Attacks on medical missions: overview of a polymorphous reality: the case of Médecins Sans Frontières

Sa‘Da, Caroline Abu; Duroch, Françoise; Taithe, Bertrand

doi:10.1017/s1816383114000186

Cited by 13 publications

(6 citation statements)

References 33 publications

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“… 2 Initiatives exist to assist health providers operating in insecure environments, 3 4 including intense advocacy against increasing attacks on healthcare in conflict settings. However, only a small body of research studies 5 have unpacked the operational, professional and personal challenges health providers face, and none in Syria. In light of the recent allegations of chemical weapon use throughout Syria and the intimidation of medics speaking out by the Syrian government, the perspectives of healthcare workers could not be more pressing.…”

Section: Introductionmentioning

confidence: 99%

Qualitative accounts from Syrian health professionals regarding violations of the right to health, including the use of chemical weapons, in opposition-held Syria

et al. 2018

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ObjectivesTo explore the impact of the conflict, including the use of chemical weapons, in Syria on healthcare through the experiences of health providers using a public health and human rights lens.DesignA qualitative study using semi-structured interviews conducted in-person or over Skype using a thematic analysis approach.SettingInterviews were conducted with Syrian health workers operating in opposition-held Syria in cooperation with a medical relief organisation in Gaziantep, Turkey.ParticipantsWe examined data from 29 semi-structured in-depth interviews with a sample of health professionals with current or recent work-related experience in opposition-controlled areas of Syria, including respondents to chemical attacks.ResultsFindings highlight the health worker experience of attacks on health infrastructure and services in Syria and consequences in terms of access and scarcity in availability of essential medicines and equipment. Quality of services is explored through physicians’ accounts of the knock-on effect of shortages of equipment, supplies and personnel on the right to health and its ethical implications. Health workers themselves were found to be operating under extreme conditions, in particular responding to the most recent chemical attacks that occurred in 2017, with implications for their own health and mental well-being.ConclusionsThe study provides unique insight into the impact war has had on Syrian’s right to health through the accounts of a sample of Syrian health professionals, with continuing relevance to the current conflict and professional issues facing health workers in conflict settings.

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Section: Introductionmentioning

confidence: 99%

Qualitative accounts from Syrian health professionals regarding violations of the right to health, including the use of chemical weapons, in opposition-held Syria

et al. 2018

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“…Targeted examples of violence include explosives placed outside of humanitarian buildings and kidnappings and ambushes on vehicles and convoys (Fast, 2007(Fast, , 2010. In addition, places of humanitarian intervention, which often serve as home base for field staff, are highly susceptible to attack due to their consolidation of resources and perception of bias toward certain communities in the conflict (Sa'Da et al, 2013).…”

Section: Implementation and Evaluation Challenges In Conflict Zonesmentioning

confidence: 99%

Challenges and strategies for implementers and evaluators working in conflict settings

2023

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Practitioners implementing and evaluating humanitarian programs in conflict zones face unique challenges requiring context-sensitive guidance. Conflict zones—geographical areas with militarized and non-militarized violence, widespread political instability, and state-sanctioned intimidation and genocidal violence—are rife with logistical, methodological, and ethical challenges that impact implementation and evaluation. Although challenges have been well-documented, few solutions or evaluation frameworks exist to help evaluators in conflict zones confront these challenges. This article examines how the application of implementation science frameworks, specifically, Reach, Effectiveness, Adoption, Implementation, and Maintenance and the Consolidated Framework for Implementation Research, offers useful strategies to mitigate some challenges in conducting evaluations in conflict zones. Areas for future research include collaborative team approaches to using these frameworks, ethical guidance, and reporting and dissemination.

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“…Violence that affects health care delivery is a serious challenge and significant research gaps exist on this topic (Foghammar et al, 2016; Nickerson, 2015). International organizations such as Médecins Sans Frontières have documented disruptions to service delivery in Mexico such as avoiding certain territories controlled by organized crime groups (Abu Sa’Da et al, 2013). A number of prominent news outlets have documented violence towards health care providers throughout Mexico at least since 2011, yet there is a dearth of empirical research on the effect on providers and services (Castro & Villanueva Lozano, 2018).…”

Section: Violence In Mexico and Its Impact On Health Care Facilities ...mentioning

confidence: 99%

The Permeating Effects of Violence on Health Services and Health in Mexico

Vargas

Vélez‐Grau

Camacho

et al. 2021

J Interpers Violence

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Mexico’s violence related to organized crime activity has grown to epidemic levels in the last 12 years. We interviewed 22 Mexican health care providers from five states to examine how violence impacts health care services and health. We transcribed and analyzed semi-structured interviews using framework analysis. Our findings describe the ways in which community violence in Mexico permeates health care services, impacting health care providers, and the health of patients. We developed a model to reflect our main themes that illustrate how violence permeates health care services over geographic space and time. We identified three thematic categories: (a) the impact of violence on health care facilities and service provision, (b) the impact of violence on providers, and (c) the impact of violence on the health of the community. Our model articulates a dynamic process of the spread and permeation of violence. Prior literature focuses on the impact of violence as an occupational hazard and the effect of war or civil conflict on health care services. We extend this literature by documenting the impacts of widespread violence on Mexican health care services and providers. We discuss how violence impacts services, providers, and health in a country that is not officially at war. We compare our findings to previous literature on occupational violence in health professions and the impacts on health services in official war zones. Finally, we highlight the implications for health care practice and policy. We suggest that violence should be considered throughout the care continuum in Mexico and make the case for violence as a structural contributor to health and health disparities in Mexico. We suggest additional research on this under-investigated topic.

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Attacks on medical missions: overview of a polymorphous reality: the case of Médecins Sans Frontières

Abstract: The aim of this article is to carry out a preliminary analysis of issues relating to the types of violence that are directed against humanitarian medical missions.

Cited by 13 publications

References 33 publications

Qualitative accounts from Syrian health professionals regarding violations of the right to health, including the use of chemical weapons, in opposition-held Syria

Qualitative accounts from Syrian health professionals regarding violations of the right to health, including the use of chemical weapons, in opposition-held Syria

Challenges and strategies for implementers and evaluators working in conflict settings

The Permeating Effects of Violence on Health Services and Health in Mexico

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