Health Care in Danger: Respecting and Protecting Health Care

Using our permanent seat in the UN Security Council, the UK advocates for the protection of all civilians in crisis situations, including medical personnel and facilities and humanitarian personnel and assets, in line with IHL.

In 2016, with UK co-sponsorship, the UN Security Council passed resolution 2286 strongly condemning attacks and threats against the wounded and sick, medical and humanitarian personnel exclusively engaged in medical duties, their means of transport and equipment, as well as hospitals and other medical facilities

The UK took the opportunity last month to respond to the Secretary General’s annual report on Protection of Civilians, which focussed on the implementation of 2286 and made recommendations, including:

• Taking practical steps to mitigate impacts on the ground. Work is ongoing to fortify healthcare facilities in Syria and to promote access to mobile clinics in Yemen.
• We’re sharing our expertise overseas, helping foreign governments and their armed forces comply with International Humanitarian Law, and helping them improve the effectiveness of their military justice systems- aiming to ensure accountability for these crimes.
• We recommend the collection of better and more systematic data on attacks on medical facilities and personnel. The SG has committed to doing this within the UN system, we need to support and contribute to these efforts. It’s not enough to collect the data, we need to use it. The UK has therefore called for more Council briefings from the whole UN family including OPCHA, OHCHR and the Special Representative for Children in Armed Conflict when attacks on medical facilities and personnel occur.

At the broader political level we have used examples from Syria (where 809 healthworkers have been killed) to highlight the urgency and importance of IHL and UNSC Resolution 2286 (May 2016) to protect health workers. The UK was actively involved in supporting this bill and will continue to condemn all attacks and violations of IHL. We have raised the importance of the Bill and pressed for member states to implement the Sec General’s recommendation  at several high level forums (UN General Assembly and World Health Assembly). To support relevant States and non-state actors implementing or reinforcing context-specific measures to enhance physical safety of health care personnel and infrastructure.

Monitoring is at the heart of compliance. We have pressed for WHO (and UNGA and WHA) to put the necessary monitoring tools and systems in place to report on attacks.  We will continue to press for WHO and its new Director General, Dr Tedros, to use its mandate to be at the global forefront of this agenda and fully implement the monitoring system. We have also joined in with like-minded member states to call on all states to cooperate in collecting and sharing data on attacks with WHO. In the absence of an agreed monitoring mechanism, we supported partners and colleagues in Syria who could no longer wait. They have developed  the first real-time monitoring and reporting tool (MVH)Monitoring Violence in Health) which we will explore whether this model can be replicated in other conflict settings.

This is a substantial thread throughout MENAD with  case study examples from Syria, Yemen, OPTs and Iraq how we have taken joined up our policy and programme objectives to implement practical measures which can prevent further attacks and promote a stronger health workforce.

Examples of these protection and prevention interventions include: providing funds and support for health actors in Syria to develop early warning systems, emergency preparedness plans. Out of desperation, Syrian health workers have requested funds to help with infrastructure (underground and fortification, blast proof windows) to protect their lives and their patients. We used flexible funds to support these requests.  We fund research and provide addition support on the staff wellbeing, trauma and pyscho-social needs of healthworkers who remain working in conflict settings. We also provide funds (through WHO and INGO partners) on ways to strengthen, train and acredit the existing health workforce.

The DFID Palestinian programme provides support to the UN inter-agency Access Coordination Unit (ACU) to improve procedures for the facilitation of access of personnel and goods to and from Israel and the oPt in-line with humanitarian principles. The ACU publishes monthly reports on access trends and developments, which are available to the public and serve as a means for the humanitarian community to advocate for improved access and adherence to UN resolutions, privileges and immunities and existing agreements.