Healthcare experts address inequalities in primary care access in London

Published 20th August 2019

20th August, London – Leading NHS and charity sector experts meet at City Hall to discuss how to tackle inequalities in primary care access, in the context of a new report by medical charity Doctors of the World which sheds light on worrying GP registration policies which discriminate against some of the most vulnerable people in our communities.

Everyone living in the UK is entitled to see a GP free of charge. This is the most effective and efficient means of preventing ill-health and promoting well being. Despite this, people in need of healthcare are wrongly turned away from GP practices in England every day.

Doctors of the World (DOTW) UK’s Registration Refused reporting (2016-2018) monitors the wrongful GP registration refusals of their patients, most of whom are migrants in vulnerable circumstances who are living in poverty. Registration Refused 2018 shows that almost one fifth of attempts by Doctors of the World’s volunteers to register patients with a GP were wrongly refused, for reasons that contravene NHS England guidance.

Lack of paperwork (proof of ID or address) was the most common reason for refused registration – accounting for 64% of cases – and is likely to disproportionately affect already vulnerable groups. Thirty percent of GP practices approached (299 of 990) refused at least one registration attempt. Almost all of these (n=256; 87%) were rated as ‘Good’ or ‘Outstanding’ by the Care Quality Commission (CQC).

The prevalence of this issue has worrying implications both for public health and the health and safety of people in need, including people who are homeless, migrants in vulnerable circumstances and survivors of trafficking and modern slavery.

The event at City Hall will take place under the umbrella of the Safe Surgeries initiative, which aims to improve access to primary care by supporting providers to offer more welcoming and inclusive services. Practices that join are part of a supportive network of GP practices who are committed to delivering inclusive and accessible services for everyone in their communities, and can access free training and practical resources.

Panel discussion will explore the question of “What should an inclusive primary care system for all Londoners look like?”. Our expert panellist will include Dr Raj Patel, Deputy National Medical Director for Primary Care for NHS England and NHS Improvement and Dr Victoria Tzortziou-Brown, Co-Honorary Secretary of the Royal College of GPs, as well as patient representatives and experts in migrant and homeless health.

 

Dr Tom Coffey OBE, Mayor of London Health Advisor, said: “The difficulties the most disadvantaged Londoners face when registering for a GP expose the stark health inequalities across our capital. Everyone should have easy access to a GP, yet this again shows that the health of Londoners is being profoundly shaped by who you are and where you live. The Mayor is taking bold steps to make London a healthier, fairer city, and we need the Government and everyone across the health and care service to do all they can to tackle these health inequalities in the long term.”

Lucy Jones, Director of Programmes at Doctors of the World UK, said: “The NHS was funded on principles of equality and non-discrimination and its better for everyone that the most vulnerable in our communities can see a GP. Yet unnecessary immigration and paperwork in GP surgeries are stopping people from getting the healthcare they need.  One fifth of our attempts to register patients with GPs are wrongfully refused. This is already worrying. However, we know that when vulnerable patients approach GP practices themselves, a successful registration is even less likely. So it’s great to see that practices and leaders in the sector are working to make their services more accessible for all”.

 

 

World Humanitarian Day 2019

Published 16th August 2019

For World Humanitarian Day, this year we celebrate the work of female humanitarians across the globe, amid the risks which they may face in serving others.

From the clinic in east London to the governorate of Sana’a in Yemen, every day women humanitarians are changing the world. They want to share their stories with you:

 

 

 

“It has become very clear to me that, if I want to see things changed, I should be in the arena. So, here I am, choosing courage over comfort every single day.” Meaza Semaw, Medical Coordinator, Ethiopia.

 

 

 

 

 

 

 

“In this patriarchal society where beating wives is considered the norm, my greatest motivation is that at least I am doing something to create awareness to prevent and reduce gender-based violence. The main challenge I face as a woman is to change the way of thinking of men because I am a “woman”. Why they would listen to a “woman”.” Dr. Syeda Mushrefa Jahan, GBV Programme Coordinator, Bangladesh.

 

 

 

 

 

 

 

 

In comparison to women (and especially mothers) suffering the war in my country, I feel extremely lucky to be on the side that provides help rather than the side in need of help. Feeling that I can make a difference, even little, to support men, women, boys, and girls in such a dire situation is just a bless!” Wafa’a Al Saidy, General Coordinator, Yemen. 

