The Lancet
Volume 390, Issue 10111, 2017, Pages 2516-2526

Health workers and the weaponisation of health care in Syria: a preliminary inquiry for The Lancet–American University of Beirut Commission on Syria (Note) (Open Access)

Fouad F.M. , Sparrow A. , Tarakji A. , Alameddine M. , El-Jardali F. , Coutts A.P. , El Arnaout N. , Karroum L.B. , Jawad M. , Roborgh S. , Abbara A. , Alhalabi F. , AlMasri I. , Jabbour S.*
  • a Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon, Global Health Initiative, American University of Beirut, Beirut, Lebanon
  • b Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
  • c Syrian American Medical Society (SAMS), Washington, DC, United States
  • d Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  • e Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon, Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon, Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
  • f Department of Sociology, University of Cambridge, Cambridge, United Kingdom
  • g Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  • h Center for Systematic Reviews on Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
  • i Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon, Imperial College London, London, United Kingdom
  • j Department of Politics and International Studies, University of Cambridge, Cambridge, United Kingdom
  • k Syrian American Medical Society (SAMS), Washington, DC, United States, Imperial College London, London, United Kingdom
  • l Multi Aid Programs (MAPS), Bekka, Lebanon
  • m SAMS, Zahleh, Lebanon
  • n Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon

Abstract

The conflict in Syria presents new and unprecedented challenges that undermine the principles and practice of medical neutrality in armed conflict. With direct and repeated targeting of health workers, health facilities, and ambulances, Syria has become the most dangerous place on earth for health-care providers. The weaponisation of health care—a strategy of using people's need for health care as a weapon against them by violently depriving them of it—has translated into hundreds of health workers killed, hundreds more incarcerated or tortured, and hundreds of health facilities deliberately and systematically attacked. Evidence shows use of this strategy on an unprecedented scale by the Syrian Government and allied forces, in what human rights organisations described as a war-crime strategy, although all parties seem to have committed violations. Attacks on health care have sparked a large-scale exodus of experienced health workers. Formidable challenges face health workers who have stayed behind, and with no health care a major factor in the flight of refugees, the effect extends well beyond Syria. The international community has left these violations of international humanitarian and human rights law largely unanswered, despite their enormous consequences. There have been repudiated denunciations, but little action on bringing the perpetrators to justice. This inadequate response challenges the foundation of medical neutrality needed to sustain the operations of global health and humanitarian agencies in situations of armed conflict. In this Health Policy, we analyse the situation of health workers facing such systematic and serious violations of international humanitarian law. We describe the tremendous pressures that health workers have been under and continue to endure, and the remarkable resilience and resourcefulness they have displayed in response to this crisis. We propose policy imperatives to protect and support health workers working in armed conflict zones. © 2017 Elsevier Ltd

Author Keywords

[No Keywords available]

Index Keywords

Health Personnel intensive care emergency medicine ambulance international law health care policy health care personnel Syrian Arab Republic Terrorism human ethics Warfare war priority journal Note human rights Humans social media risk factor war crime hospital service health care weapon health care access Syria Health Policy health care facility medical student public health
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85019723764&doi=10.1016%2fS0140-6736%2817%2930741-9&partnerID=40&md5=feb82c9ed1c1ed111320285171ae29de
DOI: 10.1016/S0140-6736(17)30741-9
ISSN: 01406736
Cited by: 42
Original Language: English