Its inclusion may have been unofficial, but respect for international humanitarian law — which included ending attacks on health care facilities worldwide — was still on the agenda at the World Humanitarian Summit in Istanbul last week.
In Geneva, health ministers attending the World Health Assembly weighed in on a global strategy to meet current and future demands for a health workforce.
But while high-level aid officials and global health experts were in discussions on these topics and more last week, bombs exploded in the Syrian coastal cities of Tartous and Latakia, killing at least 148 people and leaving close to 200 injured.
One of the blast sites was a hospital, where more than 40 patients and their family members were killed, as well as an emergency doctor and two nurses, according to a news release from the World Health Organization. At least 11 health workers were also reportedly wounded.
The event adds to the lengthy list of attacks on health care facilities across Syria since the armed conflict erupted five years ago. Between March 2011 and April 2016, NGO Physicians for Human Rights recorded 365 attacks on 259 medical facilities in Syria, leading to the deaths of 738 medical personnel. A huge percentage of those killed were doctors, nurses and medics.
But Syria isn’t the only country where medical doctors, nurses and other health care providers face grave risks in performing their duties. In 2014 and 2015, the World Health Organization found a total of 594 attacks on health care facilities, providers and other related entities across 19 countries, based on consolidated data from multiple sources, including PHR, the Council on Foreign Relations, the Armed Conflict and Event Data project and the Aid Worker Security Database.
After Syria, attacks on health care were highest in Iraq, Pakistan, Ukraine and Central African Republic within the same two-year period.
Some of the deadliest took place in Libya, Iraq and Central African Republic, according to the WHO report. In Libya, the report mentioned the execution on Aug. 14, 2015, of 12 health care providers and 22 patients. An armed robbery on a Médecins Sans Frontières hospital in CAR in Apr. 28, 2014, killed 16, including three MSF staff members.
A standout in the report however is the percentage of attacks that were “intentional,” which WHO defined as attacks that were reported to directly target health care facilities and equipment such as ambulances, providers, patients, and entities such as health ministers or their ministries and medical academic institutions. Of the total, 366, or 62 percent, were intentional, according to the report.
WHO however acknowledged that the information presented in the paper had a number of limitations, including lack of or difficulty in the verification process for some data sources, and language. Data in the report were mainly from English-language sources, according to the U.N. health agency.
Nevertheless, it is the first known attempt to present consolidated information on attacks against health care in emergency settings, and WHO hopes this will open opportunities for better data gathering on the topic to better inform advocacy efforts that call for respect for international humanitarian law as well as planning by different actors when responding to emergencies.
Part of the U.N. health agency’s recommendations is the creation of a global repository that would serve as a “one-stop shop” for all information related to the subject. With better data, it hopes the international community would have a better understanding of the long-term health impact of such atrocities on patients, health care workers and health service delivery at large.
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