How do you make health care secure in conflict zones?

Global health experts have tackled the deadly disruptions to health care caused by armed violence at the first ever meeting to address the problem. 

WCPT Secretary General Brenda Myers was among those attending the International Committee of the Red Cross (ICRC) symposium in London in April, part of a four-year project to confront the insecurity, violence and threats that undermine the delivery of health care in armed conflicts and other emergencies. 

Research from the ICRC shows that people die in large numbers not because they are direct victims of bombs or shootings but because an ambulance does not arrive in time, health personnel are prevented from doing their work, hospitals are themselves targets of attack or because the environment is too dangerous for effective health care to be delivered.

According to ICRC, ambulances have been used in suicide attacks in Afghanistan, hospitals hit by rocket fire in Libya, emergency rooms invaded by gunmen in Iraq, doctors murdered in Somalia and patients executed inside medical vehicles in Colombia.

“Physical therapists know only too well that the services they provide are urgently needed by people who have suffered from violence in conflict zones,” says WCPT Secretary General Brenda Myers. “Unfortunately, the circumstances in those conflict zones also make the provision of physical therapists difficult at best. We need to consider, with other health professions, what measures we can take in the face of this situation.”

At the London symposium, 150 professionals and humanitarian specialists discussed what governments and inter-governmental organisations could do to make sure that health services can be delivered in a secure environment. 

They proposed:

  • a concerted campaign of awareness-raising based on data quantifying the scale of the problems facing health care;
  • bold solutions from governments, such as adopting standing operational orders on the battlefield, bolstering protection and facilities for health workers and facilities and stronger legislation to protect medical neutrality;
  • a re-examination of medical ethics to ensure there is adequate guidance for health workers on dealing with the dilemmas they face while working amid conflict. 

The symposium explored how health professionals working in danger zones cope with witnessing possible violations of international law.

"Medical ethics are very much at the centre of the debate among health professionals in situations of armed violence," said Robin Coupland, a medical adviser at the ICRC and author of a study examining the issue. "In environments of violence the wounded or sick are at times refused treatment. Discrimination arising from a polarised conflict climate results in the loss of lives."

The symposium, organised by the ICRC, British Red Cross, British Medical Association and World Medical Association, will result in a report summarising its main findings and recommendations. It was the first of a series of expert consultations that will take place across the world.