Health care in danger: questions and answers

The project, which is set to run from 2011 to 2015, will focus on strengthening protection for the sick and wounded in these situations through the adoption of specific measures designed to help ensure that they have safe access to effective and impartial health care. Over the next four years, the ICRC and National Red Cross and Red Crescent Societies will urge States party to the Geneva Conventions, the health-care community at large and others concerned to devise concrete solutions and commit themselves to their implementation.

What specific problem does this project address?

Violence against health-care workers, facilities and beneficiaries is one of the most serious humanitarian challenges in the world today. And yet it frequently goes unrecognized.
An ICRC study based on data collected in 16 countries from mid-2008 to the end of 2010 shows patterns of violence that hinder the delivery of health care, ranging from direct attacks on patients and on medical personnel and facilities – including looting and kidnapping – to arrests and denial of access to health care.

Thus, urban fighting may prevent health-care personnel from reaching their places of work, first-aiders may be unnecessarily delayed at checkpoints, soldiers may forcibly enter a hospital to look for enemies or shield themselves from attack, and ambulances may be targeted or illegally used to carry out attacks. Whatever the context, poor security conditions in many parts of the world mean that the wounded and sick do not get the medical attention to which they are entitled.

Although acts that hinder the delivery of health care often violate basic principles of international humanitarian law and international human rights law, and although numerous efforts have been undertaken by the International Red Cross and Red Crescent Movement over decades to put an end to these acts, the problem nonetheless continues. Addressing it is a matter of life and death for thousands.

Why is this one of the biggest humanitarian issues today?

A single act of violence that damages a hospital or kills health-care workers has a knock-on effect, depriving many patients of treatment they would otherwise have received from the facility or workers in question. The killing of six ICRC and Red Cross nurses in Novye Atagi, Chechnya, on 17 December 1996, deprived an estimated 2,000 war-wounded per year of needed surgical care. The effect on the wounded and sick of just one violent incident directed against medical personnel or facilities may be felt by hundreds or even thousands of people.
Owing to the effects of chronic and acute threats, compounded by the persistent problem of inadequate medical services, lack of access to health care is probably one of the biggest humanitarian issues today in terms of the numbers of people affected.

What can be done ?

Tangible solutions will be devised during expert workshops organized in partnership with National Societies, States, members of health-care communities and non-governmental organizations (NGOs). Some practical solutions could include for example placing transparent plastic sheeting on hospital windows to protect patients and health-care personnel from blasts or ensuring better integration of international humanitarian law (IHL) in national legislation and military doctrine.

Through a series of regional conferences, the ICRC and Red Cross / Red Crescent Societies will review the conclusions and recommendations of the workshops and encourage States to endorse and implement them. Other major Red Cross and Red Crescent or health-related events will also be used to secure support for the Health Care in Danger project. The initiative will also help raise awareness of the issue and advocate for the adoption and implementation of specific measures to ensure that health care can be delivered safely in armed conflicts and other emergencies. It will help build a community of concern among health-care practitioners, health-oriented NGOs and others who can influence the current situation.

What does the concept of "health care" include?

It includes:

• hospitals, clinics, first-aid posts and ambulances;
• health-care personnel, whether working in medical facilities, in ambulances or as independent practitioners;
• all persons on the premises of medical facilities, including the wounded and sick and their relatives;
• Red Cross and Red Crescent staff involved in the delivery of health care, including volunteers;
• health-oriented NGOs;
• military health-care facilities and personnel.