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Threats and Violence against Health Care during the COVID-19 Pandemic in 2020

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Introduction

When the World Health Organisation (WHO) declared COVID-19 to be a pandemic on 11 March 2020, only just over 100,000 cases of the new respiratory disease had been confirmed. Less than a year later there are over 109 million confirmed cases of COVID-19, and over two-anda-half million people have died from the viral disease.

The global and rapidly spreading virus has placed unprecedented demands on health systems in most countries around the world. Health providers have struggled to keep pace with the rising care needs, and many health structures have experienced massive disruptions to their provision of health care services.

As a public health control measure many governments imposed lockdowns on their populations that were maintained, lifted, and reimposed as infection rates surged and ebbed across the world’s regions and countries.

On the front lines of the fight against the pandemic, health workers faced and continue to face difficult working conditions, including insufficient and inadequate personal protective equipment (PPE), increased working hours, psychological distress, burnout, and mass traumatisation. At the same time the world is experiencing an infodemic resulting in mis- and disinformation undermining the public health response, fuelling stigma, increasing conflict and violence, and threatening people’s physical and mental health.

In most cases, communities have applauded en masse to recognise and thank health workers for their efforts. However, there have also been numerous reports of health workers being threatened and assaulted.

Violence against health workers is not a new concern. Emergency services in particular regularly report threats or violence against health workers. For example, in the United Kingdom, the annual health staff survey for 2019 showed that over 14% of health workers said they had experienced physical violence from patients, their relatives or the public. Rising rates of violence against health services have been previously reported in India, and health workers in South Africa have spoken up about the unacceptable levels of violence they face.

Violence against health services in conflict settings has also been a considerable concern for many years. While international humanitarian law demands that health care staff and facilities should be protected, the reality is different. The Safeguarding Health in Conflict Coalition documented 1,203 incidents affecting health care in 20 countries and territories in conflict in 2019. Among these, 434 incidents occurred during the tenth outbreak of the Ebola epidemic in eastern Democratic Republic of the Congo (DRC), which has long been plagued by protracted conflict.

This report presents the documented threats and violence against health workers and facilities in the context of the COVID-19 pandemic. It discusses the perpetrators of this violence and the contexts that triggered it.

The report is based on Insecurity Insight’s monitoring of incidents affecting health care carried out throughout 2020 for the Safeguarding Health in Conflict Coalition.