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Urgent action needed to protect vulnerable women, children and health workers in the Sahel

According to a comment published in the British medical journal (BMJ) this week to coincide with World Immunization Week (April 24-30, 2022).

While the recent devastating hostilities in Ukraine have captured the world’s attention, there are a number of other longstanding and growing conflicts that also deserve the attention and political mobilization of the global community.

In 2020, for example, a record 56 active conflicts have been documented globally.

In the Sahel region, countries such as Nigeria, Burkina Faso, Mali and Niger are under violent attack by extremist insurgents and unidentified armed groups, causing alarming humanitarian consequences.

Armed conflict and attacks on civilians have displaced nearly three million people, nearly one million since January 2019.

Co-authors of the commentary, the Rt. Hon. Helen Clark, PMNCH Board Chair and former Prime Minister of New Zealand and Kersti Kaljulaid, UN Secretary General’s Global Advocate for Every Woman Every Child, former President of Estonia, call for a response sector to ensure continuity of services for women, children and adolescents in conflict and humanitarian settings.

They also urge world leaders to commit to investing more in safety and protection measures for health and humanitarian aid workers who risk their own lives trying to provide services, support and care for vulnerable women, children and adolescents in the most difficult circumstances.

In times of conflict and in difficult humanitarian contexts, even the most basic health rights – from access to safe midwifery services to routine childhood vaccinations – can be denied to vulnerable women, children and adolescents who need it.

The theme for World Immunization Week 2022, Long Live For All – in pursuit of a long life well lived, is a timely reminder that while providing life-saving vaccines against dangerous childhood diseases remains a global ambition, it does not has not yet been universally achieved, especially for those caught up in conflict.

If an armed conflict occurs within 10 km of a child’s place of residence, the chances that a child receives a vaccination are 47.2% lower.

Of 8.4 million people in the northeastern states of Nigeria: Borno, Adamawa and Yobe (BAY states) that would require humanitarian assistance in 2022, more than 30% of households report barriers to accessing essential health services.

North East Nigeria also has lower vaccination rates than other parts of Nigeria: 42% of children in the North East have never been vaccinated, while this is only true of 8% in the Southeast (National Immunization Coverage Survey, 2016/2017).

As a result, many children die from vaccine-preventable diseases and other infectious diseases such as malaria, acute watery diarrhea, cholera and measles.

Burkina Faso has been declared free from wild poliovirus in 2015, but in 2020 was one of 15 countries on the African continent experiencing outbreaks of paralysis cases linked to other forms of poliovirus.

“In chaotic and desperate situations caused by conflict, in difficult humanitarian contexts, health and aid workers are key actors in the protection and assistance system. Their intervention nourishes the hope of the right to health and well-being of the victims and the affected populations”, declares Marleen TemmermanDirector of the Center of Excellence in Women’s and Children’s Health at the Aga Khan University of East Africa and member of the PMNCH Board of Directors.

“The harm and loss caused to health and humanitarian workers in conflict zones calls for a multisectoral and equitable response. It is time to act to protect those who protect the health and well-being of women, children and adolescents, even in perilous security contexts. It is time for all actors involved in the humanitarian field to take concrete and innovative actions so that health and humanitarian personnel no longer suffer damage or lose their lives in the performance of their mission.

Women, children and adolescents in situations of conflict and humanitarian crisis face additional threats to their lives and well-being.

Ten million child deaths less than five years between 1995 and 2015 around the world can be directly and indirectly attributed to conflict. Women of childbearing age living near high-intensity conflict are three times more likely to die than women living in stable environments.

Health and humanitarian workers also risk their own safety and lives trying to maintain service coverage, care and support for vulnerable women, children and adolescents in conflict situations.

They can become victims of conflict, either as accidental victims of attack or as deliberate targets of hostile forces. Violence against aid workers caused 484 individual victims in 2020of which 117 died, making 2020 the worst year on record for the second year in a row.

In Mali, the The SHCC identified 11 incidents violence or obstruction of healthcare workers in 2020. At least four ambulances were damaged in these incidents. A common form of violence against health care providers was the shooting and damaging of ambulances by armed groups. These types of attacks often targeted volunteer aid organization ambulances and local health care providers.

On December 31, 2021, Burkina Faso’s Ministry of Health has announced that 444 health facilities (30.7% of the total) have been impacted by insecurity in the regions most affected by the humanitarian crisis. 149 establishments are completely closed, depriving approximately 1.8 million people of access to health care. Ninety-six percent of these facilities closed due to direct attacks by unidentified armed groups, forcing health workers to abandon their work.

ALSO READ: The Sahel crisis and efforts to resolve it

“To protect those who protect us, there is an urgent need to coordinate investments in a targeted manner to promote safe access to services, including the delivery of vaccines and other essential services and commodities through private-public efforts. multilevel and multisectoral,” write Helen Clark and Kirsti Kaljulaid in the BMJ.

“If health workers are to provide vaccines and other essential services in these settings, they need constant protection, as urged by the United Nations Security Council (resolution 2286) and mandated by international humanitarian and human rights law. The international community should hold States and armed groups accountable for respecting international humanitarian law in the territories they control.

The impact of conflict and humanitarian crises on women, children and adolescents and health workers who risk their own lives to protect others will be explored in more detail at an upcoming virtual summit hosted by PMNCH, the most major global alliance for women’s, children’s and adolescents’ health. .

On Thursday, May 19, 2022, Balancing Lives: Honoring Commitments in Humanitarian and Fragile Contexts will bring together representatives from governments, the private sector, non-governmental organizations, academic institutions, health professional associations, youth-led organizations and grassroots campaign groups to explore what form a global response to these challenges.

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Founded in 2005, PMNCH is the world’s largest alliance for the health and wellbeing of women, children and adolescents, with 1,250 partner organizations working together across 10 constituencies: partner governments, donors and foundations, NGOs , adolescent and youth groups, international private sector, health professional associations, academic and research institutes, global funding mechanisms, intergovernmental organizations and United Nations agencies. The PMNCH is hosted by the World Health Organization, based in Geneva.

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