands of health in humanitarian emergencies.
The World Health Organization (WHO) has after extensive advocacy delivered by the health care professionals and humanitarian actors put an increasing attention to the issue. The need of comprehensively address this threat is addressed in the WHO resolution WHO’s response, and role as the health cluster lead, in meeting the growing demands of health in humanitarian emergencies. Dr Bruce Aylward, WHO Assistant Director General for Polio and Emergencies, is in charge of implementation of this revolution. During WHA67 Technical Briefing Dr. Bruce stated “This is reason to raise the alarm on the increase of harm in conflict and non conflict settings. It is not just the violent assaults you see on health workers that are visible in the media, but also attacks on the health system, including misuese of health facilities for military, kidnapping, medical ethics violation, intimidation and harressment of patients and healthcare workers, leading to a potential increase in death and illness, and contradictory to the right to health. It represents the abendonment of the principle of the sanctity of healthcare”.
The WHO Director General Dr. Margaret Chan has addressed this topic before as a topic dear to her heart, her great support was exemplified by her attendance in the technical briefing in WHA67 even though having to be in seven other parallel sessions. Dr. Chan stated “Healthcare is under attack now more than ever. We should be clear these are attacks on patients, hospitals, ambulances, violating international human rights law. These attacks have become widespread, which must not be tolerated as the new norm. We need to re-educate the world about the situation that is totally unacceptable. We must remind all parties concerned on their responsibility on what can and needs to be done by the international community. Healthcare personnel must be protected and not let vulnerable to attack”.
The topic of violence towards health workers and facilities result in a dilemma of health care professionals following the medical ethics and delivering health in line with international humanitarian law, or to assure their own safety. The majority of the health care professionals being victim of violence in emergencies and faced with this dilemma, is marjory local and national humanitarian actors. Valerie Amos, United Nation under secretary general for humanitarian affairs and emergency relief coordinator, pointed out during the technical briefing, that when weaker parties during war situations take strategies that conflict with international law, and the other parties do so as well in response to this, it is in fact the civillians that suffer. Lately even international humanitarian actors that were once safe from attack, are now legitimite military targets, including hospitals. Military personel enters clinics looking for the enemy. Wounded and sick are attacked, medical personel is illegally detained, abducted or killed. We see increasing politicalisation of healthcare related issues. In some cases, peoples health and children’s health is used as a pawn for power and influence. The solution lies in prioritizing health over political differences, and to regain the previous very deeply implemented respect to the medical field and professions.. No one, organization or government, can address these issues alone. We need partnership between UN, humanitarian agencies, NGOs and local health authorities. Countries can engage through advocacy and diplomacy. Government to systematically record violations and work for regain respect to the medical ethics and international humanitarian law in their society. Data gives people who want to be advocate the tools they need to make the case. We need dialogue, discussion, and clear adherence to the commitments to humanitarian law. Peter Maurer, President of the International Committee of the Red Cross summed up the impact for all “Entire populations suffer when healthcare workers flee and systems disintegrate”.
Materials are being stolen from hospitals, sick people are taken from their beds and are executed by armed individuals. But these are just example situations and we are far from aware of all cases where these situations are reality. There is a vast under notification.
How does the above specifically relate to IFMSA and medical students? Why is it important that you as future medical doctor are aware about this threat? For one, we’ll be the future physicians dealing with these issues, but the fact is that the situation is already affecting medical students around the world. There have been attacks, for example mentioned in Central Africa, on students who stayed to help in medical emergencies. These students had to take refuge in safe locations.
The situation is over all step by step getting worse, but the international society have been mobilizing in order to jointly address this topic. Accountability systems need to be in place, to ensure that international human rights law is respected at all times and the created recommendations are implemented. Data has to be collected and reporting needs to be done on all specific cases to create momentum in fighting attacks on health care. In addition to this it is important to spread awareness. starting with, yes, medical students. Medical students and future health care works are a very much important target group concerning implementing knowledge about the current situation and actions needed to be taken in order to find a solution. The morning after the Technical Briefing in the WHA67, IFMSA had a meeting with the World Medical Association, International Committee of the Red Cross and the International Council of Nurses. The meeting aimed to discuss a joint strategy on limiting danger in healthcare. We hope to be able to involve you all into tackling these very severe and pressing issues, we need your support, and we need your voices to be heard for the right to health and the sanctity of health, to be respected by all and at all times. We as medical students can take actions and contribute to a solution to this problem.
Standing Committee on Medical Education Director
Liaison Officer on Human Rights and Peace