TY - JOUR
T1 - Review of attacks on health care facilities in six conflicts of the past three decades
AU - Briody, Carolyn
AU - Rubenstein, Leonard
AU - Roberts, Les
AU - Penney, Eamon
AU - Keenan, William
AU - Horbar, Jeffrey
N1 - Funding Information:
The Syrian pediatrician, Dr. Mohammad Wassim Maaz died in an airstrike on the al-Quds hospital in Aleppo, Syria in April 2016 which killed him, a dentist, three nurses and 22 civilians (Fig. 1). The Al-Quds hospital was supported by Médecins Sans Frontières and the International Committee of the Red Cross. A group of doctors still practicing in Aleppo commemorated him by saying, “We will always remember Dr. Maaz as the kindest and bravest of souls, whose devotion to treating the youngest victims of this war was unparalleled,” We dedicate our research to the memory of Dr. Mohammad Wassim Maaz and to the other physicians, nurses, and allied health professionals around the world who have died practicing in the face of humanitarian crises and war.
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/5/2
Y1 - 2018/5/2
N2 - Background: In the ongoing conflicts of Syria and Yemen, there have been widespread reports of attacks on health care facilities and personnel. Tabulated evidence does suggest hospital bombings in Syria and Yemen are far higher than reported in other conflicts but it is unclear if this is a reporting artefact. Objective: This article examines attacks on health care facilities in conflicts in six middle- to high- income countries that have occurred over the past three decades to try and determine if attacks have become more common, and to assess the different methods used to collect data on attacks. The six conflicts reviewed are Yemen (2015-Present), Syria (2011- Present), Iraq (2003-2011), Chechnya (1999-2000), Kosovo (1998-1999), and Bosnia and Herzegovina (1992-1995). Methods: We attempted to get the highest quality source(s) with summary data of the number of facilities attacked for each of the conflicts. The only conflict that did not have summary data was the conflict in Iraq. In this case, we tallied individual reported events of attacks on health care. Results: Physicians for Human Rights (PHR) reported attacks on 315 facilities (4.38 per month) in Syria over a 7-year period, while the Monitoring Violence against Health Care (MVH) tool launched later by the World Health Organization (WHO) Turkey Health Cluster reported attacks on 135 facilities (9.64 per month) over a 14-month period. Yemen had a reported 93 attacks (4.65 per month), Iraq 12 (0.12 per month), Chechnya > 24 (2.4 per month), Kosovo > 100 (6.67 per month), and Bosnia 21 (0.41 per month). Methodologies to collect data, and definitions of both facilities and attacks varied widely across sources. Conclusion: The number of reported facilities attacked is by far the greatest in Syria, suggesting that this phenomenon has increased compared to earlier conflicts. However, data on attacks of facilities was incomplete for all of the conflicts examined, methodologies varied widely, and in some cases, attacks were not defined at all. A global, standardized system that allows multiple reporting routes with different levels of confirmation, as seen in Syria, would likely allow for a more reliable and reproducible documentation system, and potentially, an increase in accountability.
AB - Background: In the ongoing conflicts of Syria and Yemen, there have been widespread reports of attacks on health care facilities and personnel. Tabulated evidence does suggest hospital bombings in Syria and Yemen are far higher than reported in other conflicts but it is unclear if this is a reporting artefact. Objective: This article examines attacks on health care facilities in conflicts in six middle- to high- income countries that have occurred over the past three decades to try and determine if attacks have become more common, and to assess the different methods used to collect data on attacks. The six conflicts reviewed are Yemen (2015-Present), Syria (2011- Present), Iraq (2003-2011), Chechnya (1999-2000), Kosovo (1998-1999), and Bosnia and Herzegovina (1992-1995). Methods: We attempted to get the highest quality source(s) with summary data of the number of facilities attacked for each of the conflicts. The only conflict that did not have summary data was the conflict in Iraq. In this case, we tallied individual reported events of attacks on health care. Results: Physicians for Human Rights (PHR) reported attacks on 315 facilities (4.38 per month) in Syria over a 7-year period, while the Monitoring Violence against Health Care (MVH) tool launched later by the World Health Organization (WHO) Turkey Health Cluster reported attacks on 135 facilities (9.64 per month) over a 14-month period. Yemen had a reported 93 attacks (4.65 per month), Iraq 12 (0.12 per month), Chechnya > 24 (2.4 per month), Kosovo > 100 (6.67 per month), and Bosnia 21 (0.41 per month). Methodologies to collect data, and definitions of both facilities and attacks varied widely across sources. Conclusion: The number of reported facilities attacked is by far the greatest in Syria, suggesting that this phenomenon has increased compared to earlier conflicts. However, data on attacks of facilities was incomplete for all of the conflicts examined, methodologies varied widely, and in some cases, attacks were not defined at all. A global, standardized system that allows multiple reporting routes with different levels of confirmation, as seen in Syria, would likely allow for a more reliable and reproducible documentation system, and potentially, an increase in accountability.
KW - Attacks
KW - Conflict
KW - Facilities
KW - Health care
KW - Surveillance
KW - Syria
KW - Yemen
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UR - http://www.scopus.com/inward/citedby.url?scp=85046248814&partnerID=8YFLogxK
U2 - 10.1186/s13031-018-0152-2
DO - 10.1186/s13031-018-0152-2
M3 - Review article
C2 - 29743939
AN - SCOPUS:85046248814
SN - 1752-1505
VL - 12
JO - Conflict and Health
JF - Conflict and Health
IS - 1
M1 - 19
ER -