 

 

 

 

 

“As Nelson Mandela said: “What counts in life is not the mere fact that we have lived. It is what difference we have made to the lives of others that will determine the significance of the life we lead.” This quote inspires me a lot and Doctors of the World is providing us this platform to make a difference in others’ lives. Working with them as a pharmacist, involved in drug procurement, supply, and management, gives me the satisfaction of being part of this humanitarian work and help in the provision of essential drugs to needy people.” Aneela Tahir, Senior Pharmacist, Pakistan. 

 

 

 

 

“As a feminist, I think individual and collective self-care should be recognized as key strategies to enable female humanitarian professionals, especially national staff, to build up personal resilience and maintain their participation in humanitarian movements and actions. This latter is key if we want to achieve our objectives.” Lucille Terré, Former Programme Coordinator, Central African Republic.

 

 

 

“Being a humanitarian worker is a very fulfilling work: it’s a way to contribute, through my field of experience, in strengthening links between populations and individuals throughout the world. I share, give, receive, meet, especially with those most in need of material help, but often so rich in moral values.” Anne Kamel, Medical Coordinator, Emergency Relief Programmes.

 

 

Joint Letter to the Home Secretary

Published 30th July 2019

30th July 2019

 

Dear Home Secretary,

 

Congratulations on your appointment to one of the great offices of state. You will lead the Home Office through a period of great challenge, but at a moment of great opportunity for reform. We are writing to you as organisations that work with, are led by, or represent people who have moved to the UK and have made it their home. We want to raise a number of pressing issues, which require action if the immigration and asylum system is to regain the trust of the public.

 

Allowing people who seek safety in the UK to re-build their lives

As a global power and as the fifth richest country in the world with a proud history of providing safety to those in need, Britain has an obligation to lead by example and guarantee shelter and safe passage to those who seek asylum or refuge from conflict, persecution and crisis. We can and must build a system where safe, legal routes to asylum are accessible to all who need them. We must build a system where asylum decisions are made quickly and fairly, so that people can rebuild their lives in the UK. Currently, people seeking asylum in the UK are effectively banned from working, meaning that they are at a high risk of destitution and denied the opportunity to provide for their families and contribute to the economy. Funding cuts to ESOL (English for speakers of other languages) classes must be reversed and new long-term funding guaranteed. We need comprehensive support systems which help those who seek asylum to navigate life here and become active members of their local communities by allowing them to work and study.

 

Keep families together

All families belong together. Under current rules however, British nationals must demonstrate they earn an income well above the minimum wage in order to live with their partner in the UK. British nationals with parents abroad find it almost impossible to bring them here as they grow older. As a result, tens of thousands of British families live in separation, with children unable to see their parents except through Skype. The UK should make it easier for its citizens to build a life here with the people they love. Refugees in the UK who have lost everything should have the right to be reunited with their close family in the UK so that they can make a fresh start together and integrate in their new community. Reintroducing legal aid is vital for them to navigate the complicated process of being reunited with their families.

 

Secure the rights of European citizensand their family members and protect vulnerable groups

We welcome the Prime Minister’s announcement to guarantee the rights of European citizens in the UK, but we urge the government to enshrine those rights in UK law. The Home Office must step up its efforts to provide adequate and concrete information about the EU Settlement Scheme to EU citizens and their family members who are often non-EU nationals. This should include targeted outreach activities to vulnerable EU citizens such as elderly people, children in care, disabled people, rough sleepers and victims of domestic violence. These groups are at risk of not being aware of the scheme at all, of being misinformed, of not having access to accurate information and support services to navigate the scheme and of eventually facing the hostile environment if they miss the application deadline.

 

Stable work and study routes

Our current immigration system ties workers to employers, distorting the market and creating opportunities for exploitation and short-term visas. Ever-changing requirements make workers’ lives unstable. We need more sensible, more flexible rules that encourage long-term integration and stability for families. Children and young people who grew up in the UK or were born in this country should have equal access to education and work as their British peers regardless of their parents’ immigration status. The Home Office should guarantee easy and affordable access to citizenship for this young generation.

 

Treat human beings with humanityand end indefinite detention

Our immigration enforcement system treats people brutally: families are woken in the middle of the night by immigration raids and parents are taken away in front of their children. Too many people are detained unlawfully and with no idea when they may be set free. Access to healthcare within detention is often inadequate. The Home Office under your predecessors started to take important steps in reforming immigration detention and pursuing alternatives to detention. There is cross-party support in Parliament for a 28-day time limit on detention. We ask you to pursue these reforms with urgency.

