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This bulletin from the Aid Security and COVID-19 series highlights conflict related violence continued to affect health care despite calls for a global ceasefire.
It is based on publicly available reports of incidents that injured or killed workers, damaged health facilities or health transport at the time of the COVID-19 response.
Event descriptions have not been independently verified.
The reported events in this bulletin are unlikely to be a complete record of all events that affected health care.

Attacks on Health by Non-State Actor Groups

On 23 March 2020, UN Secretary General António Guterres called for a global ceasefire amid the COVID-19 pandemic. Reminding the world that in war-ravaged countries health systems have often collapsed and that health professionals have been targeted, he called on warring parties to cease hostilities, silence guns, stop the artillery, and end airstrikes on civilians. While a number of conflict actors originally agreed to the ceasefire, many non-state actors did not.

Insecurity Insight’s monitoring of attacks on health care for March and April 2020 show that conflict related violence continued to affect health care in at least 11 countries.
• Despite the COVID-19 concerns, at least four health facilities were closed following damage or attacks in Afghanistan, Cameroon, Myanmar, and Yemen reducing access to health care for the population.

• At least five health workers were violently killed in March and April in Afghanistan, Somalia, South Sudan, Syria and Yemen.

• At least eight health workers were kidnapped between March and April 2020: o In South Kivu, DRC, an MSF team was held kidnapped for three days. o In Libya, four health workers from the Ibn Sina Public Hospital in Sirte were reported missing over a two-week period following an ‘arrest’ by an armed group in the area. o In Burkina Faso, the chief nurse of Koualou was kidnapped by armed men. o In Yemen, two workers from the Emirati Red Crescent were kidnapped. They were later found dead.

Loss of trained medical workers during a pandemic weakens the ability to respond effectively.
• Vital COVID-19 equipment was lost and effects the delivery of effective health services. Ambulances were damaged or destroyed by an IED in Garissa county in Kenya, fired at in Bani Walid, Libya and seized from a hospital in Libya and a port in Yemen. This not only reduces the available health transports, but also makes it less safe for patients to use health transport when needed.

• The neutrality of health services in conflict was compromised in Syria when regime soldiers deployed to a military location using an ambulance.

• Health equipment was broken or ransacked in Bungulu and Lubero in North Kivu, DRC, and during an attack on a clinic in Taiz city, Yemen. A track transporting medicine was attacked in Mandera country, Kenya.

Some events had a direct impact on the COVID-19 response.
• In Yemen, ambulances provided by the WHO specifically for the COVID-19 response were stolen. In Myanmar, a marked WHO vehicle transporting COVID-19 testing samples came under gunfire. In Libya, two health professionals were killed while on their way to a meeting to discuss measures for rehabilitation institutions against COVID-19.

• See previous bulletin on the direct impact airstrikes had on quarantine centres in Yemen, and the destruction of equipment reportedly intended for the COVID-19 response in Libya.

• The full impact of the consequences of attacks on health care on the pandemic will only become apparent with time.