The Safeguarding Health in Conflict(SHCC) coalition is a group of international nongovernmental organizations working to protect health workers, services, and infrastructure. The coalition has three main objectives:
- Raise awareness of the problem of attacks on health workers, facilities, transport systems, and clients
- Work with national and global organizations to strengthen the documentation of such attacks and increase accountability for violators
- Empower local groups to play a safe, active role in documenting attacks and demanding accountability at national and international levels
Extract from SHCC Report on Violence against Health Care in Conflict (document link here) :
Health Care in Conflict Zones: A 2023 Report on Violence and Its Impact
The “Critical Condition: Violence Against Health Care in Conflict 2023” report sheds light on the grave issue of violence directed toward health care systems and professionals in conflict zones. As humanitarian crises around the globe intensify, health care workers, facilities, and the populations they serve find themselves increasingly vulnerable. This report, produced by the Safeguarding Health in Conflict Coalition (SHCC), documents the alarming rise in attacks against providers, especially in conflict-affected regions.
Increasing Violence Against Health Care Workers
One of the trends highlighted in the report is the increase in violence against providers. In 2023, over 2,562 reported incidents targeted health workers, facilities, and vehicles across 30 countries. This represents a 25% rise from the previous year. The conflicts in regions such as Myanmar, Sudan, Ukraine, and the Occupied Palestinian Territories (oPt) accounted for a significant portion of these incidents. In these areas, health care systems have been bombarded, looted, and repurposed for military objectives, further degrading the provision of medical services.
In 2023, nearly 487 health workers were killed, 240 were kidnapped, and over 445 were arrested or detained. Health care workers have increasingly become the victims of targeted attacks, being tortured, murdered, or injured while attempting to provide essential care to populations in need. For instance, medical professionals working in hospitals and ambulances were attacked with drones, bombs, and firearms, making it clear that the sector has become a frontline in many conflicts.
Impact on Health Care Facilities and Access
The destruction and occupation of health care facilities have a profound impact on the ability of civilians to access medical care. In countries such as Sudan, Ukraine, and Myanmar, hospitals were routinely shelled, looted, or occupied by military forces. In Sudan, 70% of health facilities in conflict areas ceased functioning by mid-2023, forcing millions to go without care. In Gaza, two-thirds of the health facilities have been rendered non-operational due to the ongoing conflict, exacerbating an already dire humanitarian crisis.
Health care infrastructure was also severely affected by airstrikes, missiles, and drone attacks. In Ukraine, hospitals and clinics were damaged by drone and missile strikes, especially in the Russian-occupied regions, where a quarter of health facilities no longer function. The impact is even more severe in the Palestinian territories, where health facilities have been caught in the crossfire of Israeli airstrikes, particularly during the escalation of the Israel-Hamas conflict in October 2023.
Health Workers’ Plight: Arrests, Kidnappings, and Killings
The SHCC report also documents a disturbing pattern of health workers being kidnapped, arrested, and even killed. Countries like Haiti, Somalia, and the Democratic Republic of Congo (DRC) witnessed the abduction of numerous health professionals by armed groups. These kidnappings often resulted in ransom demands, with health workers being targeted for their perceived wealth. In Haiti, gang violence caused widespread insecurity, with health workers being kidnapped while en route to provide care in remote areas.
Similarly, in countries like Myanmar, Sudan, and Ethiopia, health workers were often arrested and detained under accusations of political affiliation or opposition to the ruling forces. In Afghanistan, the Taliban arrested 65 health workers, accusing them of immorality or other violations of the group’s strict interpretation of religious laws. These arrests, often followed by harassment or interrogation, have made it increasingly difficult for medical professionals to work in conflict-affected areas.
The Consequences for Women’s Health Care
Women’s access to health care in conflict zones has been particularly affected, especially in countries with repressive regimes. In Afghanistan, for instance, women health workers faced severe restrictions on their mobility and work, further limiting access to health services for women and girls. The Taliban’s restrictions on female health care workers have led to a shortage of health professionals, with women increasingly being barred from providing or accessing health services. Similarly, in regions like the Occupied Palestinian Territories and Sudan, the ongoing violence disproportionately affects women and children, as access to reproductive and maternal health care services becomes limited due to facility closures and staff shortages.
Health Care as a Tool of War
The report highlights a disturbing trend in which health care facilities and personnel are being used as tools of war. In many conflict zones, combatants occupy hospitals, using them as bases for military operations. In Sudan and Myanmar, armed forces used hospitals as military installations, making them targets for opposition attacks. In Ukraine, Russian forces repurposed health care facilities for military objectives, denying civilians access to critical health services. This use of health care spaces for warfare not only violates international humanitarian law but also puts countless lives at risk.
Global Response and Recommendations
The SHCC report calls for stronger global leadership in addressing the violence against health care workers and facilities. It emphasizes the need for accountability and justice, urging international bodies such as the International Criminal Court (ICC) to prioritize war crimes investigations where health care facilities and workers have been attacked. The report also encourages national governments to conduct independent investigations into attacks on health care systems and impose sanctions on perpetrators.
Additionally, the report highlights the need for better prevention measures, including the ratification of international treaties like the Arms Trade Treaty, which seeks to limit the flow of weapons to conflict zones.
Strengthening Health Care in Conflict Zones
To mitigate the impact of violence on health care, the report calls for increased support for health workers, including psychosocial care and legal assistance. It stresses the importance of training health workers in conflict settings on their rights and responsibilities, as well as providing them with the necessary resources to continue delivering care safely. The inclusion of security costs in health care project budgets is also recommended to ensure that medical teams in conflict zones are adequately protected.
Health workers and facilities should also be given priority in global funding efforts, especially in conflict-affected regions where medical services are under constant threat. Organizations like the World Health Organization (WHO) and other UN bodies must take a more active role in advocating for the protection of health care and mobilizing international action to prevent future attacks.
Conclusion
The violence against health care in conflict zones is a growing humanitarian crisis that demands immediate global attention. As aid workers continue to risk their lives to provide essential services, it is crucial that international bodies, governments, and civil society come together to end the impunity for such attacks. Strengthening these systems and protecting medical personnel is not only a matter of upholding international law but also ensuring that millions of people have access to aid in the midst of conflict. The SHCC report underscores the urgency of this issue and provides a roadmap for the global community to act in defense of health care in conflict zones.