ICRC statement on mounting threats to the delivery of health care - Economic and Social Council

20-07-2012 Statement

Economic and Social Council (ECOSEC), Humanitarian Affairs Segment, New York, 20 July 2012, ICRC statement by Pierre Dorbes.

Mindful of the themes of this year's ECOSOC segment on evidence-based humanitarian decision-making and partnerships for effective humanitarian assistance, the ICRC would like to raise what is probably one of the most serious humanitarian concerns today in terms of numbers of people affected. Yet one of the most neglected. I am talking about threats to the delivery of health care as well as to the safety of those who deliver it.

Today, access to and delivery of health care are threatened in a variety of ways in many countries. To mention just a few recent examples, hospitals in Somalia have been shelled; ambulances in Libya and Syria have been shot at; and wounded people in Afghanistan may languish for hours in vehicles that are held up at checkpoints. In short, a blatant contempt for the neutral status of health-care facilities, transport and personnel is today all too common.

Aware of this reality, the ICRC decided to compile information on violence against health care from various countries and published a study in 2011. It was based on data collected in the field in 16 countries over a period of 2.5 years. This study revealed a wide range of systematic threats to the delivery of health care and the safety of health-care personnel. Such threats range from a generally poor security environment to denial of access to care, and on to arrest and kidnapping of health workers, looting of health-care facilities and even direct attacks on those facilities, on patients and on health-care personnel. The violent events actually recorded by the ICRC are only the tip of the iceberg. But they clearly indicate high levels of vulnerability both for the wounded and sick and for health staff in armed conflicts and other complex emergencies worldwide.

The ICRC documents and analyses these events in order to respond with greater precision in terms of humanitarian action in the field.

Based on the analysis of events registered during the first four months of this year, the ICRC wishes to highlight the following three main observations. First, it is local providers of health care who are most at risk and affected. Second, State security forces and non-State armed groups are equally at fault for violence against health care. Lastly, over one quarter (27%) of people affected by such violence were killed (20%) or wounded (7%) as a result.

In response to this reality, the ICRC decided to launch a four-year initiative, entitled "Health Care in Danger", to identify and implement concrete measures for improving security in the provision and access to health care in armed conflicts and other emergencies. However, it soon realized it could not address this issue of major humanitarian concern all by itself. The organization therefore brought it to the attention of the 31st International Conference of the Red Cross and Red Crescent, held in Geneva in late 2011 in order to seek the support of States to engage in addressing this problem.

The Conference expressed its support for the ICRC initiative by adopting a resolution that recognizes the grave nature of this problem and stresses that efforts should be undertaken by each country to improve the situation.

This is where partnerships with other influential entities become indispensable. Working with partners such as National Red Cross and Red Crescent Societies, the ICRC has begun consultations with States as a means of involving government and independent experts from around the world in 10 workshops through 2012 and 2013. Between 300 and 400 experts from government ministries, armed forces, academia, national Red Cross and Red Crescent Societies, national and international NGOs, and the health-care community will be consulted in the process.

These workshops will produce practical recommendations for measures that can be taken at the national level to tackle a variety of problems. This process is not intended to create new international instruments or broader legal frameworks. Rather, it is geared towards specific decisions and practical measures. A report on progress achieved over the next four years will be presented to the 32nd International Red Cross / Red Crescent Conference in 2015.

In addition, it will be important for the ICRC to continue engaging with all those interested in and concerned by the issue in order to promote actual implementation of the recommendations. The organization will remain proactive in its dealings with anyone who can positively influence the safe delivery of and access to health care.

On behalf of the many patients and health-care personnel suffering the effects of violence around the world today, the ICRC calls for your support in this humanitarian initiative over the next four years. It really is a matter of life or death.