When one hears the phrase “health care in danger,” one’s mind immediately goes to images of burning ambulances on war-ravaged streets, surgeons struggling to perform operations under artillery fire, or perhaps nurses being held hostage at gunpoint.
In many parts of the world, this is a reality, but this is not the only reason why ICRC invests in raising awareness on “health care in danger,” or why we work tirelessly around the world to ensure respect for the medical mission. The reality is that health staff, ambulances, and facilities face challenges that make their jobs more dangerous than they need to be.
Patients and families seeking health care also face many dangers trying to access those basic rights. The medical mission is threatened by various forms of violence, even in countries not struggling with wars or conflicts.
If anything proves how precarious the medical mission can be, it’s a global pandemic like Covid-19, which has highlighted in many ways the pressure health staff face daily. This pressure comes not only from the increased demand for health care, but also from to the added burden of stigmatization, accusations of health staff being vectors of the disease, and physical and verbal aggression.
Incidents of violence affect not only the health staff, but often end up hindering a population’s ability to access medical services, and sometimes even life-saving procedures. Stigmatization is a danger that has equally threatened populations trying to seek medical attention. In many instances around the world, patients were prevented from reaching hospitals due to stigmatization.
With its devastating consequences for the patients, as well as long-term impacts on access to and delivery of health care for many, violence is a critical humanitarian issue that must be addressed. So, how do we address these challenges? How do we ensure that people have access to this most basic of human rights? We work with health staff and listen to their stories, we work with communities and listen to their needs, and we work to address the grievances that may be caused by misinformation, mismanagement, or inadequate infrastructure.
We also work with governments to advocate for specific laws and legislation to protect health care staff and facilities, as well as people’s right to access these services.
Through our work with the health sector, governments, and populations, we’ve identified a number of common challenges around the world, all of which contribute to some form of hindrance to the effective and safe delivery of health care. We already mentioned stigmatization, which is a major challenge during the spread of communicable diseases.
Other challenges include lack of communications, or unclear procedures, leading to misunderstandings and, eventually, violence. In some parts of the world, not having clear traffic laws enshrining the importance of respecting the sirens of an ambulance create undue delays that lead to unnecessary deaths.
In fact, ambulances and pre-hospital care often face many challenges which lead to delays in transporting critical patients. What is clear is that the challenges facing the medical mission are global and cross-cutting, and demonstrate a need for everyone to share the responsibility of ensuring the respect of this vital service. Everyone in society has a role to play to improve access to treatment and the delivery of impartial and efficient health care.
ICRC has many projects around the world to help address some of these identified challenges. An example of the importance of not only improving procedures, but clarifying and communicating them to the public, is right here in Bangladesh, where ICRC has been supporting the Emergency Department (ED) of Sadar Hospital in Cox’s Bazar.
The hospital’s ED staff is no stranger to violence and aggression, even prior to the Covid-19 outbreak. Physical and verbal abuse towards the staff was commonplace, and heavily impacted the morale and ability of the staff to perform their duties. Everyone, without exception, has the right to health care and life-saving interventions, but a major source of frustration comes from misinformation and a lack of awareness.
If patients and families of patients don’t understand the concepts behind medical triage, or the general rules of the health centre, they may perceive what is routine work to be neglect. ICRC worked with local communities to ensure understanding of the rules and policies set by the hospital, such as the “one patient plus one attendant policy,” and why this is important to allow health workers to perform their jobs.
But communities have also had their concerns and highlighted to us that respect is a mutual effort. Therefore, it was equally important to work with hospital personnel to remind them of their rights and responsibilities, which include treating their patients humanely, not abandoning anyone in need, providing impartial care without discrimination, and respecting patient right to confidentiality.
If Covid-19 has proven anything to the world, it is the importance of trusted and resilient medical services. Nobody wants to see their loved ones suffer from undue delays, or their doctors, nurses, and health staff unable to deliver effective services due to violence. It is therefore everyone’s responsibility to ensure the respect of the medical mission and our right to seek health care. It is, after all, a matter of life and death.
Adam Aboshahba is Protection Coordinator, International Committee of the Red Cross (ICRC) in Bangladesh.