 

End the Hostile Environment

Our communities, our public spaces, our public services and our workplaces should be places open to us all, where no one fears discrimination or persecution. The hostile environment builds a border through our hospitals, homes, schools, police stations and communities. Doctors, landlords, police officers and teachers have been tasked with verifying immigration status and often people who look or sound ‘foreign’ are asked to show their papers in order to see a doctor or go to school. We are also concerned about the collection and processing of increasing amounts of personal data of migrants and the lack of safeguarding in place to regulate its use in the broader immigration process. We must end the hostile environment so that discrimination is effectively challenged and communities can unite, build bridges and prosper. Additionally, the recommendations of Wendy Williams’ Lessons Learned Review must be published immediately. We ask you to commit to ending the Hostile Environment.

 

Build a better Home Office

The Home Office should make timely, correct and fair decisions about people’s status, supporting people to get on with their lives and become active members of their community. It should not price people out of status or citizenship and should be transparent and accountable. Cuts to funding and a lack of investment in training and support mean that caseworkers are overstretched and the department struggles to retain staff. Only a department that works efficiently, values its staff, embraces transparency and uses evidence to make policy can deliver an immigration system that earns public trust. We ask you to invest in that reform as a matter of urgency.

 

Recent governments have seen scandal after scandal rooted in the failure of the immigration and asylum system to work effectively and fairly. Building a better one will not be easy, but it is more essential than ever. We look forward to working with you and your department to make it happen.

 

Yours sincerely

 

Leila Zadeh, Executive Director, UK Lesbian & Gay Immigration Group

Tahmid Chowdhury, Joint-CEO, Here for Good

Kerry Smith, Chief Executive Officer, Helen Bamber Foundation

Emma Harrison, CEO, IMIX

Satbir Singh, Chief Executive, the Joint Council for the Welfare of Immigrants (JCWI)

Rosario Guimba-Stewart, Chief Executive Officer, Lewisham Refugee and Migrant Network

Josie Naughton, Chief Executive Officer, Help Refugees

Eiri Ohtani, Project Director, The Detention Forum

Arten Llazari, CEO, The Refugee and Migrant Centre (Black Country and Birmingham)

Toni Soni, Centre Director, CRMC, Coventry Refugee and Migrant Centre

Wayne Myslik, Chief Executive, Consonant

Emily Crowley, Chief Executive, Student Action for Refugees

Dr Laura Miller, Interim Director, Solidarity with Refugees

Nazek Ramadan, Director of Migrant Voice, Migrant Voice

Alice Lucas, Advocacy and Policy Manager, Refugee Rights Europe

Maya Mailer, Campaigns Director, Asylum Matters

Kate Smart, Director, Asylum Welcome

Sarah Teather, Director, Jesuit Refugee Service UK

Jo Cobley, Director, Young Roots

Jill Rutter, Director of Strategy and Relationships, British Future.

Dr Edie Friedman, Executive Director, The Jewish Council for Racial Equality (JCORE)

Nicolas Hatton, CEO, the3million

Hazel Williams, National Director, NACCOM Network

Rt Revd Jonathan Clark, Chair, Churches’ Refugee Network

Kat Smithson, Director of Policy and Campaigns, National Aids Trust

Siân Summers-Rees, Chief Officer, City of Sanctuary

Lucy Jones, Director of Programmes, Doctors of the World UK

Clare Moseley, Founder & CEO, Care4Calais

Dr Ruvi Ziegler, Chair, New Europeans

Anna Jones, Co-Founder, RefuAid

Dr Mohamed Nasreldin, Director, North of England Refugee Service

Ali Harris, CEO, Equally Ours

Kush Chottera, Executive Director of Europia

Gus Hosein. Executive Director, Privacy International

Eleanor Harrison, CEO, Safe Passage

James Wilson, Acting Director, Detention Action

Sally Daghlian OBE, CEO, Praxis

Salah Mohamed, Chief Executive, Welsh Refugee Council

 

“We are happy to register you” Practice Manager, Anwar Hussain

Published 26th July 2019

“We thought, ‘Let’s go out to the community and ask people and get them to work together with us to achieve some of the things we want to do”

 

Anwar Hussain is the Practice Manager at St Paul’s Way Medical Centre, a growing GP practice in Tower Hamlets, east London, with a list size of over 13,000 patients. The GPs and nurses at St Paul’s are supported by on-site benefit advisors, midwives, psychologists and more.

A Safe Surgery since February 2019, Anwar spoke to us about how he and his colleagues have actively engaged patients to ensure accessible, high quality care. Reflecting the ethnic make-up of the borough, the majority of St Paul’s Way’s patients are of Bangladeshi origin.

