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The war in Syria has lasted for many years and continues to cast a dark shadow over its people, including healthcare workers caring for those injured and in distress. During the war, healthcare workers have been exposed to unprecedented challenges, becoming targets of bombing, killing, siege, arrest, and torture. Moreover, healthcare workers continue to experience difficult situations that require them to make decisions with no clear or easy moral choice. The present study aimed to understand the experiences of healthcare workers and the difficulties and challenges that hinder applying existing ethical frameworks and codes for disasters within Syria’s context of revolution and war. Qualitative analysis of interviews led to classification of the ethical challenges experienced by healthcare workers into four groups: the risks from providing care; stewardship of resources and work challenges; corruption and organizational pressure; and psychological, emotional, and social stress. The study also showed that both Syrian healthcare workers and the developers of ethical frameworks adopt many similar values and principles. Yet, the participants adopted several unique moral values not identified in ethical frameworks as a result of navigating their professional duties under the circumstances of the Syrian war. At last, recognizing the challenges and precarious tasks healthcare workers cope with during wars and other similar disasters could help volunteers, medical personnel, and humanitarian organizations deciding to work in Syria better understand the specific context and obstacles for ethical decision-making. Moreover, attracting attention for and support of Syrian healthcare workers locally and globally presents a long-lasting benefit.
Pervasive violence against hospitals, patients, doctors, and other health workers has become a horrifically common feature of modern war. These relentless attacks destroy lives and the capacity of health systems to tend to those in need. Inaction to stop this violence undermines long-standing values and laws designed to ensure that sick and wounded people receive care. Leonard Rubenstein—a human rights lawyer who has investigated atrocities against health workers around the world—offers a gripping and powerful account of the dangers health workers face during conflict and the legal, political, and moral struggle to protect them. In a dozen case studies, he shares the stories of people who have been attacked while seeking to serve patients under dire circumstances including health workers hiding from soldiers in the forests of eastern Myanmar as they seek to serve oppressed ethnic communities, surgeons in Syria operating as their hospitals are bombed, and Afghan hospital staff attacked by the Taliban as well as government and foreign forces. Rubenstein reveals how political and military leaders evade their legal obligations to protect health care in war, punish doctors and nurses for adhering to their responsibilities to provide care to all in need, and fail to hold perpetrators to account. Bringing together extensive research, firsthand experience, and compelling personal stories, Perilous Medicine also offers a path forward, detailing the lessons the international community needs to learn to protect people already suffering in war and those on the front lines of health care in conflict-ridden places around the world.
Humanitarians are required to be impartial, independent, professionally competent and focused only on preventing and alleviating human suffering. It can be hard living up to these principles when others do not share them, while persuading political and military authorities and non-state actors to let an agency assist on the ground requires savvy ethical skills. Getting first to a conflict or natural catastrophe is only the beginning, as aid workers are usually and immediately presented with practical and moral questions about what to do next. For example, when does working closely with a warring party or an immoral regime move from practical cooperation to complicity in human rights violations? Should one operate in camps for displaced people and refugees if they are effectively places of internment? Do humanitarian agencies inadvertently encourage ethnic cleansing by always being ready to 'mop-up' the consequences of scorched earth warfare? This book has been written to help humanitarians assess and respond to these and other ethical dilemmas.
From natural disaster areas to conflict zones, humanitarian workers today find themselves operating in diverse and difficult environments. While humanitarian work has always presented unique ethical challenges, such efforts are now further complicated by the impact of globalization, the escalating refugee crisis, and mounting criticisms of established humanitarian practice. Featuring contributions from humanitarian practitioners, health professionals, and social and political scientists, this book explores the question of ethics in modern humanitarian work, drawing on the lived experience of humanitarian workers themselves. Its essential case studies cover humanitarian work in countries ranging from Haiti and South Sudan to Syria and Iraq, and address issues such as gender based violence, migration, and the growing phenomenon of ‘volunteer tourism’. Together, these contributions offer new perspectives on humanitarian ethics, as well as insight into how such ethical considerations might inform more effective approaches to humanitarian work.
