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This week the International Committee of the Red Cross (ICRC) launches a global campaign-"It's a matter of life and death"-which aims to improve security and delivery of effective and impartial healthcare in situations of armed conflict and other contexts of widespread violence. 1 This is timely. Events in Libya, Bahrain, Yemen, and elsewhere make it clear that when people take up arms for whatever reason, violence perpetrated against healthcare facilities and personnel is all too common.
In such contexts, healthcare is often suspended, withdrawn, or impossible. The wounded and sick are denied effective healthcare when hospitals are rendered non-functional by explosive force or forcibly entered by fighters; when ambulances are hijacked; and when healthcare personnel are killed, injured, threatened, kidnapped, or arrested for treating insurgents.
Ultimately, the ICRC campaign is about something intuitive to all health professionals who have worked in a context of conflict: that a secure environment is a prerequisite for the delivery of healthcare. 2 It is surprising that currently no mechanism exists for reporting violent events that affect healthcare. 3
In a study of violent events affecting healthcare, the ICRC makes the case-and convincingly so-that insecurity of healthcare is one of the biggest, most immediate, and yet unrecognised humanitarian problems in today's conflicts. 4 Using all possible sources, the ICRC has collected and analysed reports pertaining to 655 violent events that have affected healthcare in 16 unnamed countries where it is operational. The study details the different types of perpetrators of violence, the means used by the perpetrators, who is...