Patient and community involvement are a clear priority for the practice. They both are encouraged to help shape services, and patient Health Champions are recruited and trained to engage and empower their communities, friends, and families. Anwar says:

“When we first took over the practice we wanted to learn from patients… we thought ‘how do we open this up for more people to come in and give us ideas about how we can improve services?’ And we thought ‘Let’s go out to the community and ask people and get them to work together with us to achieve some of the things we want to do’”.

St. Paul’s takes an open approach to patient registration, but accessibility remains one of their greatest challenges. They used to require proof of address and ID, but as many patients had neither, they realised a change was needed.  Having met patients who were turned away elsewhere, Anwar is conscious that other local practices have a different approach. He explained:

“We say, “You know what, we’re happy to register you” and it works out fine. There are still some surgeries who probably are not aware of how flexible they can be”.

Patients without a fixed address can register with the practice address and according to Anwar, this hasn’t raised any challenges – patients generally have a phone number or email address that staff can use to contact them. He’s hopeful about the potential for online services to improve access and raising awareness of these services is a current focus.

When one of their GPs heard about Safe Surgeries, St Paul’s decided it was a perfect fit, as well as a way to celebrate and share the work they’ve been doing for some time. Anwar says:

“We’re always kind of a forward-thinking surgery, we always want to try something new… to learn and try new incentives…We thought, ‘Actually we’re already doing this so why not buddy up with these guys and shout out about it a bit more’”.

Anwar is keen to raise awareness about what Safe Surgeries does and how GP surgeries, doctors and managers can make registration processes easier for patients. Ultimately, he hopes it will improve access for their wider community too, because there are still so many patients who are not seeing a doctor because they think they can’t or because they don’t have the right documents to hand.

 

To sign your practice up as a Safe Surgery and become part of a group of over 200 inclusive practices, click here.

*The GP practice in the image is not St Paul’s Way Medical Centre.

Written by Isabel Abbs and Jennie Corbett.

Emergency: Ebola, a growing crisis in DRC

Published 22nd July 2019

In the Democratic Republic of Congo, the second-worst outbreak in history is spreading quickly.

 

Doctors of the World is concerned about the spread of Ebola that is affecting a growing number of areas in DRC.

Our team is working in Butembo and Katwa, in North Kivu, the main centres of contagion. The most recent data from the Ministry of Health shows the escalation of Ebola cases in DRC.

2,484 cases of Ebola have been confirmed, and 1,698 people have died due to the outbreak. The numbers are likely to be higher as cases aren’t been referred due to mistrust in the system and fear of being stigmatised.

The geographical location of the DRC makes the situation more complex. Bordering with nine countries, the DRC risks becoming the epicenter of an international outbreak. “The areas most impacted by the epidemic are close to neighboring countries like Uganda, where there has already been a case, and Rwanda”, says Ricardo Angora, coordinator of mental health and psychosocial support in the DRC for Doctors of the World.

Ebola infects humans through close contact with animals and people. It can spread very quickly, through small amounts of bodily fluids and through contact with contaminated environments. This creates a series of challenges in containing the outbreak.

We are currently supporting the Ministry of Health in responding to the epidemic through training in control and prevention of the infection. Further, we train personnel to identify and refer potential cases without putting themselves at risk. We also offer psychosocial support to those working in the first line, helping to rebuild social support networks that have been destroyed by the disease and by the context of violence and poverty.

The effects of Ebola go beyond the deaths it causes and the people it infects. Perhaps the most devastating consequences are those derived from its weakening and destructuring of health systems. The population, which already had low confidence in them, has stopped coming seeking treatment for fear of contagion or to be falsely diagnosed and stigmatized.

We continue to work to provide care for all those affected and are planning to scale up. Please consider making a donation today to ensure our work can continue.

Volunteer Week Messages

Published 4th July 2019

During Volunteer Week, in June 2019, we asked some of our supporters to share a message for our volunteers. Here are some of them:

 

I think it’s wonderful that the volunteers give up their time to help those in need. It seems this help is needed more and more in our country – and with the state of Politics at the moment will become even more relevant. Thank goodness there are good people around like you who have empathy for others and behave in an unselfish manner. – Kay

GP-Paquita-De-Zulueta

After this week’s Woman’s Hour serial about Modern Slavery and Ken Loach’s film “I Daniel Blake”, it’s obvious that there is a desperate need for your services. I am so grateful than in this time of a heartless government, someone is doing something to treat people who would otherwise not be able to find medical help either through fear or inaccessibility of services otherwise. I am fortunate in not needing the services, but I am so pleased that you don’t mess about talking the talk, but just get on with it. Thank you from the bottom of my heart. – Rwth

