It’s vital to uphold the medical code of conduct
In the wake of Côte d’Ivoire’s disputed election results in 2011, the country experienced a wave of violent demonstrations and arrests, and many people were forced to flee their homes. Deteriorating security conditions had a serious impact on access to health care for the wounded and the sick. We met with Thérèse Aya N’Dri-Yoman, former Minister of Health HIV/AID prevention of Côte d’Ivoire, to get her views on how best to deal with obstacles to health care.
Why is it so important for everyone to respect health-care providers and facilities?
Everyone needs health care at one time or another and everyone is entitled to it. Medical facilities need to be protected: when people can’t find treatment in an emergency, the consequences can be serious, if not fatal. It’s a matter of survival. Emergencies are, by their very nature, unpredictable. People in need of health care during an emergency must be able to use their nearest medical facility. That’s why it’s so important that we get the message across to people that health-care facilities and personnel need to be protected.
What challenges did you face in protecting health-care delivery during the armed violence?First and foremost, we had to make sure that both medical facilities and health-care workers were safe. Keeping hospitals safe and secure was a real problem, as they were often looted or vandalized. Stealing goods for consumption is understandable, in a way. But it’s harder to accept the destruction of research and X-ray equipment, which everyone knows is essential. Particularly worrying were the attacks on health-care personnel. Medical workers were often dealing with highly agitated people, be they combatants or civilians, and everyone was impatient for treatment. In some cases, health-care personnel simply weren’t able to respond immediately and so were verbally threatened or even physically attacked.
Can you tell us about any specific incident that you had to handle during this period?
There was one time when combatants brought an injured man to Treichville University Hospital. The staff member they approached wasn’t in a position to deal with the case immediately, so they attacked him. This sparked a protest among the medical personnel. We had to calm everyone down and, with the help of the Ministry of Defence, take appropriate measures to improve security at the medical facility.
What can the authorities do about this problem?
It’s important to explain to health-care workers how vital it is to uphold the medical code of conduct. According to this code, they are obliged to treat everybody according to their need, impartially and without discrimination.
Arms carriers and the general population should be reminded that medical facilities are a sort of sanctuary, in that they are places where staff treat the sick and the wounded regardless of their political affiliation. It needs to be conveyed that taking it out on medical personnel means taking it out on people who may one day save a member of your family – or yourself, for that matter!
New white paper in Côte d’Ivoire helps prepare doctors to work in midst of violence
For over a decade, health-care personnel in Côte d'Ivoire found themselves working in a general climate of violence as the country was struck by repeated crises and outbreaks of armed conflict. Sometimes the staff fell victim to violence; sometimes they committed acts of violence themselves. Taking these experiences into account, the National Council of the Order of Physicians in Cote d'Ivoire decided to draft a white paper on the issue, with input from the ICRC. It marks an excellent first step towards making sure that health-care workers are better prepared and trained to act appropriately in dangerous situations in the future. The white paper is intended as a set of practical recommendations primarily for doctors, but also for the authorities and arms carriers. It contains guidelines, along with the World Medical Association’s code of conduct, specifying the duties of every doctor. In particular, health-care personnel are reminded that they should uphold the worldwide medical ethical code, which states that health care should be provided to all patients without discrimination. This collaboration between a national medical body and the ICRC proved highly successful and is something that could certainly be replicated elsewhere in the world.
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