Revisiting Medical Service Delivery in Conflict Zones
By: Kathryn Mixon
Medical service delivery to the front lines of conflict is one of many competing priorities for the international community in war zones. The reemergence of polio in Syria, for example, underscores the importance, but also the difficulty, of providing medical services to populations affected by conflict.
Violent and persistent conflict compromises health care infrastructure, as facilities and medical personnel are targeted by both rebel and government forces and hospitals see dwindling supplies. Nearly two-thirds of hospitals have been destroyed or abandoned in Syria. The current state of the Syrian health care system, like the recent polio outbreak, is typical of prolonged civil wars in fragile states. The Syrian Ministry of Health is understaffed, overburdened, and lacks sustained access to children living on the front lines. The Syrian government continues to block access for many humanitarian workers, and the ones who have made it in are threatened with targeted attacks and kidnapping.
International health actors moved swiftly to implement an emergency outbreak response in Syria and in the surrounding countries, and the Syrian government agreed to send health care workers into rebel-held territory in an attempt to reach all 3 million Syrian children under the age of five. Polio, however, remains one small part of a serious and growing public health crisis—one that could have been prevented or mitigated had international organizations had safe access to conduct surveillance and disease programming.
Many international health organizations, especially those that traditionally operate through official channels, have struggled to find solutions for service delivery during conflicts like the one in Syria, a multisided, complex, and sustained crisis. As the international community tackles future complex crises around the world, navigating unofficial channels and working with unconventional partners, like civil society organizations or local councils, will be key to ensuring that medical services are not compromised in times of war.