 

It was wonderful to receive a message such as yours about volunteers and their heroic work. Although I am not one of them, I am well aware of the roles they play to make life better for others. So I take this opportunity to join you and the rest in praising and thanking them for what they are. Thank you, volunteers. – John

I am so proud of you all at DOTW, and although I’ve never met you personally, I feel privileged to be a small part of the organisation and to help in a small capacity – wish I could do more! Your brilliant medical volunteers are superb, and thank goodness they are there to help where and when needed. Bravo to you ALL at DOTW – Jean

Refugee Week 2019 – Abelarda’s story

Published 21st June 2019

“Without Doctors of the World’s support in the Mother and Child Centre in Yemen, we could have died! I was in my ninth month of pregnancy and I was bleeding. We had a similar case in our village before Doctors of the World came, where the pregnant girl had died, and I was so scared that the same thing might happen to me. I was admitted to the Mother and Child Centre and was advised to have a cesarean operation. Doctors of the World’s doctors and referral team transported me to a hospital where I had my operation and gave birth to my healthy baby. I was discharged after one week. May Allah reward Doctors of the World.”

Refugee Week 2019 – Aaminah’s story

Published 19th June 2019

As part of Refugee Week, we are sharing stories about doctors and patients across the globe, with a special focus on post-natal care. Read our first story:

Aaminah, Doctor and volunteer in Slovenia:

“One patient I transferred was a desperately sick little baby who was only two months old and had been born just before his family fled from Syria. He had a respiratory infection, was unable to feed and was in bad respiratory distress.

The parents and baby were travelling together with no extended family members, and we managed to negotiate with the hospital to keep all of them together at the hospital. They had already been admitted in Turkey for a few days during their travels, and I think they knew that their child was still unwell.

The mother was only 20 years old but she was so strong. The pediatrician I referred them to was an amazing old school doctor who spoke excellent English and was clearly very skilled. After a thorough history and examination, her first action was to give the baby a bath. She was amazing at reassuring the parents and was very empathetic; offering them showers and washing all their clothes.

I thought the child would have to be admitted for at least 48 hours and the pediatrician agreed, but it was nice to see the family all together in a safe space in the meantime.”

 

 

 

Refugee Week 2019

Published 18th June 2019

We’re celebrating Refugee Week! June 17th– 23rd is Refugee Week, which celebrates refugees’ contributions across the UK and promotes the fostering of a better sense of community.

This year, we are celebrating Refugee Week in two ways. Firstly, we have taken over the walls on the upper floor at BoxPark Croydon with our latest Print for Refugees collection. This is a part of an on-going project where talented photographers donate their works to be sold at reduced rates, with all proceeds going to Doctors of the World! You can browse the stunning collection or buy one of our stylish Prints for Refugees t-shirts here. And don’t miss your chance to come and see the collection in person before the end of June!

Secondly, we will be sharing some thoughts around maternity and the early stages of life for refugee children. We will explore the concept that the first thousand days of a child’s life are instrumental in shaping their future circumstances, and taking a look at how refugee families can access health care to shape better futures for their children.

The cost of life: historical vote on transparency

Published 31st May 2019

After several days of negotiations, accompanied by an intense mobilization of activists and health associations, the resolution on the transparency for medicines, vaccines, and other health products was adopted at the World Health Assembly (WHA) in Geneva.

Today, when new treatments are launched in the market they are at prices in the tens and hundreds of thousands of pounds per year, and per person. This is especially true for treatments against cancer: just this week, a treatment was marketed in the United States at a price exceeding $2 million per person.

These prices threaten the right to access to care, and the bases for these prices are not made public.

A resolution on transparency for drug pricing was proposed by Italy, and quickly joined by several countries including Spain, Greece, the Netherlands, and South Africa. It was voted on at the 72nd World Health Assembly in May, 28th 2019.

In the market of medicines, vaccines, and health technologies, opacity is the rule. Citizens, states, and health systems do not have access to basic information on the products, such as the investments in research and development, the share of public investment and the costs of clinical trials.

States negotiate prices in competition with each other, without having all the necessary information, including the prices of medicines negotiated by other countries.

By demanding greater transparency, this resolution rebalances the negotiating framework and facilitates cooperation between states. It will now be possible to better understand and be aware of the real value of new health products, and to move towards fairer prices, allowing access to the best care for all in sustainable health systems.

