Intended for healthcare professionals

Education And Debate

Deaths among humanitarian workers

BMJ 2000; 321 doi: (Published 15 July 2000) Cite this as: BMJ 2000;321:166
  1. Mani Sheik, research associatea,
  2. Maria Isabel Gutierrez, research associatea,
  3. Paul Bolton, research associatea,
  4. Paul Spiegel, senior associatea,
  5. Michel Thieren, programme officerb,
  6. Gilbert Burnham, director (
  1. a Center for Refugee and Disaster Studies, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD 21205, USA,
  2. b Department of Emergency and Humanitarian Action, World Health Organization, 1211 Geneva 27, Switzerland
  1. Correspondence to: G Burnham
  • Accepted 25 April 2000

The nature of humanitarian relief has changed dramatically in the past decade as conflicts have ceased being wars between states and are now largely internal conflict taking place amid the anarchy of weakened or collapsed states.1 Increasingly, civilians and those who try to protect and assist them are seen as legitimate targets for extortion, harassment, rape, and brutality.2 Providing assistance while protecting the providers is the dilemma facing all international aid organisations. 3 4 To gain a better understanding of deaths in this group, we analysed 382 deaths in humanitarian workers between 1985 and 1998.

Most humanitarian organisations believe that the number of deaths among relief workers has been increasing.5 Although data exist for deaths among development workers, Peace Corps volunteers, and other expatriates, there have been no data on deaths among humanitarian workers.69

Summary points

Wars between states have been largely replaced by internal conflict and anarchy, which have put the lives of civilians and humanitarian workers at ever increasing risk

Between 1985 and 1998 nearly a half of deaths traced were in workers from UN programmes, and a quarter were in UN peacekeepers

Most deaths were due to intentional violence (guns or other weapons), many associated with banditry

One third of deaths occurred in the first 90 days of service, with 17% dying within the first 30 days; the timing of death was unrelated to previous field experience

The number of deaths peaked with the Rwanda crisis in 1994 and has been decreasing for all groups except for non-governmental organisations, where it continues to increase


We collected information from the records of aid agencies and organisations. We included any death between 1985 and 1998 occurring in workers in the field or as a result of them having worked in the field during emergency or …

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