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ICRC: Health-care workers suffer attacks every single week
by International Committee of the Red Cross
An incident of violence against health-care facilities or personnel has taken place every single week since the passage two years ago of a U.N. Security Council Resolution meant to increase respect for the sanctity of health care.
Just this week, armed men stormed a hospital in the Central African Republic where an International Committee of the Red Cross (ICRC) surgical team operates, threatening patients, medical staff and Red Cross volunteers. An ambulance was stopped and threatened in the street.
The U.N. Security Council resolution passed with overwhelming support, an indication the world believes that people, especially in areas of conflict, must be able to safely seek medical care. Sadly, from May 2016 to today, the ICRC has registered in 16 countries alone over 1,200 incidents of violence against health-care facilities or personnel.
In Afghanistan, for example, attacks against health workers and the use or destruction of health-care facilities by arms carriers has cut off thousands if not millions of people from medical care. The attacks health personnel face include threats, kidnappings, and killings.
“Attacks against health facilities and personnel are a double tragedy,” said ICRC President Peter Maurer. “First, such attacks wound and maim people seeking and providing health care. But they also deprive an uncountable number of people from receiving aid in the future, crippling the hopes of recovery for people in desperate need.”
The passage on May 3, 2016 of UNSC Resolution 2286 was a strong step by the international community to address violent attacks on health care, but commitments to prevent and mitigate this violence must be followed by action.
The ICRC urges that these steps take place in conflict zones:
1) Armed forces refrain from attacking civilians or civilian infrastructure including health-care facilities, personnel and vehicles.
2) The lifting of any blockade that prevents the delivery of necessary medical items and the evacuation of sick and wounded people.
3) Investigations into incidents of violence against health care and accountability for attacks that violate international humanitarian law.
The destruction of health infrastructure and the disruption of health services have been particularly disturbing in conflicts in the Middle East. More than half of Syria’s public hospitals and health-care centres are closed or only partially functioning. Some of them have been hit by multiple air strikes. The provision of medical supplies in certain areas of the country as well as the evacuation of the wounded and sick have been consistently obstructed.
In Iraq, the destruction of civilian infrastructure in areas affected by the most recent hostilities has been massive. In Salah al-Din more than a third of health centres are damaged or destroyed. In Yemen, only 45% of the country’s health infrastructure was functioning at the end of 2017, and most did not have enough medical supplies.
“Even wars have rules,” Maurer said. “The wounded and sick must be protected in all circumstances. Violence that deprives them of access to health care violates international humanitarian law, and, ultimately, it makes us all a little less human.”
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Can horizontal inequalities be overcome
by Frances Stewart, Yu-Chieh Hsu, Milorad Kovacevic
UNDP Human Development Reports
Can horizontal inequalities be overcome, by Frances Stewart, Professor Emeritus of Development Economics at the University of Oxford.
Horizontal inequalities are inequalities between groups with different identities, like blacks and whites, women and men, Muslims and Hindus, or Hutus and Tutsis, among many examples. Such inequalities are unjust and resented. When severe, horizontal inequalities can cause violent conflict.
These inequalities are often extremely persistent. Blacks in the United States have been poorer than whites since they first arrived as slaves; despite emancipation, they remain less well educated, poorer, and discriminated against in multiple ways.
Similarly, the Romany people have been deprived throughout Europe for centuries. There are many persistent horizontal inequalities in developing countries, which are often linked to geography. For example, northern groups in Nigeria or Ghana; Somalis in Kenya; Hutus in Rwanda and Burundi; or Muslims in India. Today the long-term impoverishment and persecution of the Rohingya people in Myanmar is in the news.
Yet some groups do manage to overcome their disadvantages. Chinese and Filipino immigrants to the United States started much less well off than the majority, but now have above average education. The same upward mobility has been shown by Bangladeshi immigrants to the United Kingdom. Catholics in Ireland were for centuries worse off than Protestants in every respect, but they too have caught up in education and incomes.
What accounts for these differences in the dynamics of horizontal inequalities?
First, we must acknowledge that there are very strong forces holding back deprived groups. Being poorer, they have less money to invest in assets and in the education of their children, and have weaker access to loans as well. As social networks tend to be concentrated within groups, people from poorer groups have less useful contacts for access to good schools or jobs.
There is also considerable societal discrimination, both formal and informal. Formal restrictions on people because of their identity was critically important in determining access to education, assets, and work, for example, in Apartheid South Africa. While formal restrictions are increasingly outlawed in many countries, much informal discrimination remains. People with names or appearance that suggest they are from a particular group often find it more difficult to get access to housing or jobs, for example. Where groups face political inequalities – because they are in a minority or because they lack voting rights as non-citizens – it makes it more difficult to secure changes in government policy to counter their disadvantage: indeed, government policy may deliberately discriminate against them. In many cases, these forces trap people from deprived groups in permanent deprivation. The big question is whether and how this situation can be changed.
Government policy can do a lot. Governments can provide special opportunities for members of deprived groups – school scholarships, quotas in education and employment, assistance with loans and housing, for example. Measures like these have been adopted in Brazil and the US for the black population, in Malaysia for the Malays, in Mexico for indigenous peoples and in New Zealand for the Maoris. But for the most part, while these policies have helped a bit, they have not reversed or eliminated the horizontal inequalities.
Another approach is to use universal policies that reach everyone, but by design help poorer groups most. For example, regional policy can be directed towards giving special assistance to poorer regions and groups. Effective universal social services and cash transfers help those who were previously without access. Policies like these have been adopted in Brazil, Peru and Bolivia; they have helped reduce the gaps in health and education, but they have not succeeded in reducing horizontal inequalities in economic opportunities or outcomes. It seems that comprehensive policies are needed to have a significant effect, including both direct and indirect, or universal, policies.