This resolution represents democratic progress, as it strengthens the right to information, and also progress for global public health. Transparency and cooperation between states will make it possible to move towards more affordable prices, no longer based on maximizing profits.

We celebrate this resolution as first step towards a fairer system. The commitments made by this proposal must now be followed by concrete measures across Europe and further clarity on markups, production costs, research and development costs, and transparency over the sources of investment.

Impunity Remains: Attacks on Health Care in 23 Countries in Conflict

Published 23rd May 2019

 Washington – There were at least 973 attacks on health workers, health facilities, health transports and patients in 23 countries in conflict in 2018, the Safeguarding Health in Conflict Coalition reported today. At least 167 health workers died and at least 710 were injured. This marks an increase in the number of documented attacks compared to 2017, when the Coalition reported 701 such instances.

The Coalition’s sixth annual report documents attacks on vaccination workers, paramedics, nurses, doctors, midwives, community volunteers, drivers and guards, in violation of international norms and interrupting global efforts to stop dangerous disease outbreaks such as Ebola and eradicate polio.

Evidence of attacks in the report, Impunity Remains: 2018 Attacks on Health Care in 23 Countries in Conflict, was gathered from humanitarian organizations, the World Health Organization and other United Nations (UN) agencies and Coalition members, as well as from open source data.

 

The report offers accounts of specific attacks, including:

  • In Afghanistan in January, a suicide bomber drove an ambulance packed with explosives through a busy checkpoint then detonated a bomb that killed at least 95 bystanders.
  • In February, 13 Médecins Sans Frontières International-supported hospitals and clinics in East Ghouta, Syria, were hit by bombs or shells.
  • In March in the northern Nigerian state of Borno, Boko Haram insurgents armed with automatic weapons, rocket-propelled grenades and gun trucks attacked an internally displaced persons camp, killed two Nigerians working for the International Organization for Migration and a doctor working for UNICEF, and kidnapped two midwives and a nurse. The two midwives were executed in September and October.
  • In one mass demonstration in the occupied Palestinian territory in April, at least 33 health workers were injured. Four paramedics were struck by direct fire and 29 health workers suffered from tear gas inhalation.
  • In May and June, armed men entered Bambari Hospital in the Central African Republic, firing shots, pillaging the hospital and threatening Muslim patients, who were forced to flee.
  • In November in the Democratic Republic of the Congo (DRC), the Allied Democratic Forces group attacked near the Ebola Emergency Operations Center and hotels where many Ebola responders were staying, killing seven UN peacekeepers and 12 members of the DRC military. Ebola treatment centers in the area were closed for two days as a result.

 

The greatest number of attacks occurred in Afghanistan, the Central African Republic, Libya, the oPt, Syria and Yemen. Airstrikes were conducted against hospitals in Syria and Yemen. Vaccinators were attacked in Afghanistan, the CAR, the DRC, Pakistan, Somalia and Sudan. Eighty-eight health workers were killed in Syria. More than 500 health workers were injured in the oPt. Armed men entered a health facility in the DRC, looted and beat patients, and attacked and raped a nurse.

“Attacks on health facilities and health workers not only cause immediate damage and loss of life but also impede access to essential health services for vulnerable people around the world, jeopardizing universal health coverage and global health security,” says Carol Bales, advocacy and policy communications manager at IntraHealth International, who oversaw the report’s production. “We need to do more to ensure health workers are safe and able to improve and save lives.”

 

International humanitarian law—codified in the Geneva Conventions and its Additional Protocols, as well as international human rights law—prohibits attacks on health facilities and health workers. The United Nations Security Council has repeatedly condemned attacks on health facilities and health workers and demanded that governments take concrete actions to protect health facilities and medical workers during armed conflict.

 

The new Safeguarding Health in Conflict report calls on states in conflict, through their ministries of defense, interior and health, to do more to protect health workers, end impunity and ensure that access to health care is available to all. Its recommendations include:

  • States should strengthen military doctrine and training, reform laws that permit parties to deny health care to those they deem enemies and arrest caregivers, and improve investigations and accountability mechanisms for those who initiate attacks.
  • The UN Security Council and the UN Secretary-General must ensure that international investigations and accountability procedures take place for states that permit impunity.

 

The Safeguarding Health in Conflict Coalition, of which Doctors of the World is a member, consists of 40 organizations working to protect health workers and services threatened by war or civil unrest. The Coalition presses governments and United Nations agencies for greater global action to protect the security of health care.

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