Health Workers In Danger: Call To Action

Violence against health-care workers is a serious humanitarian challenge in the world today and one that has profound public health consequences. It is not possible to provide health services and deliver public health programmes if infrastructure is destroyed or health workers are killed or forced to flee.The impact of this violence is often greatest on the most impoverished countries. For example, a suicide bomber murdered a number of medical students in 2009 in Mogadishu, Somalia, when he detonated his bomb at a university graduation ceremony; the students were only the second group of medical graduates to emerge in that country in the last 20 years.

More developed countries are not immune. Earlier this year health workerswere arrested for treating prodemocracy protestors injured in demonstrations in Bahrain. The health workers, many of them leading medical specialists, treated the injured and had witnessed the atrocities committed by the security forces. As a consequence, many were abducted, detained and interrogated. At the time of writing, trials before military courts continue for many of those arrested. Health professionals have a duty to treat all patients without regard to politics race or religion; this being a fundamental tenet of the principle of medical neutrality. The treatment of the Bahrain health workers hasbeen described as “one of the most egregious sets of violations of medical neutrality and breaches of international law that … [has been] seen in decades”.

It seems there is an increasing incidence of serious attacks on health workers. , Assaults against health workers have become a feature of armed conflict despite their prohibition by the laws of war; these attacks are often part of a broad assault on civilians, used for military advantage and committed without regard for the ethical obligation of health professionals to provide care to patients irrespective of affiliation. There is a need for improved information gathering in order to better understand and react to these acts of violence. It has been suggested that the WHO is best positioned to provide leadership in this area. The WHO has shown leadership in other seemingly intractable problem areas such as the ethical recruitment of health workers from developing countries.

Health professionals in all countries, including our own, are no strangers to dealing with violence in the workplace as Waikato District Health Board’s zero tolerance campaign against such violence has highlighted. However, the increasingly violent and complex environment that our colleagues have to endure in conflict countries is on a scale unimaginable to most of us. More must be done to ensure the wounded and sick have timely access to health care. Primary responsibility for safeguarding health care rests with politicians and combatants. However, all health professionals can help by building a community of concern. The International Committee of the Red Cross seeks to increase awareness of this issue through its Health Care in Danger campaign. The NZMA has shown leadership in New Zealand by writing to the World Medical Association calling for more assertive protest against the treatment of the detained Bahrain health workers. The medical profession has a strong legacy of advocacy on issues such as nuclear disarmament, climate change and other challenges facing society. Those wishing to support measures to protect health workers against violence in conflict countries are encouraged to seek further information by visiting relevant websites, including those of the ICRC, Amnesty International and Physicians for Human Rights.

Dr Brendon Gray, Head of Medicolegal Services (New Zealand), Medical Protection Society and Member of the New Zealand Committee for the Dissemination of Humanitarian Law, Wellington.

Dr Paul Ockelford, Chair New Zealand Medical Association and Director of Clinical Services, Diagnostic Medlab, Auckland.

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