Red Cross Red Crescent
ISSUE 2.2011redcross.int
THE MAGAZINE OF THE INTERNATIONAL
RED CROSS
AND
RED CRESCENT
MOVEMENT
Focus on the ‘Arab Spring’
Images o sufering and heroism rom Libya to Yemen
Falling of the radar
A 360-degree look at rebuilding lives in Iraq
Out o sight, out o mind
A visual journey into the world’s orgotten disasters
Health carein danger
The International Red Cross andRed Crescent Movement
is made up of theInternational Committee of the Red Cross (ICRC), theInternational Federation of Red Cross and Red CrescentSocieties (IFRC) and the National Societies.
The International Committee o the RedCross
is an impartial, neutral and independentorganization whose exclusively humanitarianmission is to protect the lives and dignity o victims o armed confict and other situations o violence and to provide them with assistance.The ICRC also endeavours to prevent suering bypromoting and strengthening humanitarian lawand universal humanitarian principles. Establishedin 1863, the ICRC is at the origin o the GenevaConventions and the International Red Cross andRed Crescent Movement. It directs and coordinatesthe international activities conducted by theMovement in armed conficts and other situationso violence.
The International Federation o Red Crossand Red Crescent Societies
works on the basiso the Fundamental Principles o the InternationalRed Cross and Red Crescent Movement to inspire,acilitate and promote all humanitarian activitiescarried out by its member National Societies toimprove the situation o the most vulnerablepeople. Founded in 1919, the IFRC directs andcoordinates international assistance o theMovement to victims o natural and technologicaldisasters, to reugees and in health emergencies.It acts as the o cial representative o its membersocieties in the international eld. It promotescooperation between National Societies andworks to strengthen their capacity to carry outeective disaster preparedness, health and socialprogrammes.
The
International Red Cross and Red Crescent Movement
is guided by seven Fundamental Principles:
humanity, impartiality, neutrality, independence, voluntary service, unity
and
universality.
All Red Cross and Red Crescent activities have one central purpose:
to help without discrimination those who sufer and thus contribute to peace in the world.
International Federation ofRed Cross and Red Crescent Societies
National Red Cross and Red Crescent Societies
embody the work and principles o theInternational Red Cross and Red CrescentMovement in more than 186 countries. NationalSocieties act as auxiliaries to the public authoritieso their own countries in the humanitarian eldand provide a range o services including disasterrelie, health and social programmes. Duringwartime, National Societies assist the aectedcivilian population and support the army medicalservices where appropriate.
W
HEN I STARTED working as anICRC ield surgeon, I oundtreating people wounded inconfict both challenging and rewarding.One day, when ghting erupted in suburbsnear our hospital, the security environmentbecame severely degraded and I wasunable to do what I thought best or themany wounded.Our sta could not cross town to get towork. The lights went out when the gen-erator was hit by a stray bullet. Armed menentered the hospital and threatened someo the nurses. Later, I was struck by a simple act: just asthe need or health care peaks, confictand insecurity make the delivery o andaccess to health-care most di cult. Thisis not only because wounded people re-quire emergency surgical care but alsobecause confict makes whole populationsvulnerable to disease. Cholera epidem-ics are requently associated with confictbecause thousands o people’s access toclean drinking water may be impossible es-pecially i whole populations are displaced.Even during times o peace, many commu-nities have only basic health care; this maysimply evaporate when confict erupts. Insecurity o health care takes many orms.Hospitals are hit by shells and mortars.Health-care workers are threatened and, inthe worst cases, killed or kidnapped. Am-bulances are ambushed. These incidentsare the most obvious and are most likely tobe reported on by the media. However, or each event that gets mediaattention, there are thousands o others.Ambulances are oten held or hours atcheckpoints. Soldiers enter hospitals look-ing or wounded enemies and disruptinghealth care at the same time. Authorities
Guest editorial
ISSUE 2.2011
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RED CROSS RED CRESCENT
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1
Health care: most dif cultwhen it is most needed
may deny a particular ethnic group ac-cess to a hospital. Armed groups may stealhospital supplies. All o these are obstacleswhich impinge on the right o woundedand sick people to health care. It is becoming clear that the insecurity o health care is a major — but largely unrec-ognized — humanitarian issue. For eachviolent event bringing insecurity to health-care acilities or workers, there is a ‘knock-on’ eect through which the wounded andsick suer even more because health careis rendered impossible or, at best, di cultto provide or access. Yet outside the humanitarian sector, thisproblem is barely acknowledged, under-stood or addressed — either by the publicat large or by those obliged to protect thewounded and sick, hospitals, ambulancesand health-care workers under interna-tional humanitarian law. This is why the health unit o ICRC’s assis-tance division began in July 2008 to collectreports o violent events, including eventsinvolving threats o violence, rom 16countries where confict had an impact onhealth care delivery. The data were drawnboth rom the media reports (news wires,newspapers and major TV or radio newsoutlets) and rom the internal and publicreports o humanitarian agencies. The resultant ICRC report,
Health care inDanger: a sixteen-country study
, released inAugust 2011, collected, processed and ana-lysed a total o 1,342 reports detailing 655separate events o violence or threats o vio-lence aecting health care over a 30-monthperiod. In that time, the study revealed that733 people were killed and 1,101 injureddirectly as a result o an incident or attack related to armed violence. Aside rom suchstatistics, the study revealed real threats tohealth care, as well as serious vulnerabilities,in countries where the ICRC is operational.(See also pages 4 and 5.) How should the Red Cross Red CrescentMovement respond? First, it is critical thateld activities increase in scope to tacklereal, everyday issues about the saety o health care acilities and personnel. Thisinvolves closer cooperation with NationalSocieties. Second, the Movement mustintensiy its diplomatic eorts to securea powerul resolution at the 31st Interna-tional Conerence with buy-in rom majorstakeholders. Third, we must use publiccommunication to build a community o concern about insecurity o health careand a culture o responsibility among thosewho can make a real dierence. Those who take up arms or whateverreason must understand and ull theirobligation to respect international human-itarian law and protect both those whoneed health care as well as those who risk their lives to deliver care when and whereit’s needed most.
By
Robin M. Coupland
Robin M. Coupland is a ormer ICRC feld surgeon andnow works as a medical adviser or the ICRC in Geneva.
Insecurity of health careis a major — but largely unrecognized — humanitarianissue.
Your turn
I you would like to submit an opinion article orconsideration, please contact the magazine at
rcrc@irc.org
. All views expressed in guest editorials arethose o the author and not necessarily those o theRed Cross Red Crescent Movement or this magazine.
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Red Cross, Red Crescent Magazine. No. 2, 2011
Red Cross / Red Crescent magazine covers a range of humanitarian issues. Articles include features on the activities of Red Cross and Red Crescent Societies as they seek to help people around the world. The magazine is free of charge. You can find previous issues here: http://www.redcross.int/EN/mag/archives.html
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