Impunity remains: Attacks on healthcare in 23 countries in conflict

This report documents attacks against vaccination workers, paramedics, nurses, doctors, midwives, patients, community volunteers, and drivers and guards, in violation of longstanding human rights and humanitarian law norms to protect and respect health care in conflict. Apart from the immediate human suffering they cause, attacks deprive populations of access to health care and jeopardise the achievement of the WHO’s goals for universal health coverage. Vaccination workers were attacked in six countries, impeding the broad reach of crucial vaccines such as polio. Moreover, many of the countries in this report face acute shortages of health workers as measured by the WHO’s standards, and ongoing violence against health care will likely exacerbate the problem.

In 2018, the Safeguarding Health in Conflict Coalition documented a total of 973 attacks on health in 23 countries in conflict. At least 167 workers died in attacks in 17 countries, and at least 710 were injured. Hospitals and clinics were bombed and burned in 15 countries. Aerial attacks continued to hit health facilities in Syria and Yemen. The number of documented attacks represents a significant increase from their last report of 701 attacks in 23 countries in 2017. However, it cannot be determined whether this higher number signifies a greater number of attacks in 2018 than in 2017 or an improvement in reporting mechanisms, in light of the implementation of the World Health Organization (WHO)’s Surveillance System of Attacks on Healthcare (SSA). SHCC incorporated data from six of the eight countries and territories that the WHO currently reports on, and it remains likely that the true number of attacks is even higher than reported overall.