Attacks on health workers in conflict zones reach highest level ever recorded: report | global health

Attacks on health workers, hospitals and clinics in conflict zones increased by 25% last year, reaching their highest level on record, according to a new report.

While the increase was largely due to new wars in Gaza and Sudan, persistent conflicts such as those in Ukraine and Myanmar also saw such attacks “at a relentless pace,” the Safeguarding Health in Conflict coalition said. .

Researchers recorded more than 2,500 incidents of “violence or obstruction of health care” in 2023, including the murder or kidnapping of health workers and the bombings, looting and occupation of hospitals.

The coalition called for domestic and international prosecutions for “war crimes and crimes against humanity involving attacks on the wounded and sick, healthcare facilities and healthcare workers.”

Their report highlighted cases of attacks on children’s hospitals and sites where immunization campaigns were being carried out, leaving people vulnerable to infectious diseases. He also warned of a new trend in which drones armed with explosive weapons are used to attack health facilities.

Leonard Rubenstein of the Johns Hopkins School of Public Health, who chairs the coalition, said violence inflicted on health care workers and facilities had “reached appalling levels.” The report included examples where workers had been deliberately attacked and others where fighters were reckless or indifferent to the damage caused, he said.

“The lack of restraint we are seeing since the beginning of the conflicts suggests to me that the law on health care protection has had no meaning for combatants,” Rubenstein said.

“The only consistent feature of the attacks was the continued impunity for these crimes. For more than a decade, despite their repeated commitments, governments have failed to live up to these commitments and have failed to reform their military practices, have failed to end arms transfers to perpetrators, and have failed to bring those responsible for crimes to justice. before justice.”

An immunization clinic in El Geneina, Sudan. The attackers destroyed the cold chain, vaccines and a building, and looted vehicles, a Unicef ​​official in the West Darfur capital said. Photography: Unicef

The coalition is made up of more than 40 non-governmental organizations and has produced annual reports for the past 11 years. Identified 2,562 incidents of violence or obstruction of medical care in conflicts in 2023.

These include 685 cases in which health workers (including doctors, nurses and ambulance drivers) were arrested or kidnapped, and 487 cases in which they were killed, almost double the number in 2022.

In other cases, health facilities were damaged or destroyed by both government forces and non-state armed groups. Those facilities were also “increasingly occupied or repurposed for military use,” in violation of humanitarian law, according to the report.

The figures should be considered underestimates, because it is difficult to obtain information from conflict zones, the researchers said.

They identified 11 countries and territories where children’s health services were affected, including the bombing or occupation of al-Nasr Children’s Hospital in Gaza City, the Juwana Amal Center for Children with Cancer in Khartoum and the Kherson Regional Children’s Clinical Hospital. in Ukraine.

Protracted conflicts have “cumulative and long-lasting effects,” the report warned, leaving little or no health system functional even after the violence ends.

Rubenstein said: “The impact on the population’s access to health care is enormous after these attacks – and continues even when conflicts subside, as we see in Tigray, Ethiopia, in Yemen – due to the destruction or severe damage to the health system and the departure of so many health workers.”

He said statements by Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, and other officials condemning violence against health care could be “a foundation for more concerted global leadership.”

Rubenstein said that must include prosecutions to deliver justice and act as a deterrent. Monday’s announcement by the chief prosecutor of the International Criminal Court that he was seeking arrest warrants for Hamas and Israeli officials for war crimes was “welcome,” he said.

“We need accountability for many crimes committed in that war, but it is also important that crimes specifically related to the provision of health care or the misuse of health facilities be charged,” Rubenstein said. “And I think we haven’t seen that yet.”

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