2017 WHD campaign: #NotATarget – World Humanitarian Day 19 August
World Humanitarian Day is held every year on 19 August to pay tribute to aid workers who have risked and lost their lives in humanitarian service. The Day was designated by the General Assembly in 2008 to coincide with the date of the 2003 bombing of the United Nations headquarters in Baghdad, Iraq. Each year, World Humanitarian Day focuses on a theme, bringing together stakeholders from across the humanitarian system to advocate for survival, well-being, and dignity of people affected by crises, and for the safety and security of aid workers.
2017 WHD campaign: #NotATarget
Around the world, conflict is exacting a massive toll on people’s lives. Trapped in wars that are not of their making, millions of civilians are forced to hide or run for their lives. Children are taken out of school, families are displaced from their homes, and communities are torn apart, while the world is not doing enough to stop their suffering. At the same time, health and aid workers – who risk their lives to care for people affected by violence – are increasingly being targeted.
Humanitarian Health Action
Health care is under attack
We witness with alarming frequency a lack of respect for the sanctity of health care and for international humanitarian law: patients are shot in their hospital beds; medical personnel are threatened, intimidated or attacked; vaccinators are shot; hospitals are bombed.
What are attacks on health care?
We consider attacks on health care to be any act of verbal or physical violence or obstruction or threat of violence that interferes with the availability, access and delivery of curative and/or preventive health services during emergencies.
Attacks on health can include bombings, explosions, looting, robbery, hijacking, shooting, gunfire, forced closure of facilities, violent search of facilities, fire, arson, military use, military takeover, chemical attack, cyberattack, abduction of health care workers, denial or delay of health services, assault, forcing staff to act against their ethics, execution, torture, violent demonstrations, administrative harassment, obstruction, sexual violence, psychological violence and threat of violence.
What are the consequences of attacks on health care?
Every attack on health care has a domino effect. Such attacks not only endanger health care providers; they also deprive people of urgently needed care when they need it most. And while the consequences of such attacks are as yet largely undocumented, they are presumed to be significant – negatively affecting short-term health care delivery as well as the longer-term health and well-being of affected populations, health systems, the health workforce, and ultimately our global public health goals.
Think of the years of education and experience lost with the early and tragic death of each health care worker. Think about the time and resources and dedication it takes to develop one doctor. Think of the resources required to rebuild one hospital. We cannot accept these losses as normal.
What information do we have on attacks on health care?
There is no publicly available source of consolidated information on attacks on health care in emergencies. For 2014 and 2015, WHO consolidated available data on individual attacks from open sources and found:
- 594 reported attacks in 19 countries facing emergencies
- 959 deaths, 1561 injuries
- 63% against health care facilities; and 26% against health care workers
- 62% of the attacks intentionally targeted health care.
While we recognize that these numbers are not comprehensive, they are a first attempt to provide a consolidated global view of attacks on health care in emergency settings and they serve to highlight the alarming frequency of attacks over the past two year.
Is there sufficient reporting of attacks on health care?
We believe there is considerable under reporting–most likely due to limited awareness of the possibility, means and use of reporting, perceptions of the usefulness of reporting, limited resources and time, fear of reporting, complexity and limitations of existing reporting systems, lack of standardized definitions for use in data collection, and cultural perceptions of violence.
What additional information do we need?
We need a more standardized approach to gathering and sharing information on attacks on health care and their consequences to health service delivery so that the information that is being collected is comparable. The most significant knowledge gap is the consequences of attacks on health care delivery, on the health of affected populations, on health systems, on the health workforce, and on longer-term public health. This is a priority for data collection moving forward.
Quantitative and qualitative information would help us. A combination of quantitative and qualitative information will help us to understand the extent and nature of the problem and to identify and implement concrete actions to reduce the risk and impact of attacks during emergencies.
What can be done to stop attacks on health care?
Priority actions include the following:
- Gather and consolidate comparable data; establish national registries
- Document the consequences of attacks to health care delivery and public health
- Establish national legislation to uphold International Humanitarian Law
- Implement risk reduction measures, including through WHO’s Safe Hospitals Programme
- Engage communities in protecting health care
- Inform emergency response plans with security risk analysis
- Document and apply good practices, including the recommendations of ICRC’s Health Care in Danger (HCiD) project
- Promote and apply ethical principles in health care delivery
- Speak out and advocate with zero-tolerance