Health workers in war-torn countries often have the skills and wealth to leave their homeland for greener (or at least safer) pastures abroad. Iraq is no exception; according to some unverified numbers, half of Iraqi doctors have fled the country since 2003 and those remaining live in constant danger. Their fears are not unfounded. In March 2005, 115 people were killed outside an Iraqi health clinic in the city of Hilla. The victims were lined up outside the clinic to get medical tests necessary for jobs in the Iraqi government. In April, five health workers were kidnapped on their way to an IDP camp near Kandahar. After the incident, health workers refused to travel to the area until their security could be guaranteed. Regarding the kidnapping, Dr. Abdullah Fahim, the Afghan Ministry of Health spokesman said:
“If the security of our health workers is not ensured, then we cannot put more health workers at risk and we won’t be able to send more doctors to the camp”
In both examples, health workers were either directly or indirectly targeted by combatants because of their perceived connection to the government. In Iraq, the health workers were (amongst other things) screening recruits for the Iraqi security forces. In Afghanistan, the health workers were riding in a government vehicle.
To prevent the flight of health workers and preserve indigenous health services in conflict zones, a negotiated “health neutrality” must be considered. The lack of access to health workers effects both sides of a conflict, and thus by banning government health workers from directly assisting either side’s military operations (such as screening Iraqi Army recruits), their security could be better guaranteed. This model is not entirely new. The ICRC has been benefiting from a strict neutrality stance for more than a century.
Nobody disputes that the primary function of government health workers is to provide their services to all in need. Imposing a “wall” between government health ministries and government military operations would solidify the notion of the neutrality of health security between combatants and guarantee the protection of the health workers themselves, thus lowering the rate of “doctor drain”.
Christopher R. Albon is a political science Ph.D. specializing in armed conflict, public health, human security, and health diplomacy.