Intended for healthcare professionals


Nearly 1500 health workers were attacked or arrested in 2021, report finds

BMJ 2022; 377 doi: (Published 25 May 2022) Cite this as: BMJ 2022;377:o1315
  1. Elisabeth Mahase
  1. The BMJ

In 2021, 1335 incidents affecting healthcare were reported across 49 countries and territories in conflict, with hospitals destroyed, workers killed, and ambulances hijacked, a report by the Safeguarding Health in Conflict Coalition has found.1

The report found that nearly 1500 health workers were affected, with at least 94 assaulted, 161 killed, 170 kidnapped, 320 injured, and 713 arrested. A total of 188 health facilities were destroyed or damaged. There were 223 incidents where armed conflict parties entered health facilities, and 82 where armed conflict parties occupied health facilities. Additionally, 111 health transport vehicles were damaged or destroyed, and 64 were stolen or hijacked.

Writing in the report, Leonard Rubenstein, coalition chair and a professor at Johns Hopkins Bloomberg School of Public Health, said, “Perhaps 2022 will be an inflection point, as images and reports of attacks on healthcare and their consequences in Ukraine continue to go viral, accompanied by frequent and loud demands for accountability—but it won’t be if the lassitude of the international community continues.”

The coalition found that, although the number of violent incidents against healthcare in conflicts in Syria and Yemen had declined, explosive weapons continued to be used in attacks on hospitals, weakening health systems that were already severely damaged. It found that the armed conflict in Ethiopia, which began in November 2020, has led to the “wholesale destruction” of much of the health infrastructure in the Tigray region. In December 2021, a survey found that, because of the violence, 79% of about 250 facilities surveyed in Tigray were damaged and only 3% were fully functional. The World Health Organization reported that only 22% of facilities in the Amhara and Afar regions were fully functional.

Meanwhile, the military coup in Myanmar—which began in February 2021 and triggered country-wide protests led in part by healthcare workers—has seen 29 health workers killed, over 500 arrested, at least 118 public health facilities raided or occupied by military forces, and 41 ambulances attacked.

“As a general principle, health workers have ethical and legal obligations to provide care, regardless of the political stance or identity of the patient, but the State Administrative Council government viewed this obligation as an act of defiance and targeted health workers that provided this care. Communities considered to be hosting political dissidents were systematically denied care,” the report said.

In the Middle East, the coalition reported the destruction of at least 30 health facilities in just 11 days in Gaza, as well as continued restrictions on access to healthcare in Gaza and the West Bank. In Afghanistan, it found 107 incidents of violence against or obstruction of healthcare in 2021. The report said that the humanitarian situation “deteriorated significantly” after the Taliban took control in August 2021, as donors withdrew support for government health facilities and international sanctions were imposed. By December 2021, the United Nations Office for the Coordination of Humanitarian Affairs reported that more than 75% of the Afghan population—30 million people—required humanitarian aid.

Commenting on the report, Joe Amon, director of global health at Drexel University, said, “Global leaders—the UN Security Council, political leaders, militaries, and ministries of health—must move from rhetoric to action and take concrete steps to stop attacks on health care and hold perpetrators to account.”