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09/13/2013

Medical neutrality: a dying principle?

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Doctors and staff of the Salmaniya Hospital in Manama joined demonstators on the hospital grounds to protest against Bahraini security forces who were halting the dispatch of ambulances to scenes of demonstration. Lucas Oleniuk/Toronto Star

The doctor's mission is straightforward: to save lives. Even in times of war and conflict, the health worker's modus operandi is to treat the patient on the table, regardless of his or her uniform, nationality, race or creed.

Medical neutrality is a time-honoured concept, one first enshrined in international law by the Geneva Convention of 1864. But these days, it seems to be increasingly coming under fire.

Matthew Watson with the UPMC Center for Health Security has written a piece today about the growing problem of violent attacks against health workers around the world. His article coincides with a new UN report on Syria, finding that "the denial of medical care as a weapon of war is a distinct and chilling reality of the war in Syria."

As Watson writes, it has "long been held that medical care providers and their patients and places of practice should be held safe."

"However, recent reports of violence targeting healthcare workers provide evidence that the prohibition of violence against healthcare workers has degraded and requires strengthening and enforcement."

He lists several examples of health workers recently coming under attack:

* Syria, where healthcare workers have been intimidated, repressed, targeted and even arrested and detained. According to today's UN report, the authors have come to the "overwhelming conclusion" that "government forces deny medical care to those from opposition-controlled and affiliated areas as a matter of policy." There is also evidence of anti-government forces attacking hospitals, according to the report.

The group Physicians for Human Rights has subsequently issued a press release, calling for the international community to address war crimes in their Syrian negotiations. "Government forces have shelled maternity wards, tortured patients instead of treating them, and arrested doctors for doing their courageous work," said senior medical advisor Dr. Vincent Iacopino in the release. "In a conflict where more than 100,000 lives have already been lost, attacking the health care system cannot be tolerated from either side.”

In a conflict where more than 100,000 lives have already been lost, attacking the health care system cannot be tolerated from either side.” - See more at: http://physiciansforhumanrights.org/press/press-releases/phr-urges-us-and-international-community-to-address-war-crimes-in-syria-negotiations.html#sthash.2AvWpTC8.dpuf
Dr. Vincent Iacopino, PHR’s senior medical advisor. - See more at: http://physiciansforhumanrights.org/press/press-releases/phr-urges-us-and-international-community-to-address-war-crimes-in-syria-negotiations.html#sthash.2AvWpTC8.dpuf
Dr. Vincent Iacopino, PHR’s senior medical advisor. - See more at: http://physiciansforhumanrights.org/press/press-releases/phr-urges-us-and-international-community-to-address-war-crimes-in-syria-negotiations.html#sthash.2AvWpTC8.dpuf

* Pakistan, where several vaccination teams have been recently violently attacked. (Not included on Watson's list is Nigeria, where polio workers have also been targeted in the past year)

*Somalia, which Médecins Sans Frontières recently pulled out of after spending 22 years in the country providing medical services. The humanitarian aid agency said conditions in Somalia have become unacceptably dangerous for health workers, with 16 of its own staffers killed since 1997.

In 2008, the Red Cross began recording violent incidents against health workers in countries where it has operations, issuing its first report in 2011. Their initial report documented 655 violent incidents between July 2008 and December 2010; a follow-up report this year documented 921 in 2012.

Watson concludes his piece by calling for global action to combat the erosion of medical neutrality, a long-held -- and necessary -- international principle.

"As healthcare delivery in conflict zones become more dangerous, decisive action is needed to protect healthcare workers and facilities," he writes.

Jennifer Yang is the Star’s global health reporter. Follow her on Twitter: @jyangstar

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No doubt its becoming dying principles. at the time of oath they agree to serve us but often they changed !


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