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Ensuring that health services remain operational in emergencies and conflicts

A) Objectives of the pledge:

The infringements and threats to health workers are increasingly frequent. Health officials, doctors, nurses, health technicians, psychologists, social workers, and others, work in unsafe areas, conditioned by fear and insecurity.

The Pan American Health Organization (PAHO), has been working together with the Ministry of Health of Colombia for many years, providing technical cooperation for the protection of health services in areas of violence and for the consolidation of the so-called “registry of violations against the Medical Mission” that were reported in that country between January 1995 and June 2003.

When applied to conflict situations, the Safe Hospitals initiative, approved by PAHO Member States in 2004, acquires a very important meaning and constitutes an objective on its own. The Hospital Safety Index helps health staff to assess the safety of their health facilities and avoid becoming a casualty of conflicts or disasters by providing a snapshot of the probability that a hospital or health facility will remain operational in emergency situations.

PAHO, through its Department of Emergency Preparedness and Disaster Relief, upon request of its Member States and subject to the availability of resources, commits to support the Countries in the Americas in ensuring that health services remain operational in emergencies and conflicts.

B) Action plan:

Increase awareness and training on prevention of violence against health workers.

Continue to focus on improving the information quality and development of the protocols of the Medical Mission and to advocate for the improvement of the safety and working conditions of the Medical Mission in the territories affected by violence and armed conflict.

Strengthen the implementation of the Safe Hospitals Initiative, in close collaboration with the International Committee of the Red Cross’ Health Care in Danger project, the International Federation of Red Cross and Red Crescent Societies and other relevant intergovernmental and nongovernmental bodies.

Urge all partners active in the humanitarian or health fields to promote actions that ensure the safety of health personnel and assure that ambulances, other medical vehicles, health facilities or other structures which facilitate the work of health personnel are utilized for humanitarian purposes only;

Promote the application of the Hospital Safety Index, in particular of those aspects related to conflicts, security, and complex emergencies, like: Hazard analysis in relation to the place where the health facility is located includes an assessment of the scenarios of armed conflicts, civil unrest, terrorist attacks, violence and crime; Assessment of the security level of the health facility’s perimeter; Level of security at the hospital’s entrance and its internal circulation; Existence of provisions for the circulation of ambulances, other vehicles, staff, patients, and visitors; Specific identification and permits for health care personnel according with their areas of responsibility; Identification of restricted or limited access areas inside the health facility; Safety standards regarding the safe location of the hospital’s Emergency Operations Center; Security, protocols and procedures for internal and external telecommunication; Security against robbery and violence inside the health facility; Protocols and procedures to prevent kidnap of patients and health; Restriction of the use of weapons inside the health facility; Provisions to prevent limit and respond to attacks on health care workers inside and outside the health facility.

C) Indicators for measuring progress:

N/a

D) Resource implications:

N/a

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