A potential system to protect health during armed conflict

“The Iraqi Governments decision to allow doctors to carry guns to protect themselves after many doctors were killed during the US invasion in 2003 was not helpful and made no difference,” according to Dr Salam Ismail, director of Doctors for Iraq, during a panel discussion, chaired by Timothy Large, the editor-in-chief of Thomson Reuters AlertNet, on what is meant by health protection during armed conflict at Imperial College London last week to mark the launch of the next phase of the International Health Protection Initiative (IHPI).

IHPI logo

In addition to continuing to promote the health protection resolution, the IHPI has two new additions: 1) an interactive, constantly updated, map of the world showing the sites relating to media reports from countries in which there are attacks on health and/or healthcare; and 2) a live blog enabling health workers or individuals living in war zones to securely, and in confidence, report by email or SMS any attacks on health (including photographs or video clips when appropriate). IHPI will then verify these reports and alert local non-governmental organisations and the media to these attacks on health care.

The panel discussion dealt with the difficult issue of what health protection means and how far such protection should go. In every single modern conflict the Geneva Conventions—which enshrine the protection of health and health care (workers, patients, facilities, supplies, vehicles) in international law—have been blatantly disregarded—a fact emphasised by panellist and child and adolescent psychiatrist, Lynne Jones, the course director at the International Institute for Humanitarian Affairs. The panel discussion dealt with the troublesome question: in 2011, is the enforcement of health care protection a realistic option, or should the international community admit that the Geneva Conventions are now an aspiration rather than the foundation of human rights?

Most of the panellists, including Ginny Barbour, chief editor of PLoS Medicine, Matthew Ellis, Convenor of the International Child Health Group, and Jimmy Walker, International Vice President of the Royal College of Obstetricians and Gynaecologists, argued for the need for better documented evidence of attacks on health care. International human rights lawyer, Hugh Davies, stressed the importance of upholding the safety of those reporting such attacks on health care.

Professor David Southall, one of the founders of the International Health Protection Initiative, advocated that health and health care be protected from attack, perhaps by a military force and proposed a novel idea of how such a protection force might work: “Just as doctors accept that the police are sometimes needed to enforce the protection of women or children who are being abused, so the international community should consider whether a similar system is required to protect civilians from those who are defying Geneva conventions and international humanitarian laws.”

Professor Southall suggested that just as the courts are the cornerstone of child protection, given the appropriate international mandate, the international criminal court could issue injunctions for health protection in situations where health facilities were being attacked. It would then be the responsibility of an international ethical military force, perhaps mostly led by women, to protect patients, staff, drugs, equipment etc at the health care facility.

The Thomson Reuters Foundation filmed the discussion, which will be on-line soon.

Competing interest: RM is one of the founders of the International Health Protection Initiative

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