Violence against health care workers saw an increase in 2022, considered the most Violent Year in the Last Decade.
The new report — Ignoring red lines: Violence Against Health Care in Conflict 2022— documents 1,989 attacks and threats against health care facilities and personnel across 32 countries and territories in armed conflict and situations of political violence throughout 2022.
In the report, the Safeguarding Health in Conflict Coalition (SHCC) said that incidents increased by 45% in 2022 compared to 2021.
“Over the last year, we identified a 45% increase in reported incidents of violence against or obstruction of health care in conflict zones as compared to 2021,” said Christina Wille, director of Insecurity Insight. The Insecurity Insight led the data collection and analysis for the report. “Health workers have been systematically targeted with violence, killed, arrested and kidnapped while health facilities have been destroyed with explosive weapons and robbed of essential medicine and equipment.”
UKRAINE AND MYANMAR
Following Russia’s invasion of Ukraine in February 2022, the report documents 782 violent incidents against health throughout the first 10 months of the conflict alone. Several of these include destruction of the health infrastructure, shooting at ambulances and deaths of health workers. In Myanmar, the report records at least 271 violent incidents since the February 2021 coup d’état by Myanmar’s junta. The junta arrested health workers or brutally killed for caring for the wounded and bombing of health facilities.
OTHER COUNTRIES
In protracted conflicts in Afghanistan, the Democratic Republic of the Congo, Nigeria, South Sudan, the occupied Palestinian territory and Yemen, the report found severely high rates of attacks on health. Across the wider Sahel, the report also reveals how insecurity for health care providers has been growing as the humanitarian space has been shrinking.
HEALTH FACILITIES DAMAGED OR DESTROYED
The Safeguarding Health in Conflict Coalition reported at least 704 incidents of health facilities damaged or destroyed in 25 countries. This included 468 in Ukraine, 45 in Myanmar, 29 in the DRC, 12 each in Yemen and Syria, and 11 in Sudan.
Explosive weapons, including from air and drone strikes, improvised explosive devices (IEDs), missiles, and shelling, most frequently damaged health facilities. Damage also caused in arson attacks, lootings, ransacking, and raids. Russian forces repeatedly shelled and bombed health facilities in Ukraine, where at least 50 hospitals were hit multiple times. In Myanmar, incidents in which air and drone strikes hit health facilities tripled in 2022 compared to 2021. Despite the declining overall intensity of the wars in Syria and Yemen, hospitals in those countries continued to be subjected to bombing and shelling. Health facilities were frequently subjected to arson, notably in Myanmar and the DRC.
In the report, the authors talk of looting of health facilities, medicines, supplies, and ambulances as common in conflicts throughout the world. They report 104 such incidents in Ukraine, 33 in the DRC, 30 in Myanmar, and 15 in Burkina Faso. Ambulances were subjected to hijacking and the stealing of supplies in civil wars in West and Central Africa, especially in Burkina Faso.
HEALTH WORKERS KILLED
In 2022, over 230 health workers were killed across 26 countries. This includes 78 in Ukraine, 27 in Myanmar, 26 in Afghanistan, 11 in Sudan, and 10 each in the DRC, South Sudan, and Syria. Health workers were killed while providing care to injured persons. They got killed by shelling or air-dropped bombs. Intercommoned violence, drive-by shootings and home invasionsalso killed health workers.Some were tortured to death and others killed after kidnapped. Health workers were often injured in the oPt in the context of clashes. In many other contexts, injuries among health workers remain vastly under-reported.
KIDNAPPED, ABDUCTED, AND TAKEN AS PRISONERS OF WAR
In 2022, at least 298 health workers were kidnapped or taken as prisoners of war (POWs) in 20 countries. It includes 61 in Ukraine, 50 in the DRC, 37 in Nigeria, 35 in Cameroon, and 26 in Mali. High numbers of health worker kidnappings continued across West and Central Africa, where the numbers stood at almost 200 in 2022. Cases increased in the DRC and Cameroon, while decreases reported in Burkina Faso and Mali. Health worker kidnappings remained common in Nigeria. The kidnappings happened while Health travels to or from work or to remote areas to provide health care services, and from their homes.
Russian forces or people working with Russian personnel abducted or imprisoned Health workers in Ukraine and took them as POWs. Many were interrogated and beaten.
ARRESTED AND HARASSED
More than 290 health workers were arrested in wars and conflicts across 19 countries and territories in 2022. This includes 112 in Myanmar, 71 in Iran, 31 in Afghanistan, 19 in Syria, and 14 in Cameroon. Arrests continued at high levels in Myanmar, with incidents increasing in Afghanistan, Cameroon, and Iran compared to previous years. Health worker arrests persisted in Syria.
ATTACKS ON VACCINATION CAMPAIGNS
Community health workers engaged in vaccination campaigns were attacked on at least 28 occasions in Afghanistan, Mali, Myanmar, Nigeria, Pakistan, South Sudan, and Sudan. In Afghanistan 10 polio vaccination workers were fatally shot, eight of them in a single day in four separate incidents in Kunduz and Takhar provinces.
“Some of these assaults are well-known and frequently reported, especially the bombing and shelling of hospitals and clinics,” said Leonard Rubenstein, chair of the SHCC. “attacks on vaccinators in seven countries, deprive millions of children protection from measles, polio and other diseases, as vaccination campaigns have to be suspended, he added. Rubenstein is professor at the Johns Hopkins Bloomberg School of Public Health.
RECOMMENDATIONS
- End impunity through prioritizing prosecutions of war crimes and attacks on health
- Strengthen prevention against the obstruction and prevention of the delivery of health care through reform of law and military doctrine and training and restrictions on arms transfers.
- Reform the World Health Organization’s system for collecting and disseminating data on attacks on health care.
- Strengthen global, regional and domestic leadership on the protection of health care across states and UN bodies.
- Support health workers through ministries of health, UN member states, donors, and health organizations.