This book provides an early exploration of the new field of disaster bioethics: examining the ethical issues raised by disasters. Healthcare ethics issues are addressed in the first part of this book. Large-scale casualties lead to decisions about who to treat and who to leave behind, cultural challenges, and communication ethics. The second part focuses on disaster research ethics. With the growing awareness of the need for evidence to guide disaster preparedness and response, more research is being conducted in disasters. Any research involving humans raises ethical questions and requires appropriate regulation and oversight. The authors explore how disaster research can take account of survivors? vulnerability, informed consent, the sudden onset of disasters, and other ethical issues. Both parts examine ethical challenges where seeking to do good, harm can be done. Faced with overwhelming needs and scarce resources, no good solution may be apparent. But choosing the less wrong option can have a high price. In addition, what might seem right at home may not be seen to be right elsewhere. This book provides in-depth and practical reflection on these and other challenging ethical questions arising during disasters. Scholars and practitioners who gathered at the Brocher Foundation in Geneva, Switzerland in 2011 offer their reflections to promote further dialogue so that those devastated by disasters are respected by being treated in the most ethically soun d ways possible.
This text is an introductory overview of healthcare provision in different humanitarian conflicts, designed for healthcare professionals and students from a wide range of backgrounds.
Most observers did not expect the Arab spring to spread to Syria, for a number of seemingly good reasons. Yet, with amazing rapidity, massive and unprecedented anti-regime mobilization took place, which put the regime very much on the defensive; what began as the Syrian Uprising in March 2011 has evolved into one of the world’s most damaging and protracted conflicts. Despite over six years having passed since the inception of the Syrian Uprising, this phenomenon remains difficult to fully grasp, both in terms of underlying forces and long-term implications. This book presents a snapshot of how the Uprising developed in roughly the first two to three years (2011–2013) and addresses key questions regarding the domestic origins of the Uprising and its early trajectory. Firstly, what were the causes of the conflict, both in terms of structure (contradictions and crisis within the pre-Uprising order) and agency (choices of the actors)? Why did the Uprising not lead to democratization and instead descend into violent civil war with a sectarian dimension? With all 19 chapters addressing an aspect of the Uprising, the book focuses on internal dynamics, whilst a subsequent volume will look at the international dimension of the Uprising. Taking an innovative and interdisciplinary approach that seeks to capture the full complexity of the phenomenon, this book contributes significantly to our understanding of the Syrian conflict, and will therefore be a valuable resource for anyone studying Middle Eastern Politics.
The war in Syria, now in its eighth year, continues to take its toll on the Syrian people. More than half of the population of Syria remains displaced; 5.6 million persons are registered as refugees outside of the country and another 6.2 million are displaced within Syria's borders. The internally displaced persons include 2 million school-age children; of these, less than half attend school. Another 739,000 Syrian children are out of school in the five neighborhood countries that host Syria's refugees. The loss of human capital is staggering, and it will create permanent hardships for generations of Syrians going forward. Despite the tragic prospects for renewed fighting in certain parts of the country, an overall reduction in armed conflict is possible going forward. However, international experience shows that the absence of fighting is rarely a singular trigger for the return of displaced people. Numerous other factors—including improved security and socioeconomic conditions in origin states, access to property and assets, the availability of key services, and restitution in home areas—play important roles in shaping the scale and composition of the returns. Overall, refugees have their own calculus of return that considers all of these factors and assesses available options. The Mobility of Displaced Syrians: An Economic and Social Analysis sheds light on the 'mobility calculus' of Syrian refugees. While dismissing any policies that imply wrongful practices involving forced repatriation, the study analyzes factors that may be considered by refugees in their own decisions to relocate. It provides a conceptual framework, supported by data and analysis, to facilitate an impartial conversation about refugees and their mobility choices. It also explores the diversified policy toolkit that the international community has available—and the most effective ways in which the toolkit can be adapted—to maximize the well-being of refugees, host countries, and the people in Syria.
This volume compiles lessons learned by field researchers, many of whom have faced demanding situations characterized by violence, distrust and social fragmentation.
The third edition of this work sets out a comprehensive and analytical manual of international humanitarian law, accompanied by case analysis and extensive explanatory commentary by a team of distinguished and internationally renowned experts.