Delivering healthcare in situations of conflict or violence

http://www.bmj.com/cgi/doi/10.1136/bmj.d4671
Urgent action is needed to improve security and delivery of effective and impartial healthcare in situations of armed conflict or widespread violence, according to a global campaign launched by the International Committee of the Red Cross (ICRC) today.
"This is timely," writes Professor Vivienne Nathanson, Director of Professional Activities at the British Medical Association, in an editorial for the BMJ. "Events in Libya, Bahrain, Yemen, and elsewhere make it clear that when people take up arms for whatever reason, violence perpetrated against healthcare facilities and personnel is all too common."
She adds: "In such contexts, healthcare is often suspended, withdrawn, or impossible. The wounded and sick are denied effective healthcare when hospitals are rendered non-functional by explosive force or forcibly entered by fighters; when ambulances are hijacked; and when healthcare personnel are killed, injured, threatened, or arrested for treating insurgents."
This view is supported by an ICRC study of violent events affecting healthcare, warning that "insecurity of healthcare is one of the biggest, most immediate, and yet unrecognised humanitarian problems in today's conflicts."
As a result, the ICRC has pledged to actively promote measures to improve security and the delivery of healthcare in its entire field of operations. For example, to better protect hospitals from the effects of explosive force, deter armed entry into healthcare facilities, and ensure ambulances are given rapid and unhindered passage.
Professor Nathanson points out that these measures "clearly do not lie within the health community but in the domain of law, politics, humanitarian dialogue, and operating procedures of military bodies."
But, she says, the ICRC's study and work highlights two broad roles for the health community. Firstly, healthcare professionals who are likely to be working in insecure environments must have adequately training on how medical ethics apply in these different and difficult circumstances.
Secondly, she says there is a need to build a community of concern that goes beyond the health community to those who are in a position to ensure security of healthcare in places and situations where they are most needed.
Contact:
Vivienne Nathanson, Director of Professional Activities, British Medical Association, London, UK
Email: ftranza@bma.org.uk