Health workers should not risk attacks caring for those in war zones

In early February, an American paramedic from Bordentown, N.J., was caring for a wounded civilian in the eastern Ukrainian city of Bakhmut when he was hit by a missile and killed. The medic, a former Marine named Pete Reed, was in Ukraine as part of a humanitarian mission. He had been traveling in a convoy clearly marked with a red cross.

We don’t know whether Reed was intentionally targeted or whether it was yet another indiscriminate attack; both are war crimes. But the paramedic’s death was only one of hundreds of recent attacks on health workers, facilities and transport in Ukraine.

In 2022, the World Health Organization and nongovernmental organizations have recorded more than 700 such attacks. These include missile attacks that hit hospitals and clinics, as well as attacks targeting individual health workers and patients, the theft and destruction of health equipment, and occupation of health facilities by military forces.

Collecting data on such incidents in wartime is not easy, and past efforts among groups doing such work have sometimes found little overlap in recorded incidents — suggesting that the number of attacks documented by any one group may significantly underestimate the overall incidence of attacks.

The attacks on health care workers and facilities in Ukraine are not limited to battle zones. The eastern and southern regions of the country have been targeted the most but health workers have been killed and health facilities destroyed throughout the country, including in Kyiv and in Lviv in the west. In other parts of the country, Russian shelling has interrupted power and water, disrupting operations and targeting civilian infrastructure. 

The phenomenon of health workers coming under attack is not limited to Ukraine or to countries at war. Data from the Safeguarding Health in Conflict Coalition found that attacks in Ukraine were just over a third of all attacks on health care in conflicts around the world in 2022, which numbered almost 1,900.

The assaults continue. In late January, for example, in Myanmar, media sources reported on attacks by the Myanmar military, junta and armed groups who seized ambulances and set them on fire. Government officials reportedly interrogated medical staff at hospitals and clinics about their participation in protest activities; stole hospital equipment and medicines; arrested volunteer aid workers providing medical care; and set on fire two pharmacies.

The global toll of these attacks has been recorded by the Safeguarding Health in Conflict Coalition and its partners since 2014. As a member of that coalition, verifying accounts of indiscriminate and targeted attacks on health workers striving to provide care in times of armed conflict and pandemic conflict is numbing. But we can’t look away.

Pete Reed surely knew the risks he faced in volunteering as a medic in Ukraine. Those risks, however, should not include being attacked for providing care to wounded or sick people. His death reflects choices made by combatants to violate international law that prohibits such attacks.  Militaries and other combatants worldwide repeatedly breach a simple and straightforward rule: Medics and other humanitarian workers must be protected. Hospitals and clinics should not be targets of artillery, ransacked or looted. People in need of medical care should not be prevented from accessing that care.

These principles are globally agreed upon and enshrined in formal terms in numerous resolutions and treaties. However, their enforcement is often nonexistent. The U.S. government can act — at the United Nations, in war crimes tribunals to come, and in joint military operations with our allies — to reinforce these principles and push for greater accountability. Reed’s death and that of hundreds of other health workers each year, are owed that effort. The effects of war will still be felt by millions in conflicts around the globe, but ensuring protection for health workers and the people they serve would represent an enormous step forward and a lasting legacy of those tragically killed in conflicts.

Joe Amon (@joeamon) is the director of global health at Drexel University’s Dornsife School of Public Health and the former Human Rights Watch health program director.