On 19 August 2003, a hotel in Baghdad was bombed, killing 22 people. Among the casualty was the United Nations Special Representative of the Secretary-General for Iraq, Sergio Vieira de Mello. Fast forward five years, it was decided by the General Assembly that 19 August would mark the World Humanitarian Day (WHD) – in memory of Sergio Vieira de Mello’s passing and many other humanitarian and medical workers around the world. Every year since then, global campaigns will run with the purpose of advocating safety for humanitarian workers, healthcare workers included.

This year, the Geneva WHD commemoration by World Health Organisation (WHO) was held at Palais des Nations on 21 August in collaboration with the International Committee of the Red Cross (ICRC), Médecins Sans Frontières (MSF), the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) and the United Nations Office at Geneva (UNOG). The newly appointed WHO Director-General, Dr Tedros Adhanom Ghebreyesus delivered his introductory remarks and proceeded with the panel discussion of ‘Violence against healthcare and its implications for affected populations, humanitarian workers and aid’.

Healthcare workers under attack; even though #NotATarget

WHO considers attacks on healthcare to be any form of violence that hinders with care-giving during emergencies. Such acts can be carried out verbally or physically through bombing, shooting, robbery, fire, abduction and many other unspeakable acts of terrorism. The attacks can be inflicted on the healthcare provider, the facility, the transport or the patient, whether intentionally or unintentionally.

The attacks violate the international humanitarian law that preserves healthcare workers and its facilities to treat the wounded, both civilians and fighters. Healthcare workers are sansctified – but they remain to be the target, depriving many of treatment. Many have spoken up against the issue through a petition-signing in order to get the rules to be respected.

WHO has been collecting data on the attacks since 2014. A four-year collective data shows a pattern of the attacks; mostly happening in Syria and other war-torn conflict areas, through intentionally targeted bombings of healthcare facilities, which devastated civilians and healthcare workers alike. The first quarter of 2017 has seen 88 reported attacks, which claimed 80 lives.

Attacks on healthcare for the period of January to March 2017. Source: WHO
Attacks on healthcare for the period of January to March 2017. Source: WHO

Among the attacks that will add to the statistics are stories closer to home, such as the one where the doctor was attacked by the patient’s relatives. In another case, when their colleagues were attacked, doctors went on strike to speak up against the violence administered by patients. Similarly, nurses also stood up for their passing colleague. In addition, due to the rise in the frequency of attacks, doctors in India are equipping themselves with protective measures.

In the frontline: Protecting the sanctity of healthcare workers

An attack on healthcare has a domino effect. When a healthcare worker is down, patients are deprived of urgent treatment, possibly leading to death. An attack on healthcare facility on the other hand, severs accessibility to treatment for the long term. Generally, the attacks burn valuable assets as it takes years to train healthcare workers and to build and equip healthcare facilities.

WHO recognises that the data collected are not comprehensive, though they do give a broad picture of the reality of the issue. This is mostly due to under reporting, because of lack of awareness and limited time and resources. WHO also proposes a standardised method of data collection that will soon roll out so that the data may be comparable; and thus bridging the gap of understanding the consequences of the attacks on short term care administration and long term public health goals.

In addition, the newly minted Security Council Resolution 2286 aims to uphold the sanctity of the law that healthcare workers should be protected in areas of conflict. However, WHO implores further consideration that violence on healthcare workers also happens outside of conflict settings, such as while fighting polio and Ebola. In the meantime, WHO remains at the forefront of data gathering and advocating the issue. MIMS


Read more:
WHO launches global initiative to halve medication errors by 2022
10 ways doctors can prevent violence in the exam room
Workplace violence means de-escalation and breakaway skills now crucial for nursing students

Sources:
http://worldhumanitarianday.org/en
http://www.who.int/emergencies/attacks-on-health-care/en/