Beirut: The conflict in Lebanon is turning out to be particularly destructive to healthcare. More health workers and patients have been killed proportionally in Lebanon than in Ukraine and Gaza, and their percentage is the highest in any active conflict today across the globe. Nearly half of all attacks on health caused the death of a health worker there.
Since October 7, 2023, 47% of attacks on health care – 65 out of 137 – have proven fatal to at least one health worker or patient in Lebanon, as of November 21, 2024, according to the figures made available today by the Surveillance System for Attacks on Health Care (SSA), established in 2017 by the World Health Organization.
In comparison, the global average is 13.3%, based on the SSA’s figures from 13 countries or territories that reported attacks in the same period, October 7, 2023 – November 18, 2024 – among them Ukraine, Sudan and the occupied Palestinian territory (oPt). In the case of the occupied Palestinian territory, 9.6% of the total number of incidents has resulted in the death of at least one medical professional or patient.
The figures revealed that 226 health workers and patients were killed in Lebanon and 199 injured between October 7, 2023, and November 18, 2024. In the same period, the SSA registered a combined total of 1401 attacks on health in the occupied Palestinian territory, Lebanon and Israel – 1196 in oPt, 137 in Lebanon and 68 in Israel.
Civilian health care has special protection
“These figures reveal yet again an extremely worrying pattern. It’s unequivocal – depriving civilians of access to lifesaving care and targeting health providers is a breach of international humanitarian law. The law prohibits the use of health facilities for military purposes – and even if that is the case, stringent conditions to taking action against them apply, including a duty to warn and to wait after warning,” said WHO Representative in Lebanon Dr Abdinasir Abubakar.
International humanitarian law states that health workers and facilities should always be protected in armed conflicts and never attacked. Health facilities must not be used for military purposes, and there should be accountability for the misuse of health facilities.
“There need to be consequences for not abiding by international law, and the principles of precaution, distinction and proportionality should always be adhered to. It’s been said before, indiscriminate attacks on health care are a violation of human rights and international law that cannot become the new normal, not in Gaza, not in Lebanon, nowhere,” said WHO Regional Director for the Eastern Mediterranean Dr Hanan Balkhy.
The majority of incidents in Lebanon impact health workers
The majority (68%) of incidents in Lebanon registered by the SSA impacted health personnel, a pattern seen repeatedly in the last few years, including in Gaza in the past year. In Lebanon, roughly 63% affected health transport and 26% affected health facilities.
Attacks on health care hit twice. First, when health workers lose their lives or when a health centre is obliterated, and again in the following weeks and months when the injured can’t be treated, those who are dependent on regular care don’t receive it and when children can’t be immunized.
“Casualty numbers among health workers of this scope would debilitate any country, not just Lebanon. But what the numbers alone cannot convey is the long-term impact, the treatments for health conditions missed, women and girls prevented from accessing maternal, sexual and reproductive health services, undiagnosed treatable diseases and, ultimately, the lives lost because of the absence of health care. That is the impact that’s hard to quantify,” said Dr Abubakar.
1 in 10 hospitals in Lebanon directly impacted
The greater the blow to the health workforce, the weaker the longer-term ability of a country to recover from a crisis and deliver health care in a post-conflict setting.
Lebanon is a lower middle-income country with a fairly advanced health system that’s been hit hard by multiple crises in recent years. After hostilities in Lebanon escalated in September 2024, the growing number of attacks on health have caused further strain on an already over-burdened system.
Today, the country’s health system is under extreme duress, with 15 out of 153 hospitals having ceased to operate, or only partially functioning. Nabatieh, as an example, one of Lebanon’s 8 governorates, has lost 40% of its hospital bed capacity.
“Attacks on health care of this scale cripple a health system when those whose lives depend on it need it the most. Beyond the loss of life, the death of health workers is a loss of years of investment and a crucial resource to a fragile country going forward,” Dr Balkhy concluded.
So far this year, between January 1, 2024, and November 18, 2024, a total of 1246 attacks on health care were registered globally, in 13 countries or territories, killing 730 health workers and patients and injuring 1255.
It may be mentioned that SSA is an independent global monitoring mechanism whose goal is to collect reliable data on attacks on health care and to then identify patterns of violence that inform risk reduction and resilience measures so that health care is protected. The SSA also provides an evidence base for advocacy against attacks on health care.
– global bihari bureau
Image by fernando zhiminaicela from Pixabay
