There was a new WHO Report issued this week (May, 2016) on deliberate attacks on healthcare workers and community health workers during emergencies around the globe.
It found that sixty-two per cent (62%) of the reported attacks intentionally targeted health care and health care workers. (Report, and summary, follows) Only 20% were reported as unintentional, the rest being unknown or undetermined.
Many of these dedicated workers were at the GHIC (Global Health and Innovation Conference) at Yale in April, 2016 hosted and organized by Unite for Sight. We at GNI want to help publicize this report, and the crisis, so that people are informed, and governments do more to ensure the safety of Global Health workers – As they seek to deal with the larger crises of extreme poverty, access to healthcare and clean water, girl marriage and complications of pregnancy, poor sanitation, education, community health and inoculation, and much more.
Using data from 2014 through 2015, “this report is a first attempt to consolidate and analyze the data that is available from open sources. While the data are not comprehensive, the findings shed light on the severity and frequency of the problem.”
How can we reduce attacks on health workers, prevent future attacks, increase safety and delivery of aid and healthcare, and better understand this problem? Those were some of the goals of the World Health Organization creating this report on “Attacks on Health Care, 2016” (Aka REPORT ON ATTACKS ON HEALTHCARE WORKERS IN EMERGENCIES). Story continues after the break >>
ReliefWeb issued a story and linked to the report – http://reliefweb.int/report/world/attacks-health-care-prevent-protect-provide as did the World Health Organization – http://www.emro.who.int/media/news/attacks-on-health-care-and-need-for-compliance-to-international-humanitarian-law.html
Unrest, problems with radicalized Muslim groups, and escalating small-scale conflicts (As well as major unrest/instability in Iraq, Syria,…) around the globe continue to place health care workers at great risk.
Dr. Ala Alwan, Regional Director of WHO, states, “Attacks against health workers and facilities in Afghanistan increased by 50% in 2015, and Syria is now the deadliest place in the world for health workers, with attacks taking place at a disturbing rate and reducing the availability of an already limited number of health care workers.” (see link above)
He also mentions that threats to volunteers and attacks on healthcare workers and staff, health facilities and those using their services pose risks to delivery of healthcare and create instability and insecurity, as well as disrupt services. And this data does not even take into account attacks against aid and development workers, and other forms of volunteers oversees. In the past, new records have been set in the numbers of attacks against these types of humanitarian workers as well.
Unfortunately while there are laws and conventions prohibiting attacks on health workers and health facilities,, aid workers and community health workers, these laws are not being complied with in areas where governments are weak or non-existent, and where local forces effectively remove the effectiveness of law enforcement. Unfortunately these areas are also usually the primary focus of much aid and development work/volunteer work. Continues after the break >>
Over the two years surveyed, there were a total of 594 reported attacks on health care that resulted in 959 deaths and 1561 injuries in 19 countries with emergencies. As mentioned above, sixty-two per cent (62%) of the reported attacks intentionally targeted health care and health care workers.
- In 2014, the consolidated figures include 338 records of attacks on health care in 19 countries.
- In 2015, the records indicate 256 attacks in 16 countries with acute or protracted emergencies.
- Syria stand alone atop the list at 38% of combined attacks, followed by Gaza and the west Bank at 9%
These attacks resulted in the death or injury of:
- Syria: 352 deaths and 668 injuries combined over the two years
- Iraq: 114 deaths and 198 injuries combined over the two years
As you can see from the screenshot of the report below, healthcare facilities and healthcare providers account for 89% of all reported attacks, 53% of which were perpetrated by State actors.
Beyond the risk to community health workers themselves, Dr. Alwan points out that thousands of people die every year not as a direct result of the violence, but because the environment has become too dangerous for health care to be delivered. The report recognizes that health needs in emergencies are often urgent and service delivery is complex. Health care workers not only deliver ongoing health and community-health programs, but must also address additional needs that can include conflict-related injuries, increases in infectious diseases and outbreaks, malnutrition, mental health problems and gender-based violence, while facing in hospital violence against staff and patients and even circumstances where hospitals are being targeted and bombed.
“Over the last several years direct, targeted attacks on health care institutions that are clearly civilian facilities have escalated greatly,” says Dr. Michael Van Rooyen, an emergency physician and the director of Harvard Humanitarian Initiative, “and Syria’s been the most notable and notorious example.” (Quoted from above article) It’s not just in Syria that field hospitals and medical aid workers are being attacked. Over the past six months, four out of 29 Medicines Sans Frontieres facilities in Yemen were hit by airstrikes, as well as a trauma center in Kunduz, Afghanistan.
Due to Syria and other ongoing violence, 2015 had the largest number ever on record of people affected by emergencies – An estimated 125 million in need of assistance.
“Underreporting of attacks is assumed due to limited awareness of the possibility, means and use of reporting, limited resources and time, fear of reporting, complexity and limitations of existing reporting systems, lack of standardized definitions for use in data collection, perceptions of the usefulness of reporting, and cultural perceptions of violence.”
The report is forthright in stating that there are limitations to the available data, and that it highlights the need for more and better data collection:
“Underreporting of attacks is assumed due to limited awareness of the possibility, means and use of reporting, limited resources and time, fear of reporting, complexity and limitations of existing reporting systems, lack of standardized definitions for use in data collection, perceptions of the usefulness of reporting, and cultural perceptions of violence. This suggests the need for more leadership on this issue in the health sector in emergency settings, more sensitization of stakeholders at country level to raise understanding of the value of reporting, and standard definitions for gathering comparable data.” – From Page 8 of the report
Most of the available data also does not clearly differentiate between types of health care providers (e.g. doctors, nurses, paramedics) who were the object or victim of the attacks. This indicates the need for more detailed reporting on deaths and injuries and object type.
From Section Four, DISCUSSION:
“The most significant gap in the available data is the lack of information on the consequences of attacks on health care delivery, on the health of affected populations, on health systems, on the health workforce, and on longer-term public health. While the consequences are difficult to estimate and quantify due to constantly changing catchment populations and limited baseline information, a priority for data collection on attacks on health care should be to document and describe these consequences.”
One of the conclusions of the report is that increased advocacy is needed to draw attention to this issue.
Hence this story by Good Neighbor Insurance:
Good Neighbor Insurance has many types of international and short term travel insurance plans that cover injuries or illness as a result of unrest, terrorism or epidemics. These include emergency evacuation. For more information check out GeoBlue Navigator Expatriate or https://www.gninsurance.com/health/more-plans/, or call us at (480)813-9100 with any questions.
The WHO also publishes a guide on travel risks, precautions and vaccination requirements,
http://www.who.int/ith/en/, also see the bottom of https://www.gninsurance.com/our-resource-hub/ for more resources.