Healthcare Delivery in Conflict Zones – Asrar Qureshi’s Blog Post #861

Healthcare Delivery in Conflict Zones – Asrar Qureshi’s Blog Post #861

Dear Colleagues!  This is Asrar Qureshi’s Blog Post #861 for Pharma Veterans. Pharma Veterans aims to share knowledge and wisdom from Veterans for the benefit of Community at large. Pharma Veterans Blog is published by Asrar Qureshi on  WordPress, the top blog site. Please email to asrar@asrarqureshi.com for publishing your contributions here.

Gaza - Credit: MSF

Gaza - Credit: MSF

Sudan - Credit: MSF

Martin Griffiths, UN Relief Chief tweeted on Sunday 15 October at 6.15PM. “The specter of death is hanging over #Gaza. With no water, no power, no food and no medicine, thousands will die.”

Israeli Prime Minister’s office has said more than 1400 people have been killed in Israel since Hamas’s offensive on October 7. Meanwhile, 2450 Palestinians have been killed in Israeli bombings on Gaza.

EU leaders have jointly and unanimously backed Israel’s right to defend itself in line with humanitarian and international law. “The European Union condemns in the strongest possible terms Hamas and its brutal and indiscriminate attacks across Israel and deeply deplores the loss of lives”. 

In another development, a second aircraft carrier has joined the first one in Mediterranean to support Israel. 

Gaza conflict is the latest in a series of wars raging in various parts of the world. Ukraine & Russia conflict has completed 600 days. Sudan war between two generals is almost in its 6th month. Syria is in a state of war for several years. Various conflicts in African region and elsewhere have also been going on years. In Pakistan, we have been at war with terrorists for nearly forty years.

Whatever the nature of conflict, whoever the parties are, and no matter whose side you are on, the real casualty are civilians and the already weak or poor healthcare delivery system.  War conflicts have a profound and often devastating impact on healthcare delivery systems in the regions affected by conflict. These impacts can vary based on the nature, scale, duration, and intensity of the conflict, but they generally have significant consequences for both the healthcare infrastructure and the health of the population. 

Here are some critical aspects in which conflicts impact healthcare delivery systems.

Damage to Healthcare Infrastructure

 War conflicts often result in the destruction or severe damage of healthcare facilities, including hospitals, clinics, laboratories, and medical supply depots. This damage disrupts the normal functioning of healthcare services and limits access to care.

The leader of the worldwide Anglican Communion, the Archbishop of Canterbury posted on X (Twitter), “I appeal for the evacuation order on hospitals in northern Gaza to be reversed – and for health facilities, health workers, patients and civilians to be protected.” “The Ahli hospital was hit by Israeli rocket fire last night, with four staff injured in the blast.”

Although the international laws such as Geneva convention stop from targeting civilians and protect their lives and wellbeing, it never happens. We have seen indiscriminate attacks on healthcare personnel and civilians everywhere.

Building a hospital and running its functions is a time consuming and costly enterprise. The building cost besides, the equipment cost is astronomical. In a war zone, no equipment will be replaced, ever. 

Shortage of Healthcare Personnel

Conflict zones experience an exodus of healthcare professionals, as they may become targets themselves, flee due to safety concerns, or have limited access to necessary resources and training. This exacerbates the existing shortage of healthcare workers and disrupts patient care. 

It takes 10 years or more to make a specialist doctor, who may be lost due to injury or death in a matter of minutes. We have seen that while most healthcare professionals stay to serve because they feel very strongly about their call of duty, some may leave due to imminent danger to them or their loved ones.

Shortage of HCPs further weakens the already poor healthcare infrastructure. As conflicts intensify, the number of injured keeps multiplying, and the need for more HCPs increases. Reduction, on nay pretext, cannot be afforded.

Disruption of Supply Chains

Conflict disrupts supply chains for medical equipment, pharmaceuticals, and other essential supplies. This can lead to shortages of crucial medications, surgical supplies, and equipment needed for both routine and emergency healthcare services. 

Supply chain disruption may be caused due to financial factors, such as, the non-availability of liquid cash, or foreign exchange for imports, or non-availability of logistic options. Whatever, the reason may be, supply chain disruptions compound the already precarious situation.

Restricted Access to Healthcare

Conflict often restricts or denies access to healthcare services due to security concerns, roadblocks, curfews, or territorial control by armed groups. Civilians may struggle to reach healthcare facilities, especially in areas heavily affected by conflict. 

We are already seeing this thing happening in all conflict zones. The armed factions make it a point to block access to healthcare in order to put additional pressure on the community and the opposite side.

Increased Disease and Injury Burden

The conflict itself and its aftermath can lead to a higher incidence of injuries, trauma, infectious diseases, mental health issues, and chronic conditions due to violence, displacement, inadequate sanitation, and compromised living conditions.

The incidence of healthcare issues has been on the rise all over the world due to conflicts. In the latest situation in Gaza, the number of Palestinian deaths is 2450, while the number of injured is over 7000.

Mental Health Impact

War conflicts have a significant impact on mental health, leading to a rise in psychological trauma, post-traumatic stress disorder (PTSD), depression, anxiety, and other mental health disorders, not only among civilians but also among healthcare workers.

Scars people carry due to loss of families, loss of assets, loss of homes, lack of food and water, violence against their own person or their loved ones, are just some of the factors impacting mental health. The absence of medical care complicates the issue further.

Displacement and Refugee Crisis

War invariably forces civilians to flee their homes, resulting in a massive influx of internally displaced persons (IDPs) and refugees. These populations often lack access to adequate healthcare, leading to health crises in makeshift camps or host communities.

Millions of people are living in refugee shelters and camps for years. Pakistan was forced to accommodate millions of Afghan refugees since war broke out there in 1979; over a million are still living here.

Rationing of Care

Due to resource constraints and overwhelming demand for healthcare, rationing becomes a necessity. Healthcare providers must prioritize care based on urgency and the likelihood of saving lives, which can result in difficult ethical decisions and unequal access to healthcare.

Such decisions are extremely difficult to take because each life is important. However, it must be done. The whole world is already becoming exhausted from the constant demand for help due to wars, conflicts, natural disasters, and man-made disasters.

Long-term Health Effects

The health impacts of conflict can persist long after the cessation of hostilities. Chronic health issues, disabilities, and socio-economic disparities resulting from the conflict can affect the population for generations.

US has caused long term suffering to the largest number of people in the world. The nuclear attacks on Japan, use of Agent Orange in Vietnam, carpet bombings in Afghanistan, cluster bombings in so many places, caused very long-term health effects, some of which continue. 

Healthcare is among the primary casualties of wars and conflicts. While its need increases manifold, healthcare delivery become scarce. We are seeing a constant increase in the conflicts and more and more geographies are getting involved and affected. Some of these conflicts, such as Sudan, do not make any sense at all, but it is there. As ordinary citizens, we do not know the factors leading up to these conflicts, who instigates these, who aids and abets, who uses whom, and who gets benefitted. However, we, the ordinary citizens, are suffering in the worst possible manner. 

Concluded.

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