Conflict zones worldwide have increased 65% over the last three years, threatening economic growth and causing humanitarian crises. The destruction that results from conflict can haunt communities for years, leading to widespread displacement and food insecurity as important infrastructure is wiped out by fires, looting, and shelling.

Unfortunately, attacks on healthcare facilities and staff are also becoming more common. These attacks have the potential to reverse progress on public health goals and worsen poverty, especially in fragile nations. 

Deliberate Targeting of Healthcare Infrastructure

In many areas of the world, essential health services rarely meet the full needs of the population. But when a hospital is bombed or taken over by armed forces, a fragile healthcare system can quickly become overwhelmed by an influx of patients, disrupting other lifesaving services.

Though it is illegal under international humanitarian law to attack healthcare facilities and workers in conflict zones, both government troops and nonstate actors (an organization or individual who isn’t part of the government) regularly act with impunity. 

Health facilities in Syria have faced regular bombardment during the country’s recent civil war. The World Health Organization (WHO), which regularly tracks attacks on healthcare facilities and personnel in conflict zones, reports that nearly a quarter of hospitals and one third of primary healthcare centers in Syria are considered non-functional.

Over the course of more than a year of fighting, hospitals throughout the Gaza Strip have been rendered ineffective; 94% of the healthcare facilities are either damaged or destroyed. The medical centers that remain functioning report frequent power outages and limited resources that restrict their ability to serve the 90% of Gazans who are internally displaced.

In both areas, healthcare workers have shared harrowing accounts of surgeons having to use unorthodox methods to save people’s lives. Without consistent medical supply chains, some surgeons in Gaza must operate on patients without anesthesia, while physicians in Syria report utilizing flashlights or cell phone lights to treat patients during blackouts.

In addition to the frequent shelling of healthcare infrastructure in Ukraine, attacks on ambulances and other forms of health transport target first responders at higher rates compared to other medical personnel; since Russia’s invasion began in February 2022, an average of 200 ambulances per year have been damaged or destroyed.

Attacks on Healthcare Workers

During conflicts, healthcare professionals also face a greater risk of being hurt or killed. According to Physicians for Human Rights (PHR), an NGO that tracks human rights violations around the world, there was a 25% increase in violent attacks against healthcare workers and facilities in conflict zones last year compared to 2022. In Ethiopia, Human Rights Watch reported instances where soldiers beat, arrested, and intimidated medical professionals in the country’s Amhara region, which has been embroiled in conflict for over a year. 

Facing a daily barrage of traumatic cases — in addition to concentrated attacks on their lives and livelihoods — some medical personnel choose to flee conflict zones for their own safety. The communities that remain not only lose access to emergency health services, but may also experience higher rates of vaccine-preventable diseases and maternal mortality.

Despite Afghanistan’s 20-year conflict officially ending in 2021, the country’s healthcare system has yet to recover. This includes a shortage of medical professionals that has made it difficult for communities to receive care, particularly in more conservative, rural areas. As a consequence, Afghanistan has a high maternal mortality rate compared to both other countries in the region and other low-income nations. 

How Conflict Can Worsen Extreme Poverty

There is a clear link between extreme poverty and poor health outcomes, partly due to a lack of access to medical resources, facilities, and personnel in low-income communities. When these regions are also fragile and prone to conflict, the disappearance of healthcare facilities and healthcare workers is widely felt and prevents people from being able to recover from illnesses, receive treatment for chronic conditions, or access vaccines — all worsening the effects of poverty.

As a result, an individual’s ability to lead a healthy life quickly disintegrates. For example, since the start of the Yemeni civil war in 2014, the healthy life expectancy (the average number of years someone can expect to live in full health) for Yemenis has dropped by nearly three and a half years from 58.9 years in 2013 to 56.5 years in 2021.

Taking Action to Improve Healthcare Services in Conflict Zones 

Conflicts of any length devastate a nation’s ability to improve health outcomes and lift communities out of poverty. It’s more than buildings that need to be rebuilt — entire systems must be reestablished to serve the population in need. However, we’ve seen the improvements in global health that peace can bring to communities battered by violence — even if the peace is temporary.

During Yemen’s civil war, health workers quickly worked to vaccinate more than 306,000 people against cholera in 2018 during a six-day pause in fighting. These pauses, known as “Days of Tranquility,” are humanitarian ceasefires agreed to by fighting parties to allow healthcare workers to address an urgent need. 

The recent polio vaccination campaign in Gaza is another example of a successful pause in conflict. In July 2024, the presence of poliovirus was confirmed in wastewater in Gaza, despite the region being free from polio for the last 25 years. The news kicked off an urgent campaign to vaccinate eligible children and highlighted the conflict’s negative effects on healthcare, such as disruptions in routine vaccination programs and a breakdown of water and sanitation systems, both of which contribute to the spread of polio. 

Despite the difficulty of reaching Gaza’s children, many of whom are displaced from their homes, the WHO and other vaccine administrators completed the necessary two-round polio vaccination campaign by early November, thanks to temporary cessations in the conflict. 

It’s clear that peace — no matter how short-lived — can lead to improved health and well-being of communities trapped in conflict. To raise your voice against conflict and call for lasting peace around the world, join our movement and take action today.