IHPI

Prioritising the protection of health care during armed conflict

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The new 2017 Resolution

The International Health Protection Initiative (IHPI) advocates for a new system within the United Nations which ensures that health care is protected during armed conflict. The international community must wake-up to the need to create an effective global protection system so that those war criminals who attack with impunity defenseless people undergoing healthcare must be stopped.  Until the world is free of people in power acting within their own self-interest, which may never be achieved, there must be a strong and rapidly deployable healthcare protection system.

IHPI stresses that, during armed conflict, healthcare must be protected by the UN, even if by doing so the actions needed breech national sovereignty by utilizing diplomatic and military measures by appropriately trained UN forces.

Following the experiences of the last 7 years, where it is clear that the UN Security Council is not able to implement protection, IHPI continues to advocate for a specially formed global health protection system, funded and established within the UN but independent of the veto accorded to the permanent members of the UN Security Council.  The linked table shows the major conflicts of interest relating to the ability of the 5 permanent members to veto substantive UN action aimed at helping to control conflict.  All 5 are global leaders in the sale of major weapons and small arms.  They are also very rich and have good indicators of healthcare compared with the 10 countries where the most lethal armed conflicts are occurring in 2017.

Presentation to a joint meeting on 27-28th June 2017 of OHCHR (Office of the UN High Commissioner for Human Rights) and WHO (World Health Organisation: Department of Maternal, Newborn, Child and Adolescent Health) in Geneva 

PPTX slides


Recent article in the British Medical Journal discussing a possible relationship between the arms trade and terrorism
link to article (bmj.com)

History

IHPI is a movement of individuals, organisations, institutions and charities setup in 2010 to lobby the UN to act to uphold the Geneva Conventions and International Humanitarian Law, especially regarding the safe-guarding of health facilities, medical equipment, transport for healthcare and health-workers.  A Resolution was agreed in 2011 following a meeting of the International Child Health Group (ICHG) held in November 2010 and organized by the IHPI team and the 2011 Resolution was placed on this website.

Two organizations aiming to help protect healthcare were established after the initial ICHG meeting.  These are The Safeguarding Health in Conflict Coalition (of which the IHPI was a founding member) and the Healthcare in Danger project of the International Red Cross and Red Crescent movement.  These organisations have undertaken great work in helping to identify the magnitude of this desperate problem (see below) but, despite their efforts, the situation globally is worsening.

The background to the latest updated IHPI 2017 Resolution follows:

"War...is when some adults who don't know what good is and what love is, are throwing dangerous war toys which injure innocent people".  (Tamara aged 10 years during the war in Bosnia and Herzegovina).

3rd May 2017

The Safeguarding Health in Conflict Coalition documented the extent of violence against healthcare during 2016 in 23 countries in a compelling article entitled “Impunity Must End” Attacks included 1. The bombing, shelling, and looting of hospitals and clinics 2. The killing of health workers, emergency medical personnel, and patients 3. The intimidation, assault, arrest, and abduction of health workers and patients 4.  The obstruction of access to care including blockage of and attacks on ambulances 5. The takeover and occupation of health facilities by police, military, or other armed actors and attacks on and blockage of humanitarian actors, supplies, and their transport.

On the same date, Médecins Sans Frontières reported that during 2016  there were 74 attacks on 34 health facilities: 71 in Syria and 3 in Yemen.

17th August 2016

The World Medical Association and the International Council of Nurses issued a statement condemning the unprecedented levels of violence against health workers in Syria and other nations. They confirmed their support for UN Resolution 2286.

27th September 2016

Despite UN Resolution 2286 (see below), Professor Rubenstein, Chair of the Safeguarding Health in Conflict Coalition reported that the UN Security Council had failed to take action after an aid convoy was attacked in Syria on the 20th September 2016. He also reported the following: “In Syria alone, six hospitals were attacked in Aleppo Governorate at the end of July 2016, the highest number the region experienced in a single week since the war began. Médecins Sans Frontières (MSF) reports 19 of its facilities in Syria have been attacked since Resolution 2286 was adopted. Hospitals and health workers in Yemen, Afghanistan, and elsewhere, have also been attacked in the last three months”.

In Syria, Physicians for Human Rights verified 108 attacks on health facilities, and the deaths of 91 health professionals in 2016.

