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Healthcare in danger: ELRHA partners with ICRC to increase evidence base on violence in healthcare

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We are delighted to announce our strategic partnership with the International Committee of the Red Cross (ICRC) to increase the evidence base on violence against healthcare in conflicts and other emergencies, as part of their Healthcare in Danger Initiative (HCID).

This initiative of the International Red Cross and Red Crescent Movement aims to address the issue of violence against patients, health workers, facilities and vehicles, and ensuring safe access to and delivery of healthcare in armed conflict and other emergencies.

THE PROBLEM

It is when fighting breaks out that healthcare services are most needed, but it is also then that they are most vulnerable to attack. Doctors and nurses, ambulance drivers and paramedics, hospitals and health centres, and even the wounded and sick, have all come under attack.

This violence can disrupt the healthcare system when people need it the most. Combatants and civilians die only because they are prevented from receiving medical attention in time. Entire communities are cut off from vital services, such as maternity care, childcare and vaccinations. Sometimes the disruption can be so severe that the entire system collapses.

Violence against healthcare has attracted considerable attention, mainly due to the visibility of the most blatant violations in countries such as Syria and Yemen, but overall it remains under-researched.

While the most intense and deliberate forms of violence in high-visibility contexts have been the subject of studies and advocacy by rights groups, the true scale, impact and dynamics of violence – especially the less publicised but more widespread occurrences in many of today’s protracted conflicts – remain outside of the interest of academia and policy debates.

Though there are organisations collecting data on attacks against healthcare, it is heavily based on media monitoring, secondary sources and passive surveillance. It is skewed towards a limited number of largely Western bodies and represents the tip of the iceberg – overly focusing on high intensity incidents in a handful of contexts.

THE ELRHA-ICRC COLLABORATION

In order for us to identify solutions to address violence against healthcare, we need to know what works. We need more evidence.

To do this, we need to have a better understanding of what evidence already exists, as well as an understanding of how violence against healthcare is being measured, and what instruments and methods are being used. That’s why the ICRC has asked us to support their initiative by commissioning a Situation Analysis and Review of the Evidence Base on Violence Against Healthcare. Because of our expertise in defining humanitarian problems and conducting in-depth reviews to explore potential solutions, we can help build knowledge to tackle this problem, through identification of critical evidence gaps.

This review seeks to increase knowledge and understanding of the complexities of protection of healthcare through an academic lens, to inform and guide policy and practice. It will bring together openly sourced evidence generated from academia, humanitarian organisations, civil society and government sources which will be used to identify the priority evidence-based gaps. An eleven-person Expert Working Group, chaired by Vice President of ICRC, Gilles Carbonnier, has been set up to provide direction to the specific focus and methodology for the review.