Red Cross surgeon calls for greater security in conflict zones to protect workers, hospitals

A visiting Red Cross surgeon has warned that health care workers need additional security in conflict zones, adding that the lack of protection is one of the biggest issues facing health care today.

Dr Robin Coupland is the chief surgeon and medical adviser to the International Committee of the Red Cross (ICRC) based in Geneva.

He said governments, armed forces and the health care community must do more to make health care delivery safer around the world.

Speaking at the World Medical Association's H20 International Health Summit in Melbourne, Dr Coupland said last year health personnel suffered more than 1,800 violent incidents.

He said this in turn had a devastating effect on populations needing urgent health care.

He said the ICRC was alarmed over what it saw as the unacceptable use of explosive weapons in urban areas of conflict zones.

For seven years, Dr Coupland worked as a field surgeon in Thailand, Cambodia, Pakistan, Afghanistan, Yemen, Angola, Somalia, Kenya and Sudan.

Calls for governments, armed forces to support health delivery

Now based in Geneva, he focuses on the effects of violence and weapons and ensuring security of health care in armed conflict.

"Basically, we cannot invest in global health without thinking about security of health, health care workers, hospitals, ambulances and so forth," he said.

"Other people have to be involved in security of health care."

Dr Coupland said this was largely an issue for governments, their armed forces and their police forces.

The ICRC performed a detailed study of the different forms of insecurity in health care that range from bombardments of urban areas - which can affect hospitals - to the hijacking of ambulances.

The study also considered delays of ambulances at checkpoints to attacks as well as direct attacks on health care staff and patients.


"You cannot deliver healthcare easily in an insecure environment. In fact, we go further than that and say, security is an absolute prerequisite for someone's health and for the delivery of healthcare."

Dr Robin Coupland, chief surgeon and medical advisor to the ICRC


Dr Coupland said in one incident police stormed into a hospital in search of a criminal who was undergoing treatment.

"An armed entry into that facility can completely destroy any notion of health care as long as these operations are happening," he said.

"You cannot deliver health care easily in an insecure environment. In fact, we go further than that and say, security is an absolute prerequisite for someone's health and for the delivery of health care."

"We've gone even further and said, on a global basis, insecurity of health care is probably one of the biggest health issues in the world at the moment, and this is a great concern to us and we have to look beyond the health community for a solution to this."

According to it's annual Aid Worker Security Report, USAID said in 2013 there were 264 individual incidents of violence against aid workers, with 474 victims.

Most of them were nationals working in their home countries and 110 were UN staff.

The incidents of violence were being driven mainly by escalating conflicts and the deterioration of governance in Syria and Southern Sudan.

Dr Coupland said the biggest security guarantee for aid workers was people knowing who they are and what they do.

"And, within that, assuring people that they're going to get a safe and quality health care delivery, that is an enormous security guarantee for us."

"It allows a kind of community security, if the combatants respect us and know that, if necessary they'll get good health care from us, then we will be protected."