Malaysia adopted a systematic and comprehensive approach to reduce the inequalities between Malays and the Chinese beginning in the 1970s. Policies were directed towards education, employment, and assets and have greatly reduced the gap between the two groups, although some groups (including immigrants from the Philippines) – not covered by the policies – remain deprived. A comprehensive strategy was also adopted in Northern Ireland in response to the violence that erupted from the 1970s, also encompassing education, employment and housing. Horizontal inequalities have been largely eliminated. South Africa followed an inclusive approach, with a special focus on education and asset ownership. However, while inequalities between blacks and whites have fallen, they remain significant.
A comprehensive approach requires political leadership. In the cases just mentioned, there were special reasons why governments adopted a comprehensive strategy. In Malaysia and post-apartheid South Africa, the deprived group also formed the demographic majority and enjoyed political power. In Northern Ireland, the urgent need to attack the root causes of the violence was recognised, and action was taken by the UK government and the European Union, both accountable to wider constituencies beyond the province itself. But in many other countries the political situation is less favourable; the deprived are in a minority, and quite often non-citizens. The privileged majority may take only limited corrective action – or may even use its position to continue or worsen the inequalities.
There is an urgent need to correct such persistent horizontal inequalities, apart from their sheer injustice, not least because they are often an underlying cause of civil conflict. And the problem is growing as flows of migrants become a new source of horizontal inequality: 66 million people were forcibly displaced in 2016, almost double the number in 1997. Many of these displaced people live on the edge of society without rights in the countries to– or from - which they fled. The resulting resentments undermine social cohesion and threaten societal stability.
The Sustainable Development Goals (SDGs) recognize the need to tackle inequalities among groups as well as individuals. This needs to be translated into action. Yet the powerful levers of the IMF and World Bank are not used to this end; they do not, as yet, recognize, monitor or act on such inequalities.
Nov. 2017
Violence against women: Unacceptable and unmeasured, by Yu-Chieh Hsu, Statistics Analyst, and Milorad Kovacevic, Chief Statistician, at the Human Development Report Office, UNDP
One third of women (and more than two-thirds in some countries) have experienced physical or sexual violence inflicted by an intimate partner or sexual violence inflicted by a non-partner, according to the World Health Organization.
Violence against women and girls (VAW) is a global phenomenon that affects all societies and cuts across boundaries of age, socioeconomic status, education and geography.
The importance of eradicating VAW from a human development perspective is obvious. But how can the human development perspective help to tackle such a broad, complex and sensitive issue?
The 2016 Human Development Report “Human Development for Everyone” sheds light on two important issues: power relations and lack of data.
In her paper for the 2016 Human Development Report, Ayesha Banu argues that VAW is grounded in gendered social structures rather than individual and random acts. Embedded in cultural norms and religious and patriarchal value systems, violence is often justified and internalized by both men and women, who legitimize it as “natural” and “right”.
Violence can be reinforced by discriminatory laws and exclusionary social norms. Figures from the 2016 HDR speak for themselves: in 46 countries laws do not protect women from domestic violence. Each year, 15 million girls in developing countries marry before age 18 and that about 200 million women and girls alive today have gone through female genital mutilation and cutting, putting them at extreme and unnecessary health risks.
Such patterns of violence cut deep into many societies and if they are not tackled there is little doubt they will be perpetuated across generations. Much needs to be done to tackle these barriers and the 2016 report makes a number of recommendations.
Closely related to this is an urgent need for more and better data to inform policy making worldwide: given these shocking figures, it is almost as shocking how little is known about VAW across the world.
Target 5.2 of the Global Sustainable Development Goals calls for the elimination of “all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.” However, the two indicators linked to this Target are classified as Tier II, meaning they are not regularly measured in many countries.
Data on violence against women and girls is scarce. At the global level only half of countries collect data although there are important variations across regions.
VAW data are missing for most of the Arab States (90 percent) and for many countries from Latin America and the Caribbean (70 percent). Only in two groups – the OECD countries and the East Asia and the Pacific region – do the majority of countries have VAW data.
There are several reasons, not least, that it is notoriously difficult to collect such data when the victims can fear coming forward or even, tragically, feel ashamed. Data can also be politically sensitive, especially in some cultures.
Work is now underway to gather more evidence. UN Women’s Global Database on Violence against Women seeks comprehensive information on all forms of VAW, while UNICEF publishes key child protection indicators including “female genital mutilation/cutting” and “child marriage,” as well as data on “attitudes towards wife-beating.” The new Women, Peace and Security Index by the Georgetown Institute for Women, Peace and Security captures women’s rights violation in three dimensions: inclusion, justice and security.
The OECD’s Social Institutions and Gender Index highlights the impact of social norms and discriminatory institutions on gender equality and women’s empowerment, including “restricted physical integrity” while the Gender Equality Index from the European Institute for Gender Equality includes measures of direct and indirect violence in EU countries across time.
VAW is also a key part of human development accounting and several measures are collected. In the Human Development Report online statistical data, for example, one can explore data on women who have ever experienced violence from an intimate or a nonintimate partner.
But more systematic data collection, dissemination and analysis are needed to keep this topic at the forefront of the global development agenda.
So on the International Day for the Elimination of Violence Against Women, it is important to remind ourselves that human development cannot be achieved fully if half the population feels unsafe.
If it is not safe for girls and women to go out by themselves, how they can go to school or work to realize their potential? If they do not feel safe in their own homes then what chance do they have of living a life of dignity?

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