Annals of Tropical Medicine and Public Health
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Year : 2016  |  Volume : 9  |  Issue : 6  |  Page : 412-413
Don't we have better challenges and bigger enemies than targeting the health sector itself? Time to introspect!

Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Kancheepuram, Tamil Nadu, India

Click here for correspondence address and email

Date of Web Publication14-Nov-2016

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Don't we have better challenges and bigger enemies than targeting the health sector itself? Time to introspect!. Ann Trop Med Public Health 2016;9:412-3

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Don't we have better challenges and bigger enemies than targeting the health sector itself? Time to introspect!. Ann Trop Med Public Health [serial online] 2016 [cited 2020 Aug 9];9:412-3. Available from:
Dear Sir,

Worldwide, any violent event leads to an enormous burden on the capacity of the health centers to offer quality assured health care services to the needy.[1] However, if these violent events target the health sector itself (viz. damage to health establishments from weapons, armed entry into health establishments, damage/hijack of ambulance, health staff exploited or killed, etc.), thousands of injured and sick people can be devoid of effective health care.[1],[2]

These violent events are not isolated incidents and as a matter of fact, in a span of <3 years till 2014, close to 2400 attacks have been reported against the health staff/facilities/vehicles.[1],[3] In addition, in the last couple of months, a number of such attacks have been reported in nations such as Afghanistan, Syria, and Yemen.[1],[4] These violent events leave a serious consequence as they generally occur in those nations which already have a compromised health care delivery system and find it difficult to even extend the routine care to the people who are affected.[2],[3] These circumstances are further complicated if the relief workers are restricted to assist the people in need.[3]

It is a major cause of concern as most of these violent attacks are targeted against those individuals/facilities which are primarily protected under the international humanitarian law.[1],[3] Subsequently, thousands of people are left unattended as the essential health care services are disrupted itself. To address this challenge and bring about an improvement in the quality of life of people in the long-term, a combination of multiple international stakeholders has together started a health care in the danger (HCID) initiative.[1],[2] The primary aim is to ensure access to the health care in the regions of armed conflict/emergencies, and at the same time respect and protect health workers, facilities, and vehicles through a combination of recommendations.[1]

Under the HCID initiative, different stakeholders such as states (viz. to investigate and condemn attacks against health sector, to ensure local legislations are in accordance with the international law, to train the military to adequately protect health care and work in coordination with health and humanitarian organizations, etc.), state armed forces (to respect health workers/infrastructure in all circumstances), other nonstate actors, health organizations are targeted to effectively respond to the emerging challenges of violent attacks on the health sector.[1],[2],[3],[4] Furthermore, most of these disastrous experiences can be averted if the authorities and other stakeholders can implement practical interventions.[2],[4]

To conclude, attacks on the health facilities are one of the most critical yet unaddressed humanitarian issues. It can and should be avoided, by ensuring the observation of international humanitarian law and implementing all precautionary measures.

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Conflicts of interest

There are no conflicts of interest.

   References Top

World Health Organization. Stop the Violence. Protect Health Care – Joint Statement; 2015. Available from: [Last accessed on 2016 Feb 19].  Back to cited text no. 1
Redwood-Campbell LJ, Sekhar SN, Persaud CR. Health care workers in danger zones: A special report on safety and security in a changing environment. Prehosp Disaster Med 2014;29:503-7.  Back to cited text no. 2
PLOS Medicine Editors. Health care in danger: Deliberate attacks on health care during armed conflict. PLoS Med 2014;11:e1001668.  Back to cited text no. 3
World Health Organization. WHO Deplores Bombing of MSF Clinic in Kunduz; 2015. Available from: [Last accessed on 2015 Feb 22].  Back to cited text no. 4

Correspondence Address:
Saurabh RamBihariLal Shrivastava
Department of Community Medicine, 3rd Floor, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1755-6783.193947

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