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New report shows way forward for ambulances at risk

14-11-2013 News Release 13/195

Geneva/Sydney (ICRC) – A new report, entitled "Ambulance and pre-hospital services in risk situations," sets out ways to make pre-hospital care and ambulance services operating in areas of armed violence safer. The report was unveiled today at the International Red Cross and Red Crescent statutory meetings in Sydney, Australia.

Written by the Norwegian Red Cross with support from the International Committee of the Red Cross (ICRC) and the Mexican Red Cross, the report summarizes field experience in over 20 countries.

"In recent years, ambulances throughout the world have regularly been obstructed or attacked: in Afghanistan, Colombia, Lebanon, the occupied Palestinian territory, Libya, Yemen and Syria," said Yves Daccord, the ICRC's director-general. "This report offers no magic solutions. However, there are practical steps that the authorities, the military, and also the health-care providers themselves can take. Even in the midst of armed violence, there are ways to reduce the risk for first responders."

These steps include strengthening national laws protecting ambulance services, coordinating better with the authorities, the military and others, and adopting best practices – such as avoiding the use of armed escorts for civilian ambulances, and ensuring that staff have the right training and equipment – from countries where the problem has been addressed.

It is not enough for medical workers to clearly identify themselves as such to guarantee their safety. A core recommendation of the report is to build trust within the community. "It took the deaths of 12 Red Cross volunteers in Lebanon before 1987 to realize that it is not sufficient to be neutral in actual fact – it is necessary to also be perceived as neutral. Building that perception is hard work that requires a deliberate and coherent effort at all levels," explained Georges Kettaneh, the secretary-general of the Lebanese Red Cross.

An ambulance destroyed in an attack. This one is only a replica, but violence against health care is real, and it's often underestimated. 

Sydney, Australia.
An ambulance destroyed in an attack. This one is only a replica, but violence against health care is real, and it's often underestimated.
© ICRC

Another key recommendation is to promote the adoption and implementation of domestic legislation on the red cross and red crescent emblems providing for sanctions against those misusing them. "When protective symbols are brazenly ignored, other measures can offer only limited protection. Ideally, violations must be prevented from occurring in the first place: the challenge is to find ways of achieving that aim," said Mads Harlem, head of international law at the Norwegian Red Cross. "To begin with, awareness must be raised throughout the world of the terrible human cost of violence against health-care personnel and facilities. A culture of responsibility must be established among all concerned."

The recommendations have been developed in response to a variety of challenges regularly faced by first responders, ranging from obstruction of their work to direct attacks, in wars and other emergencies.

The ICRC gathered data on 1,405 such incidents in 22 countries between January 2012 and July 2013. Of those, 214 affected over 270 ambulances. Most were blocked or delayed while on the way to deliver health care and first aid.
 

For further information, please contact:
Anastasia Isyuk, ICRC Geneva, tel: +41 22 730 30 23 or +41 79 251 93 02
Andrea Lundt, ICRC Sydney, tel: +61 4 1848 5120


Photos

Mirwais hospital, Kandahar, Afghanistan. A taxi arrives with people injured by explosions in their village of Zhari. 

Mirwais hospital, Kandahar, Afghanistan. A taxi arrives with people injured by explosions in their village of Zhari.
© ICRC / K. Holt / v-p-af-e-01707

Bent Jbail, Lebanon. An ICRC convoy advances through bomb debris. 

Bent Jbail, Lebanon. An ICRC convoy advances through bomb debris.
© ICRC / J. Björgvinsson / v-p-lb-e-00494

Front line at Ras Lanuf, Libya. Doctors rescue a patient. 

Front line at Ras Lanuf, Libya. Doctors rescue a patient.
© ICRC / A. Liohn / v-p-ly-e-00134

Qussayr, Homs governorate, Syria. A wounded person is treated at a field hospital. 

Qussayr, Homs governorate, Syria. A wounded person is treated at a field hospital.
© ICRC / R. Garcia Vilanova / v-p-sy-e-00191