Magazine article The Nation's Health

Work to Document Violence against Health Workers Growing

Magazine article The Nation's Health

Work to Document Violence against Health Workers Growing

Article excerpt

THE DOCTOR TRAVELED from village to village in Pakistan, part of a group of health workers providing vaccinations to prevent disease.

But this doctor was employed not by a local nonprofit group or non-governmental organization, but by the U.S. Central Intelligence Agency. And in addition to working with a vaccine program, he was trying to collect DNA specimens as part of a U.S. attempt to locate Osama bin Laden.

The U.S. government has not denied its participation in the fake vaccination program, which came to light in 2011, but news reports indicate that the Pakistani government has jailed the doctor, whose efforts reportedly did not contribute to finding bin Laden. What the work did do is increase already prevalent concerns among Pakistanis and others suspicious of the vaccination program, said Robert Lawrence, MD, professor at the Johns Hopkins Bloomberg School of Public Health and an APHA member. And it may have contributed to ongoing violence against health workers that has included the murder of nearly 20 health workers participating in polio vaccination work in the past year.

Violence against health workers is not new, nor is there data suggesting that recent years have been more violent than the past--in part because such data is scant.

But that has begun to change recently as health and human rights professionals seek ways to document and prevent further violence against health workers.

In January, the deans of 12 schools of public health in the U.S. wrote a letter to President Barack Obama decrying the use of the sham vaccination program in Pakistan. They said that it would endanger other health workers--several polio vaccination workers had already been killed in Pakistan--as well as the fight to end polio.

"There was no question in our minds that these polio vaccinators were direct victims of the fallout from the use of the sham vaccinator," said Lawrence, who marshaled the efforts to send the deans' letter to Obama. "There should be no confusion about what role a health worker is going to be playing."

The Obama administration has not responded to the letter, he said.

Health workers are protected under the Fourth Geneva Convention and later amendments, which note that medical units should be protected and "Under no circumstances shall medical units be used in an attempt to shield military objectives from attack."

But violation of the conventions is rampant, and not only by armed groups or terrorists.

In Syria, for example, the government, not the rebels, has been responsible for virtually all of the brutal attacks against health workers and facilities that have occurred since violence flared in recent years, said Leonard Rubenstein, JD, LLM, MA, former executive director of Physicians for Human Rights and an APHA member. The Sri Lankan government bombed and shelled medical facilities during that country's decades-long civil war, and in Bahrain, the government targeted health workers who aided injured protesters in 2011, he said. Rubenstein is now on the faculty at Johns Hopkins University and is cofounder of Safeguarding Health in Conflict, a coalition promoting respect for human rights laws.

The coalition, which includes humanitarian groups, health provider groups and human rights organizations, is working to reduce attacks on health workers and increase accountability. It works with groups including the International Committee of the Red Cross to increase documentation of evidence of attacks and develop strategies for prevention.

In 2012, the World Health Assembly adopted a resolution calling on the World Health Organization to provide leadership on collecting data on attacks on health workers.

"This is an issue that has been ignored too long," Rubenstein told The Nation's Health. …

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