December 05, 2008
Is violent disruption of medical care pathognomonic of civil war?
From the Times today, "Hospitals Now a Theatre in Mexico's Drug War":
Hit men pursuing rivals into intensive care units and emergency rooms. Shootouts in lobbies and corridors. Doctors kidnapped and held for ransom, or threatened with death if a wounded gunman dies under their care. With alarming speed, Mexico’s violent drug war is finding its way into the seeming sanctuary of the nation’s hospitals, shaking the health care system and leaving workers fearing for their lives while trying to save the lives of others.
It seems to me that the systematic intimidation of medical personnel and the violent disruption of care are hallmarks of a civil war. It happened in El Salvador (Geiger et al., 1989). It's why MSF left Afghanistan (MSF, 2004). It happened in Rwanda. Now it is happening in Mexico.
I wonder if it is fair to say that whenever we find organized groups intent on preventing the care of others by whatever means they find expedient, civil war isn't too far off? This, of course, raises a bigger question, which is, what counts as an organized group and what counts as systematic intimidation? Do abortion clinic bombings, for instance, fit this model? I'd venture to say that they do, though I'd hesitate to call such attacks a war.
I guess it is all a question of semantics, of how willing we are to call pervasive or persistent violence a war. In any case, it's worth thinking about it: the more we reflect on this sort of question, the more likely we are to uncover threats to public health we didn't even know existed.
Posted by Ben Brown at 08:13 AM | Comments (0) | TrackBack
