The newly created ‘Attacks on Healthcare’ collection in the Humanitarian Archive is a series of oral history interviews conducted for the Researching the Impacts of Attacks on Healthcare project. Comprised of over 35 interviews, this ongoing oral history project aims to capture the experiences and perspectives of key actors from a variety of international organisations (including but not limited to the WHO, ICRC, and MSF) who were involved in managing, measuring, and researching violence against or affecting healthcare delivery, and ultimately contributing to the evolution of the concept of attacks on healthcare.
This oral history project provides first-hand insight into the persistent threat of attacks on healthcare and is a complement to the research agenda of RIAH and its partners. In addition to shaping the digital and oral history holdings of the John Rylands Research Institute, this project has also expanded the physical holdings of the Humanitarian Archive through the deposit of invaluable personal collections from interview participants, including the personal papers of Rudi Coninx, the former WHO Senior Policy Advisor in the Office of the Assistant Director-General for Emergency Response.
You can read a blog post on the RIAH collection, as well as other inquiries from the Developing Humanitarian Medicine project here.
Themes emerging from the interviews
“…they oftentimes followed up with additional bombings after health care workers would show up…”
We had a whole training on safety and when not to go to the site of like a bombing right away because they oftentimes followed up with additional bombings after health care workers would show up…physical safety stuff. But then we had an app where we had the people who were working on this fill out the date of the event, the site of the incident and sort of what happened, what was involved. And the idea was that it was like a quick drop down that you could very quickly fill out on your phone. And it kind of just look like you were writing a text message… so that people could be like relatively inconspicuous because when things like this happened, like people came out and would go to the site and help and be curious. And even if no one was hurt, people would oftentimes just want to know, what had happened- Dr. Emily Clouse, Senior Research Manager, Johns Hopkins Bloomberg School of Public Health
While the project initially endeavoured to record the testimony of individuals involved in various initiatives and campaigns that emerged in the late 2000s/early 2010s, its scope now extends to firsthand experiences of violence against healthcare in fieldwork in the 1970s and 1980s, and how these informed efforts to measure and protect colleagues in conflict settings. Despite the geographical and organisational variety of the individuals interviewed, many shared experiences and influences emerged. For example, the attack on MSF’s Kunduz hospital in 2015 played a critical role in spurring international action. These overlaps speak to the interconnectedness of the humanitarian healthcare sector and the persistence of violence. Furthermore, the interviews reveal a range of perspectives on the issue of attacks on healthcare including what constitutes an attack (hospital bombings, verbal threats to staff, supply chain interference, etc.) and therefore how best to address the problem at the local, national and international levels.
- Significant themes and narratives within the collection include:
- Firsthand experiences of attacks on healthcare personnel and facilities across multiple conflicts and time periods, dating back to the late 1970s (including the Thai-Cambodia border, Yemen, Afghanistan, and the former Yugoslavia)
- The creation of ICRC’s Health Care in Danger (HCiD) initiative and development of data collection approaches
- The creation and dissolution of MSF’s Medical Care Under Fire programme, and the significance of the attacks on hospitals in Kunduz and Dasht-e-Barchi
- Leonard Rubenstein’s impact on the issue of attacks on healthcare across the humanitarian healthcare sector, including his creation of the Safeguarding Health in Conflict Coalition
- Work on attacks on healthcare by Physicians for Human Rights in the 1980s and 1990s as part of their broader studies of conflicts in Iraq and the former Yugoslavia (Medicine Under Siege in the Former Yugoslavia 1991-1995)
- The evolution of international policy on attacks on healthcare and the development and passing of WHA Resolution 65.20 and UNSC Resolution 2286, including the development of the WHO’s Surveillance System for Attacks on Healthcare (SSA)
- Current perspectives on the sanctity of the medical mission regarding Ukraine and Gaza
- Potential future steps to address the issue of attacks on healthcare, including the efficacy of campaigns
“…you have patients that you need to evacuate because there is an attack”
I had to evacuate medical teams out of Mogadishu…because the hospital came under attack. I have been bombed in Afghanistan. …So, yeah, the idea that hospitals should not be attacked…I’ve personal experience… we had to evacuate the hospital on the Cambodian border…the idea that ‘Wow you have patients that you need to evacuate because there is an attack.’ …Yeah. That kicks in. But… nobody really speaks out when this happens. ICRC didn’t really speak out either – Dr. Rudi Coninx, former Senior Policy Advisor, Office of the Assistant Director-General for Emergency Response, WHO
- Organisations affiliated with interviewees include:
- Chatham House, the Royal Institute of International Affairs
- Harvard Humanitarian Initiative, Harvard University
- Humanitarian and Conflict Response Institute, University of Manchester
- International Committee of the Red Cross/Red Crescent
- Insecurity Insight
- Johns Hopkins Bloomberg School of Public Health
- Karolinska Institute
- Médecins Sans Frontières
- Physicians for Human Rights
- Physicians for Human Rights-Israel
- University of California, Berkeley
- World Health Organization
“Why…are we not highlighting the attacks on hospitals that are going on in Central and South America?”
Why…are we not highlighting the attacks on hospitals that are going on in Central and South America?” There are hospitals that are surrounded by gangs… I mean, there’s so much violence going on, but when I asked this very direct question to PHR [Physicians for Human Rights], they said “Funding.” So, like everybody, they can track all of this. This is a massive data endeavour…So, what I found as the as the impetus or concept really to what became the SSA (Surveillance System for Attacks on Health Care) is that globally we don’t have an idea on what’s going on in any given context. There’s no… I mean, and that’s typically what you find when you’re in research, you don’t have all of the picture – Dr. Erin Downey, Emergency Preparedness/Disaster Response expert
Get in Touch
The ‘Attacks on Healthcare’ collection is currently being processed and catalogued. The collection will be available in person at the University of Manchester Library to registered users (both audio-visual recording files and transcripts). For further information on the “Attacks on Healthcare’ collection (as well as the Humanitarian Archive), please contact Flora Chatt, Humanitarian Archivist.