The World Humanitarian Day
was observed on 19th August, 2012. One of the most crucial yet overlooked
humanitarian issues of today: violence against health care. Attacking
health-care structures and personnel, and ambulances – as well as deliberately
obstructing the efforts of the wounded to find help – are common features of
conflicts throughout the world.
In Sri Lanka and Somalia,
hospitals have been bombed. In Libya and Lebanon, ambulances have been attacked
; in Bahrain, medical personnel who gave Medicare to protesters are on trial;
and in Afghanistan, the wounded languish for hours in vehicles held up in
checkpoint queues. From Colombia to Gaza, and from the Democratic Republic of
the Congo to Nepal, there is a lack of respect for the neutrality of
health-care facilities and personnel, and medical vehicles, among both those
attacking them and those who misuse them for military gain.
The ICRC( Intl community of
the red cross) has been documenting violence against health-care facilities and
personnel, and against patients, since 2008 in 16 countries where it is
working. The number of incidents that have been recorded is striking. But
statistics represent only the tip of the iceberg: they do not capture the
compounded cost of violence – health-care staff leaving their posts, hospitals
running out of supplies and vaccination campaigns coming to a halt. These
knock-on effects dramatically limit access to health care for entire
communities, many of whose members may be suffering from chronic or war-related
health problems.
Deliberate attacks on
health-care facilities and personnel and on patients and medical vehicles
virtually always violate international law. The Geneva Conventions and their
Additional Protocols assert the right of the wounded and the sick – combatants
and civilians alike – to be spared further suffering during armed conflict and
to receive assistance. To ensure this in practice, health-care facilities and
personnel, and medical vehicles, are given protected status as long as they maintain
their neutrality and treat all patients – irrespective of their political,
religious or ethnic affiliation – equally. Medical installations, vehicles and
personnel are clearly identified by protective symbols such as the red cross,
red crescent and red crystal. Furthermore, all parties to a conflict are
obliged by law to search for and collect the wounded after battle, and to
facilitate their access to health-care facilities. These laws, binding on all,
are not always respected.
The ICRC and its partners
in the International Red Cross and Red Crescent Movement strive to find ways of
reaching and assisting those wounded during armed conflict and internal strife,
and to protect health-care facilities. Some initiatives are purely legal, such
as spreading knowledge of international humanitarian law among State and
non-State actors and raising the subject of violations with them when these
occur. Some take more material form, such as protecting hospitals with sandbags
and bomb-blast film for the windows and marking their roofs and sides with a
Red Cross or Red Crescent, or teaching safer access techniques to ambulance
crews. And some are innovative measures to meet local needs, like the taxi
referral service in southern Afghanistan, which transports the wounded from the
front lines to hospital. But more has to be done to halt violence against
health care before it occurs. Primary responsibility for protecting health care
lies with combatants and States, who have an obligation to respect the law, not
with humanitarian organizations, who invariably deal with the consequences of
violations.
The ICRC is launching a
major campaign to raise awareness of this pressing issue, and mobilizing a
community of concern. This global initiative will last four years and aims
at making a crucial difference for people affected on the ground.
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