Attacks on health workers, hospitals and clinics in conflict zones rose 25% last year to an all-time high, a new report shows.
While the increase was largely driven by new wars in Gaza and Sudan, ongoing conflicts such as Ukraine and Myanmar also saw such attacks continue “at a brutal pace.” Protection of health during conflicts coalition said.
Researchers recorded more than 2,500 incidents of “violence against or obstruction of health care” in 2023, including the killing or kidnapping of health workers and the bombing, looting and occupation of hospitals.
The coalition called for national and international prosecutions of “war crimes and crimes against humanity, involving attacks on the wounded and sick, health facilities and health workers.”
The report highlights cases of attacks on children’s hospitals and locations where vaccination campaigns are carried out, leaving people vulnerable to infectious diseases. It also warned of a new trend of drones armed with explosive weapons being used to attack health facilities.
Leonard Rubenstein, of the Johns Hopkins School of Public Health, who chairs the coalition, said violence against health care workers and facilities has “reached appalling levels.” The report included examples where workers were deliberately targeted, and others where fighters were reckless or indifferent to the damage caused, he said.
“The lack of restraint we see from the beginning of conflicts makes me suspect that the Health Care Protection Act has had no meaning for the fighters,” Rubenstein said.
“The only consistent feature of the attacks has been the continued impunity for these crimes. For more than a decade, despite their repeated commitments, governments have failed to meet these commitments and reform their military practices, halt arms transfers to perpetrators and bring those responsible for crimes to justice.”
The coalition consists of: more than forty non-governmental organizations and has produced annual reports for the past 11 years. It identified 2,562 incidents of violence against or obstruction of health care in conflicts in 2023.
This included 685 cases in which health workers – including doctors, nurses and ambulance drivers – were arrested or kidnapped, and 487 cases in which they were murdered, almost double the number in 2022.
In other cases, health facilities were damaged or destroyed by both government forces and non-state armed groups. These facilities were also “increasingly occupied or repurposed for military use,” in violation of humanitarian law, the report said.
The figures should be considered underestimates because it is difficult to get information from conflict areas, the researchers said.
They identified eleven countries and areas where children’s health care was affected, including the bombing or occupation of al-Nasr Children’s Hospital in Gaza City, the Juwana Amal Center for Children with Cancer in Khartoum and the Kherson Regional Children’s Clinical Hospital in Ukraine.
Prolonged conflict has “cumulative and lasting consequences,” the report warned, leaving little or no functioning health care system even after the violence ends.
Rubenstein said: “The impact on access to healthcare, on the population, is enormous in the aftermath of these attacks – and continues even as conflicts subside, which we see in Tigray, Ethiopia, in Yemen – because of the destruction or the serious damage to the healthcare system and the departure of so many healthcare workers.”
He said statements by Dr. Tedros Adhanom Ghebreyesus, the director-general of the World Health Organization, and other officials condemning violence against health care could “provide a basis for more coordinated global leadership.”
Rubenstein said this should include prosecutions to provide justice and act as a deterrent. Monday’s announcement by the International Criminal Court’s chief prosecutor that he was seeking arrest warrants for Hamas and Israeli officials for war crimes was “welcome,” he said.
“We need accountability for many crimes in that war, but it is also important that crimes specifically related to the provision of health care or abuse of health care facilities are charged,” Rubenstein said. “And I don’t think we’ve seen that yet.”