3rd May 2016

The UN Security Council enacted Resolution 2286 which was supported by 80 UN States. As summarized by Safeguarding Health in Conflict the UN Resolution “urges States to take steps to prevent attacks on health facilities and health workers, reform their domestic laws to strengthen protection, train their militaries and security forces in the requirements of international law, collect data on attacks, investigate violations that take place, and hold perpetrators accountable”.  

Human Rights Watch reported between 2013 and 2016 25 attacks on healthcare in 10 countries resulting in 230 deaths and closure or destruction of 6 hospitals.  Inadequate or absent proceedings for accountability were undertaken in response.

20th May 2015

A side event on Health and Wellbeing in emergencies sponsored by the Safeguarding Health in Conflict Coalition was held at the World Health Assembly. However, three years after an earlier resolution by the World Health Assembly requiring the WHO to lead on the collection and dissemination of data on attacks on healthcare, there was still a failure of governments and UN Institutions to be held accountable.

7th July 2012 

Drs. McDermott and Xenak in a  call for more effective intervention by the USA in Syria to protect healthcare. They state "To protect vulnerable civilian communities all around the world, Congress and the administration must fully support and enact as soon as possible the Medical Neutrality Protection Act — a bill that bans the sale of select U.S. military assistance to countries whose governments attack hospitals, detain doctors, intimidate patients and commit other violations of medical neutrality".

21st May 2012 

Physicians for Human Rights (PHR) published a report entitled:  "Under the Gun: Ongoing Assaults on Bahrain’s Health System". The findings of this report were based on 102 interviews, the examination of medical records and radiographic images, and site visits by PHR investigators in April 2012.

April 23rd 2012

At a healthcare in danger symposium at the British Medical Association IHPI tabled three questions:

1. "The proliferation of arms, most originating from the permanent members of the UN Security Council, is without doubt adding to the ferocity and inhumanity of existing conflicts and their effects on defenseless citizens; damaging their health and healthcare. Should we not be targeting the unethical trade in arms and inputting to the Arms Control Treaty under discussion at this time."

2. "Given that in every recent conflict the Geneva Conventions have been blatantly disregarded with impunity, isn't it time to discuss the option of establishing and implementing an international protection system which has the mandate, authority and power to protect the health and healthcare of defenseless citizens who are being deliberately targeted and attacked?  And if so what form should such an international protection system take?"

3. "Surely respect for the sovereignty of States has to be based on the responsibility of the behavior of those in power".

13 April 2012 

Grossly inadequate healthcare for 350,000 people in the Nuba mountains of Sudan being attacked by Government forces.  Atrocities resulting from seemingly unstoppable armed conflicts, this time in Sudan affecting the Nuba people.  This film from the Enough Project shows the resulting and terrible injuries suffered by women and children following air attacks on civilians.  It shows the almost non-existent health facilities available and the very small number of brave medical and nursing staff attempting to treat terrible injuries inflicted by the regime in Khartoum.

John Prendergast from the Enough project states: "This is a civilian protection crisis.  We talk all the time about the responsibility to protect human life.  Right here is a ground zero for that responsibility."

21st January 2012 WHO resolution 23/1/2012

The Executive Board of the World Health Organization passed a resolution addressing WHO’s role in humanitarian crises that included a provision mandating WHO to lead in collection and dissemination of data on attacks on health workers, health facilities, health transports and patients during armed conflict.

The World Medical Association's response to this resolution, including IHPI's support, is outlined here.

14th June 2011

An investigation into the final weeks of the quarter-century-long civil war between the government of Sri Lanka and the minority Tamil population featuring devastating video evidence of horrific war crimes is shown in a Channel 4 documentary.

The documentary shows how the Geneva Conventions were repeatedly violated by targeting healthcare.

November 29th and December 1st 2011

  1. At an international medical conference on neonatal healthcare at Imperial College London the keynote "David Harvey" lecture on "Maternal and infant healthcare during armed conflict: what can doctors do?" was presented by Professor Southall. An IHPI article summarizing this presentation was also published.
  2. At a conference on Reproductive Health in Humanitarian Emergencies at the Royal Society of Medicine Catastrophes & Conflict Forum in collaboration with the Royal College of Obstetricians and Gynaecologists there was a presentation on the latest developments with the IHPI.

 

Afghan refugees in an extremely poor camp in Northern Pakistan
Afghan refugees in an extremely poor camp in Northern Pakistan

 

© International Health Protection Initiative 2011 – 2017